Twitter Buzz and Citations: Who's Tweeting Matters for Plastic Surgery Literature.

Background: Plastic surgery and social media have become inextricably linked through patient procurement, practice growth, and academic exposure. Other surgical fields have demonstrated that tweeting is positively correlated with increased citations. This study aimed to elucidate the effect of Twitter on traditional bibliometrics in plastic surgery and parse out the kinds of tweets that are most correlated with citations. Methods: Articles from May to October of 2018 from Plastic and Reconstructive Surgery and Aesthetic Surgery Journal were analyzed to determine the citation count, number and backgrounds of Twitter users tweeting about the article, and total tweets. Multiple linear regression was performed to correlate these variables to citation count. Results: A total of 369 articles were analyzed. Plastic and Reconstructive Surgery had significantly more average tweets per article compared to Aesthetic Surgery Journal (21.8 versus 10.2, P < 0.001), Additionally, a number of tweets (r = 0.45, P < 0.001) and reaching more total followers (r = 0.48, P < 0.001) were both positively correlated with citations. Multiple linear regression demonstrated that tweets from self-identified scientists were positively correlated with citations (r = 0.99, P = 0.001). Tweets from science communicators had no correlation with citations (r = -0.012, P = 0.726). Tweets coming domestically from the country of the author were also associated with more citations (r = 0.164, P = 0.013). Conclusions: Twitter activity, including the number of followers reached, for an article is positively correlated with citations. Interestingly, the kind of person tweeting affected the citations as well. Domestic tweets and those from scientists were associated with more citations. This implies that Twitter can be an effective form of academic dissemination, provided the "right" Twitter users are promoting the article.

What Attributes Make United States Plastic Surgery Programs Desirable? Perspectives from Medical Students and Residents.

Background: Plastic surgery is a competitive specialty that attracts many qualified applicants. This study provides results of a survey conducted to identify the attributes that make integrated and independent plastic surgery residency programs in the United States most desirable. Medical students' preferences for virtual events during the 2020 to 2021 Match cycle were also investigated. Methods: An anonymous 7-question survey was deployed to plastic surgery residency program directors to forward to medical students and current residents during the 2021 to 2022 National Resident Matching Program cycle. Demographics and ranking of program attributes were collected in the survey, and data analysis consisted of both qualitative and quantitative results. Results: A total of 50 survey respondents from 28% of plastic surgery residency programs was received. The happiness and well-being of residents and training at their preferred geographical location were identified as the most desirable qualities of a program (P < 0.05). However, 82% of respondents opposed mandatory research (P = 0.002). There was a statistically significant larger proportion of students that highly valued faculty responsiveness to feedback over perceived program ranking (P < 0.05). In the context of COVID-19, virtual meet and greets, as well as resident happy hours, were rated most desirable (n = 35, 70%), followed by social media outreach (n = 23, 46%). Conclusions: Resident happiness and well-being, followed by preferred geographical location, were the most favorable program attributes. Plastic surgery residency programs may seek to better integrate these preferences within their curricula, as well as showcase them on social media, to attract high-quality applicants and optimize the training experience for matched residents.

Going virtual: effectiveness of virtual opportunities in engaging applicants for plastic surgery residencies.

Purpose: During the COVID-19 pandemic, virtual events led by residency programs have eased deficits formed by the lack of in-person opportunities. Despite their anecdotal success, there is yet a study on their utility and value, as perceived by attendees. Therefore, we sought to investigate engagement rates of virtual opportunity posts via Instagram, equipping residency programs with recommendations for future virtual event planning. Methods: The 40 PRS residency programs with the highest number of followers on Instagram were inspected for posts regarding virtual opportunities. The virtual opportunities were classified by type, medium, and intended audience. The number of opportunities within each classification was analyzed, along with the like/comment to follower ratios, and compared via ANOVA tests. Results: A total of 141 virtual opportunities were evaluated, with the most events occurring in August (21.6%). The highest engagement rates occurred in May and June, with the most common virtual opportunity being meet and greets with residents (39.2%). The most prevalent medium for virtual events was Zoom, used in 84.7% of events. The intended audience was frequently medical students (80.6%), with a significant difference in engagement between audience groups (p < 0.05). Conclusion: The pandemic has disrupted the status quo of resident recruitment. In light of these findings, residency programs should consider instilling virtual opportunities for medical students as a standard practice. Peak times to broadcast events are May or June due to higher engagement. To address attendee burnout, programs should limit events to familiar ones, such as Zoom meet and greets with residents.

Excluding Antibiotics in the Management of Nonoperative Orbital and Zygomatic Fractures.

INTRODUCTION: Indications for prophylactic antibiotic therapy in nonoperative, closed fractures of the orbit and zygoma remain controversial and are based on anecdotal data. The purpose of this study was to report the incidence of infectious sequelae among patients who presented to our institution with stated fractures and who were not administered prophylactic antibiotic therapy. The authors hypothesized that an increase in infectious complications would not be seen in these patients. METHODS: The authors conducted a prospective single site study from October 2015 to December 2019. Patients with closed, nonoperative fractures involving the orbit and/or zygoma were included. These patients did not receive prophylactic antibiotic therapy for their fracture patterns, and infectious complications including orbital cellulitis, meningitis, and bacterial sinusitis were noted if present during follow-up. RESULTS: Of 301 patients with closed, nonoperative orbital and/or zygomatic fractures, 268 were included in the study and 33 were excluded because of administration of antibiotics. The average age was 60 years, and the most common mechanism of injury was a traumatic fall. Fracture types included 100 orbital wall, 133 orbital floor, 15 orbital rim, 23 orbital roof, 48 zygoma, and 44 zygomaticomaxillary compound fractures. Infectious sequelae were not identified in any patient. CONCLUSIONS: Of the 268 patients included in the study, no infectious complications were identified during the follow-up period. This outcome further supports that the use of prophylactic antibiotics is not indicated for closed, nonoperative fractures involving the orbital and/or zygoma. Prospective randomized control studies would be useful to support this outcome and better guide clinical antibiotic prescribing practices.

Estimated National and Regional Impact of COVID-19 on Elective Case Volume in Aesthetic Plastic Surgery.

BACKGROUND: In efforts to help alleviate the strain placed on healthcare during the COVID-19 pandemic, the American Society of Plastic Surgery recommended suspending elective procedures on March 19, 2020. When this suspension was enacted, it was unknown when cases would resume. OBJECTIVES: This analysis aimed to estimate the regional economic impact of the pandemic specifically with regards to elective, aesthetic surgical procedures. As knowledge regarding the effects of the pandemic has grown, the authors then evaluated the accuracy of the projected estimates compared with actual events. METHODS: Utilizing the American Society of Plastic Surgery 2018 Plastic Surgery Statistics Report, regional case volume and surgeons' fees were obtained for the top 5 aesthetic procedures. Models developed by the Institute for Health Metrics and Evaluation were employed to estimate the anticipated duration of suspension by utilizing the date that no ventilators would be required for COVID-19 patients. This duration was utilized to calculate the volume of cases that would not occur. RESULTS: These estimates predict up to 1.3 billion fewer dollars will be collected in surgeons' fees, representing a 20% loss compared with 2018. The South Atlantic region is predicted to have the greatest number of operating room days lost. However, the Mountain and Pacific regions are estimated to have the greatest loss in case volume and surgeons' fees. CONCLUSIONS: The cumulative impact of the pandemic on life, society, and the economy is tremendous. This analysis may help guide surgeons' responses during and after the crisis.