Globalization of Plastic and Reconstructive Surgery: A Continent, Country, and State-Level Analysis of Publications

Alzahrani R, Alghamdi HAM, Gismalla MDA. Publications in Plastic Surgery and Reconstruction: A Review from a Developing Country, Sudan

Background

Plastic and reconstructive surgery services need to be improved in developing African countries. Research and article publications from those countries are limited. This review was conducted to identify published articles from Sudan in the area of plastic and reconstructive surgery.

Methods

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used for the preparation of this systematic review. A comprehensive systematic search was performed using PubMed, ScienceDirect, and Web of Science databases. Articles published in Sudan, specifically in the area of plastic and reconstructive surgery, and written in English were included in this review.

Results

The total number of articles that fulfilled the inclusion criteria was 23. The articles were written from 1969 to 2023. Only two articles were published in the 20th century. The most common study type was a retrospective study of eight articles, and the most common study area was Khartoum Teaching Hospital. Regarding the publishing journals, the number of subscription journals was six (30%), whereas open access was 17 (70%).

Conclusion

This review demonstrates the lack of articles published on plastic surgery in Sudan. Further investigation is needed to determine the challenges and problems associated with possible clarifications.

Foreign body reactions related to orofacial esthetic fillers: A systematic review

The aim of this study was to systematically review the clinicopathological data regarding foreign body reactions (FBR) related to esthetic procedures in the orofacial region. Electronic searches were performed in six databases and in gray literature using PEO acronym for the review question. Case series and case reports describing FBR related to esthetic procedures in the orofacial region were included. The JBI Critical Appraisal Checklist-University of Adelaide tool was used for measuring the risk of bias. Eighty-six studies reporting 139 cases of FBR were identified. The mean age at diagnosis was 54.12 years (14-85 years), with most of the cases reported in America, North America (n = 42/30.70%) and Latin America (n = 33/23.60%), mainly occurring in women (n = 131/94.40%). Asymptomatic (n = 60/43.40%) nodules (n = 71/50.60%) were the main clinical characteristics. The lower lip represented the most affected anatomical location (n = 28/22.20%), followed by the upper lip (n = 27/21.60%). Surgical removal was the treatment of choice (n = 53/35.70%). Twelve different dermal fillers were reported in the study, and the microscopic characteristics of the cases varied according to the material used. The results based on case series and case reports showed that nodule and swelling were the main clinical characteristics of FBR related to orofacial esthetic fillers. The histological characteristics depended on the type of the filler material used.

Independent Plastic Surgery Match Regional Trends Comparing In-person and Virtual Interview Cycles

Background

There is a trend toward matching in a different region than previous training for the independent plastic surgery match cycles from 2019 to 2021, which differs from the trend to match within the same region for integrated plastic surgery programs. Notably, residency interviews transitioned from in-person to virtual in 2020 due to the coronavirus pandemic. Therefore, we compared in-person versus virtual interview match trends from 2019 to 2023.

Methods

Zip codes and regions of each successfully matched plastic surgery applicant's medical school, residency, and plastic surgery program were gathered from publicly available data for the 2019 and 2020 in-person interview cycles and 2021, 2022, and 2023 virtual interview cycles.

Results

Although regions did not differ significantly in the proportions of positions each year (P = 0.85), there was a trend toward fewer positions in each region from 2019 to 2022. Overall, applicants were more likely to match in a different region as their medical school or residency during virtual compared with in-person interviews (P = 0.002 and P = 0.04). Applicants matched to programs further from their medical school zip code in virtual interview years (P = 0.02). There was no significant difference in distance between surgical residencies and plastic surgery residencies between the two time periods (P = 0.51).

Conclusions

Trends toward matching into a different region than prior training after the switch to virtual interviews could be attributed to applicant accessibility to interview broadly. However, this could also be due to the decreased number of independent residency positions over the years, requiring applicants to move regions and travel further from where they began their training.

Comparison of the scientific performance in hip and knee arthroplasty between the leading continents

Background

Scientific progress in the field of knee and hip arthroplasty has enabled the preservation of mobility and quality of life in the case of patients with many primary degenerative and (post-) traumatic joint diseases. This comparative study aims to investigate differences in scientific performance between the leading continents in the field of hip and knee arthroplasty.

