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  1. Abdullah S, Ahmad AA, Lalonde D
    Plast Reconstr Surg Glob Open, 2020 Aug;8(8):e3023.
    PMID: 32983779 DOI: 10.1097/GOX.0000000000003023
    Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers.
  2. Alshawaf SM, Burhamah W, Alwazzan S, AlYouha S
    Plast Reconstr Surg Glob Open, 2023 Mar;11(3):e4824.
    PMID: 36875921 DOI: 10.1097/GOX.0000000000004824
    Three-dimensional (3D) printing is a rapidly evolving field that has found its way into the medical field, providing unsurpassed contributions to the provision of patient-centered care. Its utilization lies in optimizing preoperative planning, the creation and customization of surgical guides and implants, and the designing of models that can be used to augment patient counseling and education. We integrate a simple yet effective method of scanning the forearm using an iPad device with Xkelet software to obtain a 3D printable stereolithography file, which is then incorporated to our suggested algorithmic model for designing a 3D cast, utilizing Rhinocerus design software and Grasshopper plugin. The algorithm implements a stepwise process of retopologizing the mesh, division of the cast model, creating the base surface, applying proper clearance and thickness to the mold, and creating a lightweight structure through the addition of ventilation holes to the surface with a joint connector between the two plates. In our experience, scanning and design of the patient-specific forearm cast using Xkelet and Rhinocerus, alongside implementing an algorithmic model through Grasshopper plugin has dramatically reduced the designing process from 2 to 3 hours to 4-10 minutes, further increasing the number of patient scans that can be sequenced in a short duration. In this article, we introduce a streamlined algorithmic process for the use of 3D scanning and processing software to create forearm casts that are tailored to the patients' dimensions. We emphasize the implementation of computer-aided design software for a quicker and more accurate design process.
  3. Dow T, Crawley E, Selman T, Al Youha S, Bendor-Samuel R, Brennan M, et al.
    Plast Reconstr Surg Glob Open, 2022 May;10(5):e4299.
    PMID: 35620488 DOI: 10.1097/GOX.0000000000004299
    Breast hypertrophy is known to be a source of both physical and psychosocial health deficits. Therefore, the ability to relieve these symptoms with surgical treatment is an important consideration for patients. The primary objective of this study was to assess the impact of patient body mass index (BMI) on postoperation complications. The secondary objective of this study was to assess patient demographics, surgical techniques, and patient comorbidities for their impact on specific postoperative complications.

    METHODS: A retrospective chart review of all patients who received bilateral breast reduction surgery in Nova Scotia over the past 10 years was performed. A total of 1022 patients met the inclusion criteria of the study. Logistic regression modeling was performed to identify demographic factors, surgical techniques, and patient comorbidities that impact the risk of developing specific postoperative complications.

    RESULTS: Our study population had a total complication incidence of 37.7%. BMI was not significantly different between patients who developed complications and those who did not. Logistic regression modeling showed a significant relationship that with each unit increase in BMI above the mean (25.9 kg/m2) the relative risk of patient-reported postoperative asymmetry increased by 6%.

    CONCLUSIONS: The findings of this study suggest that BMI has several nonsignificant relationships to postoperative complications following bilateral breast reduction. These trends do not translate to significantly increased complaints of asymmetry, scarring' or revision surgeries. This study also provides valuable information on the timeline of postoperative complications and when they can commonly be identified.

  4. Lim T, Kerscher M, Ogilvie A, Pavicic T, Lorenc PZ, Frank K, et al.
    Plast Reconstr Surg Glob Open, 2023 Sep;11(9):e5287.
    PMID: 37744770 DOI: 10.1097/GOX.0000000000005287
    BACKGROUND: The objective of this investigation was to create and validate five-point photonumeric scales which assess static and dynamic forehead lines.

    METHODS: Two different novel five-point photonumeric scales for the assessment of static and dynamic forehead lines were developed. Moreover, a photoguide was created, including subjects from both sexes, all age groups, and different Fitzpatrick skin types. A total of 11 raters from all over the world were involved in the digital validation, whereas four raters performed a live validation.

