ChatGPT in Plastic and Reconstructive Surgery

Background Chat Generative Pre-Trained Transformer (ChatGPT) is a versatile large language model-based generative artificial intelligence. It is proficient in a variety of tasks from drafting emails to coding to composing music to passing medical licensing exams. While the potential role of ChatGPT in plastic surgery is promising, evidence-based research is needed to guide its implementation in practice

Stepwise synthesis of [Ru(trpy)(L)(X)]<SUP>n+</SUP> (trpy = 2,2':6',2' '-terpyridine; L = 2,2'-dipyridylamine; X = Cl<SUP>-</SUP>, H<SUB>2</SUB>O, NO<SUB>2</SUB><SUP>-</SUP>, NO<SUP>+</SUP>, O<SUP>2-</SUP>). crystal structure, spectral, electron-transfer, and photophysical aspects

Ruthenium-terpyridine complexes incorporating a 2,2'-dipyridylamine ancillary ligand [RuII(trpy)(L)(X)](ClO4)n [trpy = 2,2':6',2'?'-terpyridine; L = 2,2'-dipyridylamine; and X = Cl-, n = 1 (1); X = H2O, n = 2 (2); X = NO2-, n = 1 (3); X = NO+, n = 3 (4)] were synthesized in a stepwise manner starting from RuIII(trpy)(Cl)3. The single-crystal X-ray structures of all of the four members (1-4) were determined. The Ru(III)/Ru(II) couple of 1 and 3 appeared at 0.64 and 0.88 V versus the saturated calomel electrode in acetonitrile. The aqua complex 2 exhibited a metal-based couple at 0.48 V in water, and the potential increased linearly with the decrease in pH. The electron-proton content of the redox process over the ρH range of 6.8-1.0 was calculated to be a 2e-/1H+ process. However, the chemical oxidation of 2 by an aq Ce(IV) solution in 1 N H2SO4 led to the direct formation of corresponding oxo species [RuIV(trpy)(L)(O)]2+ via the concerted 2e-/2H+ oxidation process. The two successive reductions of the coordinated nitrosyl function of 4 appeared at +0.34 and -0.34 V corresponding to RuII-NO+ → RuII-NO· and RuII-NO° → RuII-NO-, respectively. The one-electron-reduced RuII-NO° species exhibited a free-radical electron paramagnetic resonance signal at g = 1.990 with nitrogen hyperfine structures at 77 κ . The NO stretching frequency of 4 (1945 cm-1) was shifted to 1830 cm-1 in the case of [RuII(trpy)(L)(NO ° )]2+. In aqueous solution, the nitrosyl complex 4 slowly transformed to the nitro derivative 3 with the pseudo-first-order rate constant of k298/s-1 = 1.7 × 10-4. The chloro complex 1 exhibited a dual luminescence at 650 and 715 nm with excited-state lifetimes of 6 and 1 μs, respectively

Role of staged endoprosthetic revision with flap cover for limb salvage in endoprosthetic failure

Endoprosthetic replacement (EPR) is commonly required for limb salvage in bone malignancies. Endoprosthetic failure is a term used to denote mechanical failure or infection usually requiring removal of the prosthesis. Treatment of infection consists of EPR revision with or without placement of a temporary spacer. Flap cover (either local or free) may be required if the overlying soft tissues are of concern. It is claimed that the investment of the endoprosthesis in well-vacularised soft tissue facilitates the eradication of infection. This series included nine patients with endoprosthetic failure due to chronic infection who needed flap cover. These patients underwent revision of the EPR in two stages. The first stage of revision included removal of the endoprosthesis, insertion of a spacer and soft tissue reconstruction. If serial sampling of the periprosthetic space failed to demonstrate microbial growth, the spacer was exchanged for an endoprosthesis. A total of nine patients underwent staged revision of endoprosthesis. In five patients cover was provided by a local pedicled flap and in four by a free flap. Patients undergoing cover by a broad flat musculocutaneous flap (i.e. free/pedicled latissimus dorsi) performed better. This study reports the results of attempted limb salvage in endoprosthetic failure due to infection in nine cases. Initial findings in this small series indicate that staged revision and soft tissue reconstruction in the form of muscle flap investment of the endoprosthesis carries a higher rate of successful limb salvage