JMIR medical educationMarius Drysch, Sonja Verena Schmidt, Felix Reinkemeier, Flemming Puscz, Alexander Fiedler, Maria Fueth, Marcus Lehnhardt, Alexander Sogorski, Christoph Wallner
BACKGROUND: Surgical residency training faces mounting pressure from expanding subspecialty knowledge requirements alongside compressed learning opportunities. Microlearning, defined as brief, focused educational episodes, offers a pedagogically sound approach suited to fragmented clinical schedules, while large language models present capabilities for scalable content generation. However, the feasibility, quality, and educational value of large language model-generated microlearning in surgical training remain unexplored. OBJECTIVE: This study aimed to assess the feasibility and acceptability of artificial intelligence (AI)-generated microlearning modules among plastic surgery residents, evaluate content quality through systematic faculty evaluation, and generate preliminary effect size estimates for self-perceived knowledge and confidence changes. METHODS: A single-arm pilot feasibility study with a pre-post design was conducted at an academic plastic surgery residency program (N=11 residents) over 12 weeks. Six modules covering core subspecialties were developed using Google Gemini 2.5 Pro. From 60 AI-generated multiple-choice questions, 42 were selected following independent evaluation by 2 board-certified plastic surgeons using a 5-dimension rubric (accuracy, relevance, clarity, pedagogical value, and safety). Modules were released biweekly via Google Forms. Outcomes included retention, acceptability (7-point Likert scales), faculty evaluation ratings, item-level psychometrics, and pre-post changes in self-perceived knowledge and confidence. Composite scores were calculated as the mean change across all 6 subspecialty topics. Wilcoxon signed-rank tests served as the primary analysis for matched pairs (n=9). Analyses were conducted using Python 3.11. RESULTS: All 11 residents completed postassessments. Acceptability was high across all 6 subitems (all medians ≥5 out of 7). Faculty evaluation confirmed high content quality (mean quality index 4.68/5); interrater reliability was poor (intraclass correlation coefficient (3,1)=0.231). Among 9 matched pairs, composite confidence improved significantly (median change 0.33; d=0.65; P=.047), while composite knowledge showed a medium effect (d=0.71; P=.09). Topic-specific gains were largest where baseline was lowest: hand surgery knowledge (d=1.48; P=.02) and confidence (d=1.41; P=.02). Resource use and sense-of-community measures remained stable. CONCLUSIONS: AI-generated microlearning modules are feasible and acceptable for plastic surgery residency education. Faculty-evaluated content achieved high quality ratings (mean 4.68/5), and residents showed strong engagement with preliminary improvements in self-perceived confidence. The intervention was integrated into existing learning ecosystems without disrupting traditional resources or peer dynamics. These findings provide effect size estimates to support the design of adequately powered randomized trials.
ACS applied bio materialsCai Ling Yong, Alexander Shao-Rong Pang, Dinesh Kumar Srinivasan
Plastic and reconstructive surgery (PRS) aims to restore form and function, thereby improving patients' quality of life. In recent years, nanotechnology has emerged as a promising field, offering innovative solutions in tissue engineering, wound healing, implant design, and aesthetic applications. This scoping review evaluates recent advancements, clinical applications, and limitations of nanotechnology-based approaches in plastic surgery. A structured literature search was conducted in PubMed using combinations of keywords including "nanotechnology", "nanoparticles", "plastic surgery", "reconstructive surgery", "wound healing", "tissue engineering", and "aesthetic medicine", combined using Boolean operators (AND/OR). Example search string: ("nanotechnology" OR "nanoparticles" OR "nanomedicine") AND ("plastic surgery" OR "reconstructive surgery" OR "wound healing" OR "tissue engineering" OR "aesthetic medicine"). Inclusion criteria included English-language articles published within the past five years focusing on nanotechnology applications in PRS. Reviews, preclinical studies, and clinical studies were included. Editorials, conference abstracts, and studies not directly relevant were excluded. Key data were extracted, including nanomaterial types, methods of application, and reported therapeutic outcomes, and findings were synthesized through thematic analysis. This review identified diverse nanotechnology applications, including nanoskin development, nanoparticle-mediated drug delivery, nanoscaffolds for tissue regeneration, and improved biomaterials for reconstructive procedures such as breast reconstruction. Notable innovations included enhanced wound healing outcomes using clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 9 (Cas9)-based approaches, burn treatment using tilapia skin xenografts, and chitosan-based nanoparticles demonstrating antimicrobial activity and drug delivery potential. Despite promising preclinical and early clinical results, widespread clinical translation remains limited. Key barriers include insufficient long-term safety and toxicity data, challenges in large-scale production, and regulatory constraints. Nanotechnology in Plastic and Reconstructive Surgery. Created in BioRender. Yong, C.L. (2026) https://BioRender.com/l1pmh1n.