Methods

Using specific search terms all studies published by the scientific leading continents Europe, North America, Asia and Oceania listed in the Web of Science databases were included. All identified publications were analysed and comparative conclusions were drawn regarding the qualitative and quantitative scientific merit of each continent.

Results

Europe, followed by North America, Asia, and Oceania, had the highest overall number of publications in the field of arthroplasty. Since 2000, there has been a strong increase in knee arthroplasty publication rate, particular pronounced in Asia. Studies performed and published in North America and those on knee arthroplasty received the highest number of fundings. Publications regarding hip arthroplasty achieved the highest average citation rate. In contradistinction to the others, in North America most funding was provided by private agencies.

Conclusion

Although Europe showed the highest total number of publications, authors and institutions, arthroplasty research from North America received greater scientific attention and financial support. Measured by citations, publications on hip arthroplasty attained higher scientific interest and studies on knee arthroplasty received higher economic affection.

Recent Status of Procedures in a Single Nationwide Cosmetic Surgery Group

Background

Recently, cosmetic surgery demand has increased due to the spread of promotional social media in Japan. However, understanding the overall landscape remains difficult due to many clinics with varied procedure options. To understand the current trends and status of cosmetic surgery in Japan, we analyzed large-scale data from a group of clinics throughout the country.

Methods

We analyzed data from 152,457 patients in our database. The periods from September 2018 to August 2021 and September 2021 to February 2023 were defined as the first and second periods, respectively, and the statuses of procedures were compared between the two.

Results

Eye procedures were the most common (23.6%), followed by face-lifts (19.5%) and dark circles under the eyes (10.4%). Between the first and second periods, the number of procedures in the second period (128,898 cases) was overwhelmingly higher than that in the first period (23,559 cases). Orbital fat removal for dark circles under the eyes significantly increased (OR 2.97, 95%CI 2.78-3.17); procedures in provincial cities significantly increased (Kinki/Chugoku/Shikoku: OR 2.21, 95%CI 2.08-2.36); and procedures for patients with occupations where appearance is considered important, such as nightlife businesses or being a celebrity, decreased (celebrity: OR 0.44, 95%CI 0.38-0.51, nightlife business: OR 0.58, 95%CI 0.53-0.62).

Conclusions

In Japan, cosmetic surgery has become increasingly common in recent years, and the trend has been changing over time. In the future, it will be important to organize and enhance our large-scale database to disseminate more accurate and useful information.

Adverse Reactions Associated with Dermal Fillers in the Oral and Maxillofacial Region: A Venezuelan Experience

BACKGROUND

Dermal facial fillers are increasingly popular. Published reports on the clinical and histopathologic characteristics related to adverse reactions to dermal fillers in the facial region have been relatively well documented. This study adds to the literature on adverse reactions to injected filler in the oral and maxillofacial region in a South American population.

METHODS

A retrospective, descriptive cross-sectional study (2019-2020) was performed. The study population was a dermatology service in Venezuela. Clinical and histopathologic features of patients with adverse effects were documented.

RESULTS

A total of 35 cases of adverse reactions associated with cosmetic filler procedures were diagnosed during the analyzed period; of these, six cases (17.1%) involved the oral and maxillofacial region. All cases occurred in women. The mean age at diagnosis was 59.3 years (58-73). In three cases, dermal fillers were used in different locations on the face, while three involved the lips. Five patients exhibited adverse reactions to lip filler. All six cases were histopathologically diagnosed as foreign body reactions to injected material. Four and two cases revealed microscopic features compatible with hyaluronic acid and polymethylmethacrylate, respectively.

CONCLUSION

Reflecting the dramatic increase in cosmetic procedures with soft tissue fillers, this study contributed by reporting six cases of foreign body reaction involving the oral and maxillofacial region, confirmed with biopsy and histopathology.

Human Capital and Productivity in Plastic Surgery Research Across Nations

BACKGROUND

Understanding country differences in production and human capital in plastic surgery research is crucial in identifying current and future leaders in the field. In this study, we document each country's human capital and productivity in plastic surgery research.

METHODS

A web scraping algorithm was deployed on PubMed to retrieve information on every publication and every first author in 10 major research outlets in plastic surgery between 2015 and 2021. Each country's human capital in the field is proxied by the number of first authors affiliated with that country. We compare aggregate patterns and volume trajectories of publications affiliated with 110 countries in the context of their human capital.