    RESULTS: The Croma Static Forehead Lines-Assessment Scale showed almost perfect inter and intra-rater agreement in both the digital and the live setting with inter-rater intraclass correlation coefficients of 0.86 [95% confidence interval (CI): 0.82-0.89] in the first digital rating and 0.82 [95% CI: 0.78-0.86] in the second digital rating. The Croma Dynamic Forehead Lines-Assessment Scale showed almost perfect inter and intra-rater agreement in the digital setting with inter-rater intraclass correlation coefficients of 0.83 [95% CI: 0.79-0.86] in the first digital rating and 0.80 [95% CI: 0.75-0.84] in the second rating and almost substantial agreement in the live setting.

    CONCLUSIONS: The Croma Static Forehead Lines-Assessment Scale and the Croma Dynamic Forehead Lines-Assessment Scale have excellent inter and intra-rater agreements to be justifiably used in the clinical and study setting, both digitally and live across ethnic groups.

  5. Burahee AS, Duraku LS, Hundepool CA, Eberlin KR, Moore A, Dy CJ, et al.
    Plast Reconstr Surg Glob Open, 2024 Jan;12(1):e5559.
    PMID: 38264442 DOI: 10.1097/GOX.0000000000005559
    BACKGROUND: This study aimed to evaluate a novel, multi-site, technology-facilitated education and training course in peripheral nerve surgery. The program was developed to address the training gaps in this specialized field by integrating a structured curriculum, high-fidelity cadaveric dissection, and surgical simulation with real-time expert guidance.

    METHODS: A collaboration between the Global Nerve Foundation and Esser Masterclass facilitated the program, which was conducted across three international sites. The curriculum was developed by a panel of experienced peripheral nerve surgeons and included both text-based and multimedia resources. Participants' knowledge and skills were assessed using pre- and postcourse questionnaires.

    RESULTS: A total of 73 participants from 26 countries enrolled and consented for data usage for research purposes. The professional background was diverse, including hand surgeons, plastic surgeons, orthopedic surgeons, and neurosurgeons. Participants reported significant improvements in knowledge and skills across all covered topics (p < 0.001). The course received a 100% recommendation rate, and 88% confirmed that it met their educational objectives.

    CONCLUSIONS: This study underscores the potential of technology-enabled, collaborative expert-led training programs in overcoming geographical and logistical barriers, setting a new standard for globally accessible, high-quality surgical training. It highlights the practical and logistical challenges of multi-site training, such as time zone differences and participant fatigue. It also provides practical insights for future medical educational endeavors, particularly those that aim to be comprehensive, international, and technologically facilitated.

  6. Tan SK, Leung WK, Tang ATH, Tse ECM, Zwahlen RA
    Plast Reconstr Surg Glob Open, 2017 Dec;5(12):e1608.
    PMID: 29610716 DOI: 10.1097/GOX.0000000000001608
    Background: A validated questionnaire is needed to study a more holistic outcome assessment including postsurgical aesthetic satisfaction and psychosocial changes in orthognathic patients. The aim of this study was to determine the reliability and validity of 9 orthognathically relevant translated FACE-Q scales among Hong Kong Chinese orthognathic patients.

    Methods: Two hundred fifty adult Cantonese-speaking patients of 18 years or older who underwent orthognathic treatment were recruited in the Prince Philip Dental Hospital of Hong Kong. Nine of an overall of 40 independent FACE-Q scales were selected and translated into Hong Kong Chinese. The reliability, validity, and test-retest reliability were examined using Cronbach's alpha, paired t test and Pearson's correlation coefficients.

    Results: The Hong Kong Chinese version of the 9 FACE-Q scales was obtained by forward-backward translation. One hundred eight male (mean age, 25.57 ± 4.49) and 142 female (mean age, 24.61 ± 4.54) patients were recruited for the reliability and validation process. The internal consistency (0.89-0.97) and the test-retest reliability (0.73-0.90) were found to be high. The validity of the translated questionnaires was comparable with that of the original FACE-Q.

    Conclusion: The results presented here prove that the 9 translated FACE-Q scales are reliable and valid instruments for research and clinical purposes in Hong Kong Chinese orthognathic patients.

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