Surgical oncologyAmirmohsen Jaleefar, Mohammad Shirkhoda, Ata Garajei, Ali Arab Kheradmand, Arshia Zardoui, Seyedeh Zahra Mousavi, Amirsina Sharifi
BACKGROUND: Microvascular free flap reconstruction is central to contemporary head and neck cancer surgery. Although plastic surgeons have traditionally performed these reconstructions, evolving training pathways have enabled other surgical subspecialties to acquire advanced microsurgical expertise. Comparative data between plastic surgeons and surgical oncologists trained in microsurgical reconstruction remain limited. METHODS: We performed a retrospective cohort study of 300 patients who underwent head and neck reconstruction at the Cancer Institute of Iran between 2013 and 2022. Patients were stratified by operating surgeon specialty (surgical oncologist vs. plastic surgeon). Primary outcomes included operative duration, postoperative hemorrhage, flap failure, intensive care unit (ICU) stay, and mortality. Cumulative sum (CUSUM) analysis was used to assess performance trends and learning curves over time. RESULTS: Of 300 reconstructions, 192 (64.0%) were performed by surgical oncologists and 108 (36.0%) by plastic surgeons. Baseline demographics and comorbidities were comparable between groups. There were no significant differences in flap failure (9.4% vs. 9.3%), postoperative hemorrhage (7.3% vs. 3.7%), ICU stay, or mortality (4.2% vs. 3.7%). Operative duration was longer in the surgical oncology group on unadjusted analysis; however, surgeon specialty was not an independent predictor after multivariable adjustment. CUSUM analysis demonstrated stable outcomes over time for both groups, with no evidence of an active learning curve. CONCLUSION: In a high-volume center with structured microsurgical training, surgical oncologists achieve outcomes comparable to plastic surgeons in head and neck reconstruction. These findings support expansion of microsurgical reconstruction beyond traditional specialty boundaries when appropriate training and institutional support are present.
Plastic and reconstructive surgerySahand C Eftekari, Elizabeth P Wu, Emily E Zona, M Kristine Carbullido, Ellen C Via, Weifeng Zeng, Aaron M Dingle, Samuel O Poore
Microsurgery is a specialized field within plastic surgery constrained by the high cost and limited availability of surgical microscopes, particularly in resource-limited settings. This lack of access hinders trainees from developing essential microsurgical skills. Previous efforts have explored smartphone-based alternatives, but there remains a need for high-fidelity, accessible training microscopes. This study presents a novel, low-cost, travel-friendly surgical microscope designed for microsurgery training. Modified binocular objective lenses enable near-field stereoscopic viewing using a dual-mirror array. A 3D-printed chassis provides the correct top-down orientation, and an integrated light source operates on standard or battery power, ensuring usability in low-resource environments. Initial testing demonstrated a fixed 6.5× magnification, allowing trainees to perform end-to-end anastomoses on 2-mm vessels. Prototypes were deployed for microsurgery training in the United States, Rwanda, Ethiopia, and Vietnam through the SHARE (Surgeons in Humanitarian Alliance for Reconstruction, Research and Education) plastic surgery organization, Nuoy Reconstructive International, and the senior author's home institution. The authors' investigation continues to assess the effectiveness of the microscope compared with state-of-the-art surgical microscopes. By offering a low-cost, portable solution without compromising image quality, this innovation has begun to transform microsurgical education and operating room-based microscopy worldwide, increasing accessibility for trainees and patients in diverse settings.
Facial plastic surgery clinics of North AmericaSamuel E Lynch, Christopher K Hee, Rod Rohrich, David Weir, Tara Chadab, Aaron L Wiegmann
Goals in plastic surgery and aesthetic medicine include minimizing healing complications, optimize aesthetic outcomes and improve patient satisfaction. Platelet-derived growth factor BB (PDGF-BB) is among the most potent natural activators of healing. A pharmaceutical copy of natural PDGF-BB, (rhPDGF-BB or pure PDGF) is the active ingredient in four US Food and Drug Administration-approved therapies to stimulate healing of skin, mucosa, gingivae or bone. Here we describe the mechanism of action and clinical uses of off-the-shelf pure PDGF in plastic surgery and aesthetic medicine as a post-treatment adjunct to enhance patient satisfaction.
Plastic and aesthetic nursingFarida Murtiani, Rahmat Saputra, Yeni Devita, Ba'da Febriani, Amelia Marisa, Fatimah Fatimah
Postoperative pain and anxiety are significant challenges that can hinder patient recovery after plastic surgery. Hypnotherapy as a nonpharmacological adjunctive therapy offers a potential solution, but its effectiveness requires systematic evaluation. This systematic review aimed to assess the role of hypnotherapy in managing pain and anxiety during plastic surgery recovery. We conducted literature searches in PubMed, Scopus, and the Cochrane Library for randomized controlled trials evaluating hypnotherapy in plastic surgery patients. Three trials, encompassing a total of 110 patients, met the inclusion criteria. Study quality was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. Hypnotherapy reduced the incidence of postoperative nausea and vomiting (PONV) and significantly reduced postoperative pain intensity and intraoperative opioid consumption (e.g., remifentanil decreased from 761.4 mcg to 200 mcg, p = .034). Patient satisfaction was also higher in the hypnotherapy groups. However, the interventions did not produce significant differences in anxiety levels or surgical field quality. Overall, hypnotherapy appears to be a promising adjunct therapy for reducing pain, analgesic requirements, and postoperative PONV in plastic surgery patients. Nonetheless, the current evidence is preliminary and limited, underscoring the need for more rigorous research to confirm these findings and guide clinical application.