RESULTS

We find that over the studied period, two countries, the USA and China, are represented in roughly 50% and 45% of global research output and first authors, respectively, in plastic surgery. Specifically in the USA, California has the highest number of affiliated first authors and publications compared with other States.

CONCLUSIONS

Our findings reveal the clear dominance of the USA in plastic surgery research production. No specific US State stands out in the nation as much as the USA does in the global ranking of plastic surgery publications. This suggests that US plastic surgeons across the nation aim to publish. Our global analysis also suggests that countries with a higher share of first authors relative to their research output may have greater capacity to expand their research output in the future.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Impact of Senior Author Profile on Publication Level of Evidence in Plastic and Reconstructive Surgery

Plastic and Reconstructive Surgery (PRS) incorporated the level of evidence (LOE) pyramid in 2011 to highlight evidence-based medicine in plastic surgery. This study aimed to assess the relationship between the profile of senior authors publishing in PRS and the LOE of publications.

A 20-Year Analysis of Global Authorship Trends in Craniofacial Literature: Is the United States Falling Behind?

INTRODUCTION

Recent advances in craniofacial surgery have occurred in conjunction with a global proliferation of research. Although previous studies have examined geographic publication trends, little is known about these trends in the craniofacial literature.

METHODS

All craniofacial articles published from 2000 to 2020 in 3 premier craniofacial surgery journals were evaluated in 5-year increments. Geographic origin, manuscript type, and authorship characteristics were collected. Changes in publication output, geographic origin, and content were analyzed.

RESULTS

In total 3864 articles were analyzed, with the United States (U.S.) (33.46%) accounting for the majority, followed by Asia (27.04%), the Middle East (16.23%), and Europe (14.65%). The proportion of articles from the U.S. decreased significantly in the in the 20-year span (48.28% versus 33.53%, P < 0.001), whereas those originating from Asia and the Middle East increased significantly (18.62% versus 31.41% and 10.34% versus 15.66%, respectively, P < 0.001). After stratifying and selecting for regions with the greatest changes in publication output, the authors observed significant trends for the number of original investigations from 2000 to 2020 in the U.S. (Odds Ratio [OR] 1 versus 2.4, P < 0.001) and in Asia (OR 1 versus 1.8, P = 0.0052). Additionally, a significant trend in editorial/correspondence publications originating in the U.S. (OR 1 versus 0.74, P = 0.0102), Europe (OR 1 versus 0.38, P = 0.0186), and Asia (OR 1 versus 0.48, P = 0.0051) was observed.

CONCLUSIONS

Despite rising craniofacial publications over the past 2 decades, there has been a diminishing proportion originating from the U.S.

Globalization of The Journal of Craniofacial Surgery Over The Last Decade: A Continent, Country, and State Level Analysis

ABSTRACT

Craniofacial surgery continues to be a rapidly evolving field, due in part to interdisciplinary collaboration that has allowed for sharing of knowledge and methodologies, which has expanded greatly due to online journals and publications. The Journal of Craniofacial Surgery (JCS) is a highly regarded journal that has attracted attention for its mission to increase diversity and global representation in manuscript submissions and research publications. The purpose of this study is to provide an objective measurement of global participation in craniofacial research specifically as it pertains to the JCS. Through a bibliometric analysis, the country of origin of all articles published in the JCS from 2010 to 2019 was analyzed. In line with its mission, the JCS increased its overall production 1.9 times during the past decade and increased its global representation 1.6 times, as represented by the number of countries contributing (78). The journal produced 8147 articles with Turkey (1424), USA (1397), China (1178), South Korea (1023), and Italy (644) being the top producers. The highest represented states were Florida (156), New York (130), California (117), Massachusetts (112), and Pennsylvania (106). The Journal of Craniofacial Surgery has the greatest diversity of country representation of the major plastic and reconstructive journals compared. Overall the JCS has stayed true to its mission to foster craniofacial research and is a valuable resource for craniofacial surgeons across the world. This study provides an analysis of trends in global contributions to craniofacial research and highlights areas for further increasing global contributors to the field of craniofacial surgery.