Background: Health literacy of plastic surgery patients may affect surgical decisionmaking and perioperative outcomes. In addition to consulting a plastic surgeon, patients often refer to online-based resources to learn about surgical options. The aim of this scoping review was to identify evidence detailing the state of health literacy of plastic surgery patients and available resources to highlight areas of improvement for clinical practice and future research. Methods: Utilizing PubMed and Web of Science databases, 46 eligible studies that analyzed health literacy in plastic surgery patients and readability of plastic surgery resources were included. Extracted characteristics from eligible studies included study size, type of analysis, findings, and conclusions. Results: Regardless of plastic surgery procedure or subspecialty, resources presenting plastic surgery information to patients exceeded the American Medical Association and National Institutes of Health recommended sixth-to eighth-grade reading level. Plastic surgery patients demonstrated greater knowledge of preoperative indications and surgical benefits compared with postoperative outcomes and surgical risks. Conclusions: Most health literacy research in plastic surgery focuses on readability of written internet-based resources as opposed to direct assessment of health literacy in plastic surgery patients. Plastic surgery resources exceed the recommended mean reading grade level. Dedicated efforts to recognize and accommodate a patient's level of health literacy in plastic surgery should be considered.

Moyamoya disease (MMD) is a rare, chronic vaso-occlusive disease affecting the arteries of the Circle of Willis, leading to the development of characteristic collateral vessels. In this paper, we present a case of a 35-year-old Hispanic male who presented to the emergency department with new onset headaches. On examination, Glasgow Coma Scale score was 3T. The patient was investigated with head CT scan and cerebral angiogram, diagnosed as MMD, and treated with emergent ventriculostomy. Ultimately, the patient underwent extracranial-intracranial (EC-IC) bypass surgery for treatment of Moyamoya.

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Background: Digit replantation affords the opportunity to restore hand function following amputation. To date, however, few studies have evaluated functional outcomes following replantation. Therefore, it was the objective of this study to perform a meta-analysis to better characterize the predictors of hand function. Methods: A literature search was performed using the PubMed database to identify studies that focused on digit amputation/replantation and functional outcomes. Studies were evaluated for patient- and injury-related factors and their respective effects on clinical outcomes of sensation, grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Statistical analysis was conducted across the pooled data set to identify significant trends. Results: Twenty-eight studies representing 618 replanted digits were included in this study. We found the average grip strength was 78.7% (relative to contralateral), the average 2-point discrimination (2PD) was 7.8 mm, and the average DASH score was 12.81. After conducting statistical analysis, we found patients with more proximal injuries had lower grip strength scores (P < .05). We found 2PD scores were influenced by age, mechanism of injury, and amputation level (P < .05). Finally, we found DASH scores after replantation were predicted by mechanism of injury and level of amputation (P < .05). The following variables did not influence outcomes: gender, tobacco use, ischemia time, and digit number. Conclusions: Digit replant does not restore premorbid hand function but does result in adequate hand function. Expected functional outcomes following replant should be considered in the decision-making process. These data can help risk-stratify patients, guide postreplant expectations, and influence the decision for replantation.

INTRODUCTIONFacelifts are in the top five aesthetic procedures performed in plastic surgery. In 2019, almost 124,000 facelifts were performed in the United States per the American Society of Plastic Surgery. 1 Bleeding and hematomas arise in facelift surgery secondary to disrupted vascular and lymphatic networks as skin flaps are elevated, which may lead to postoperative complications and unsatisfactory patient outcomes. 2 Hematoma is the most common postoperative complication in facelifts with a reported incidence from 0.2% to 8%. 3 The pressure of an expanding hematoma on the overlying skin flaps may decrease arterial perfusion, cause venous congestion, and increase inflammation that may lead to skin irregularities. While expanding hematomas require immediate re-exploration, minor hematomas of smaller volume may be aspirated. Predisposing risk factors to hematoma in facelift surgery include male gender, history of hypertension, and coagulopathy. 4 Multiple methods have been developed, and new evidence continues to be generated about how to best manage bleeding in facelifts. This literature review aims to summarize evidence-based methods in minimizing bleeding and postoperative hematoma in facelift surgery. METHODSAn evidence-based review of methods used to minimize bleeding in facelift surgery was conducted using the PubMed database adhering to PRISMA guidelines (Fig. 1). Inclusion criteria entailed randomized controlled trials, prospective/ retrospective cohort and case-control studies, and case series. Exclusion criteria included (1) lack of availability Disclosure: Dr. Jeffrey Janis receives royalties from Thieme and Springer Publishing.