RIP original journal submissions, Pie-crusting & Tuberous Breasts.

Also: 10 events in 2024, 3 interesting hand surgery articles you should read.
RIP original journal submissions, Pie-crusting & Tuberous Breasts.

In this week's edition

  1. ✍️ Letter from P'Fella
    The end of original journal submissions
  2. πŸ€“ The Sunday Quiz
    How well do you know tuberous breasts?
  3. 🎈 Upcoming Events
    10 events in 2024.
  4. 🫡 Trending this Week
    Pie crusting is making a comeback?
  5. πŸš€ New Features
    P'Fella is now multi-lingual.
  6. πŸ”₯ 3 Interesting Hand Articles
    Dupuytrens, Trigger Finger, Flaps.
    With 1 sentence summaries!

A Letter from P'Fella

The end of original scientific publications.

Happy Friends!

Just ran into a real head-scratcher that’s rippling through the academic world – a saga where AI is quietly slipping into scientific papers, under everyone's radar. It's a curious mix of innovation and oversight, sparking debates on the very fabric of research integrity.


"β€˜As an AI model, I cannot...’" – believe it or not, phrases like this are finding their way into scientific papers, completely unnoticed by authors and peer reviewers. It's a startling indication that AI-generated content is sneaking into research, and we're all missing the signs. This whole saga, now known as #PaperGate, highlights a complex issue that's got everyone talking.

If you're unfamiliar with how chatGPT works. Essentially, a common phrases are "Here is a possible...", "As an AI model, I cannot...", "I don't have access to...". All these phrases are now appearing in published manuscripts.

Here's the important bit to understand:

These AI systems digest, analyze, and refine content, blurring the lines of originality in what's supposed to be novel research. The situation gets even trickier when you consider that these AI-enhanced submissions help to further train - these AI models are being refined with potentially unchecked and inaccurate information. This feedback loop poses significant challenges for the integrity of academic publishing.

I'm really curious about your take on this. How do we navigate these murky waters, what can we do to ensure the authenticity and reliability of our scientific endeavors?



The Sunday Quiz

The Tuberous Breast

Summary Card

A congenital deformity characterized by constricted, elevated, herniated, and hypoplastic features, while maintaining normal function.

Clinical Features
Features vary widely, commonly including asymmetry, hypoplasia, constricted base, IMF elevation, herniated nipple, ptosis, and skin envelope insufficiency.

Von Heimburg's 1996 system is crucial for assessing the condition, emphasizing the identification of specific affected areas to inform surgical strategies.

Aims to release constrictions, restore volume, reposition the inframammary fold, and achieve symmetry, involving techniques like periareolar incisions, radial scoring, dual-plane pocket creation, and may require single or two-stage procedures depending on severity.

Multiple Choice Question

In the surgical management of tuberous breast deformity, which of the following statements best describes the rationale behind the use of radial scoring techniques?

  • To increase the risk of capsular contracture by intentionally creating more fibrous tissue around the implant.
  • To decrease postoperative breast volume by compressing the breast parenchyma.
  • To facilitate expansion of the breast's lower pole and improve the contour by releasing constricted fascial bands.
  • To enhance the projection of the nipple-areola complex (NAC) without affecting the base of the breast.

Upcoming Events

A Curated List of Webinars, Courses & Conferences

"Pie Crusting" is here (again) πŸ™„

So there is this surgical technique gaining some traction on Twitter called "Pie Crusting". It seems to be popular with those who arne't trained in soft tissue reconstruction and unfortunately are suffering from a familiarity bias.

So here's the original post πŸ‘‡

The fundamental purpose is to allow a primary wound closure. Yet it also defies the basic principles of wound closure.

Here's why:

β€’ Tension: it' still present. Even after pie-crusting, the patients have notable track marks on your patient. Some patients still required staples and heavy sutures. There are also early signs of scar contraction.
β€’ Blood Supply: Reduced+++. The common indication for this technique (apparently) is post-fasciotomy. We all know this incision opens up the fascia - so the fascial blood supply is already compromised. This further affects dermal supply.

To add to this, it seems to have been published in many journals (not plastic reconstructive journals to the best of my knowledge). As you can see images below from a publication.
Original Publication

What should you do if you can't fully close a wound?

Every situation is unique, but generally, the best approach is to partially close the wound and apply a thin split-thickness skin graft. After the area has healed and if the patient is not satisfied with the appearance of the graft, there's an option to gradually remove it over time.

New Features

P'Fella is now Multi-Lingual!

Big news from thePlasticsFella - we're all about breaking down barriers and making plastic surgery know-how available for everyone, everywhere. One major hurdle we've tackled? Language.

With our shiny new AI assistant, Sidekick, chatting with thePlasticsFella just got way more inclusive. We're talking loads of languages now supported.

Go ahead, give your preferred language a whirl below!

Over time, the plan will be to build a team of plastic surgeons to translate this entire platform into several different languages (an idea I got from a twitter DM!). If you're interested, just shoot reply to this newsletter πŸ˜„

Articles of the Week

3 Interesting Hand Articles! (with 1 sentence summaries)

3 Trending Articles

  1. Risk factors for Dupuytren's? (PRS, March 2024)
    The genetic risk profile for Dupuytren disease is significantly associated with family history, age at onset, early onset, recurrence, and negatively correlated with BMI.
  2. Repeat trigger finger injections? (J Hand Surg, 2024)
    Repeated corticosteroid injections for recurrent trigger finger have diminishing success over 12 months, with high disease grade, BMI β‰₯ 25 kg/m^2, and a short symptom-free period after prior injection being strong predictors of treatment failure
  3. Don't forget about the medial arm flap! (JPRAS, 2024)
    The medial arm flap (MAF) is a reliable reconstructive option with a low complication rate, primarily used for defects in the head and neck, hand, and elbow, and is notably underutilized despite its benefits, including a well-hidden donor scar.

Thanks for reading this...

I hope you enjoyed it πŸ˜„

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