查看更多>>摘要：Dermal grafting(DG)has emerged as an innovative technique in plastic and reconstructive surgery,offering several advantages over traditional skin grafting methods.This review provides an in-depth exploration of DG,highlighting its applications,benefits,and future directions.The historical evolution of skin grafting is discussed,tracing the development of DG as a novel approach to address the limitations of conventional techniques.The review focuses on four key advantages of DG:(1)accelerated healing of donor sites;(2)improved aesthetic outcomes at recipient sites due to the elastic nature of dermal grafts;(3)increased graft availability by effectively at least doubling the amount of graft material obtained from a single donor site;and(4)utility in scar revision and reconstruction procedures,particularly in areas with restrictive scarring or contractures.Recent advancements,such as the development of a multiblade dermatome,have addressed the technical challenges associated with DG harvesting,potentially broadening the clinical adoption of this technique.Preliminary results from studies utilizing this new device have demonstrated its feasibility in producing dual grafts(split-thickness skin graft and dermal graft)concurrently,simplifying the surgical procedure.The review also explores future directions in DG,including further refinements to the multiblade dermatome,and clinical trials to validate long-term benefits.Overall,this review highlights the significant advantages of DG and its potential in advancements of plastic and reconstructive surgery,ultimately improving patient outcomes and quality of life.
查看更多>>摘要：Hyaluronic acid(HA)dermal fillers are extensively used for facial volume enhancement.Despite their widespread use,HA fillers are prone to degradation due to various factors,including enzymatic activity,pH changes,ultrasound exposure,temperature variations,oxidative stress,and ultraviolet(UV)radiation.To mitigate these issues,manufacturers have developed cross-linking techniques to improve the stability of HA fillers.Energy-based devices(EBDs)are increasingly utilized for purposes such as skin tightening,collagen stimulation,and fat reduction.However,the interaction between EBDs and HA fillers is complex and requires further investigation.Recent research has examined the effects of EBDs on HA fillers,yielding mixed results.Some studies suggest that early EBD treatment may lead to the degradation of HA fillers,while others find no significant impact.The timing between filler injection and EBD treatment appears to be crucial,with delayed treatment potentially reducing the risk of degradation.Histological examinations have demonstrated that the interactions between EBDs and HA fillers are intricate,influenced by factors such as the location of the filler and the timing of the treatment.The relationship between EBDs and HA fillers is multifaceted and affected by numerous variables,including the type of EBD,energy levels,filler characteristics,and the timing of the treatment.Further research involving diverse participant groups,various types of HA fillers,and different EBD technologies is necessary to develop comprehensive guidelines for optimal treatment intervals.
查看更多>>摘要：The introduction of generative artificial intelligence(AI)has revolutionized healthcare and education.These AI systems,trained on vast datasets using advanced machine learning(ML)techniques and large language models(LLMs),can generate text,images,and videos,offering new avenues for enhancing surgical education.Their ability to produce interactive learning resources,procedural guidance,and feedback post-virtual simulations makes them valuable in educating surgical trainees.However,technical challenges such as data quality issues,inaccuracies,and uncertainties around model interpretability remain barriers to widespread adoption.This review explores the integration of generative AI into surgical training,assessing its potential to enhance learning and teaching methodologies.While generative AI has demonstrated promise for improving surgical education,its integration must be approached cautiously,ensuring AI input is balanced with traditional supervision and mentorship from experienced surgeons.Given that generative AI models are not yet suitable as standalone tools,a blended learning approach that integrates AI capabilities with conventional educational strategies should be adopted.The review also addresses limitations and challenges,emphasizing the need for more robust research on different AI models and their applications across various surgical subspecialties.The lack of standardized frameworks and tools to assess the quality of AI outputs in surgical education necessitates rigorous oversight to ensure accuracy and reliability in training settings.By evaluating the current state of generative AI in surgical education,this narrative review highlights the potential for future innovation and research,encouraging ongoing exploration of AI in enhancing surgical education and training.
查看更多>>摘要：The integration of artificial intelligence(AI)into plastic surgery is transforming the field by enhancing precision in preoperative planning,diagnostic accuracy,intraoperative assistance,and postoperative care.AI encompasses machine learning,natural language processing,computer vision,and artificial neural networks,each offering unique advancements to surgical practice.This narrative review explores the ethical challenges of AI in plastic surgery,addressing concerns such as data protection,algorithmic bias,transparency,accountability,and informed consent.A comprehensive search adhering to PRISMA guidelines identified 63 studies,with 15 selected for in-depth analysis.Findings indicate significant ethical issues:data privacy needs stringent cybersecurity,biases in AI models must be mitigated,and transparency in AI decision making is essential.The review emphasizes the necessity for updated Health Insurance Portability and Accountability Act(HIPAA)regulations,robust validation mechanisms,and the development of explainable AI models.It also highlights the need for an independent regulatory body to oversee AI integration,ensuring ethical standards and protecting patient welfare.Although AI presents promising benefits,its successful application in plastic surgery hinges on addressing these ethical challenges comprehensively.
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