BACKGROUND: The coronavirus disease-19 pandemic has created changes in the way medicine is practiced. The move to virtual conferencing to avoid mass gatherings is a significant change to how health care professionals meet, discuss current trends, and share research. METHODS: Data from exit polls conducted after annual wound care symposiums were reviewed. Physicians, nurses, podiatrists, and other health care professionals attended. Respondents were asked to comment and reflect on their experiences of attending a virtual conference. RESULTS: Over 60% of all (N = 283) respondents stated the virtual conference was better than or on par with a live event. Many respondents had attended this live event in person in previous years. Of all respondents, 83% stated that they planned to access conference materials for the 30 days they remained posted after the event. More than 50% of respondents stated they favored the ability to communicate effectively with colleagues via the instant messaging feature offered by the conference. Approximately 80% of respondents stated that they would like to attend this and other conferences virtually in the future. CONCLUSIONS: The shift from in-person to virtual conferences has the potential to remain a significant method of attending health care conferences. Conference organizers are encouraged to consider how they can implement virtual components, including postconference access to materials, to enhance the conference experience. Additional work needs to be done to understand the impact of the virtual format on knowledge retention.

Background: Tobacco spending may exacerbate financial hardship in low-income populations by using funds that could go toward essentials. This study examined post-quit spending plans among low-income smokers and whether financial hardship was positively associated with motivation to quit in the sample. Methods: We analyzed data from the baseline survey of a randomized controlled trial testing novel a smoking cessation intervention for low-income smokers in New York City ( N = 410). Linear regression was used to examine the relationship between financial distress, food insecurity, smoking-induced deprivation (SID) and motivation to quit (measured on a 0-10 scale). We performed summative content analyses of open-ended survey questions to identify the most common plans among participants with and without SID for how to use their tobacco money after quitting. Results: Participants had an average level of motivation to quit of 7.7 ( SD = 2.5). Motivation to quit was not significantly related to having high financial distress or food insecurity ( P > .05), but participants reporting SID had significantly lower levels of motivation to quit than those without SID ( M = 7.4 versus 7.9, P = .04). Overall, participants expressed an interest in three main types of spending for after they quit: Purchases, Activities, and Savings/Investing, which could be further conceptualized as spending on Oneself or Family, and on Needs or Rewards. The top three spending plans among participants with and without SID were travel, clothing and savings. There were three needs-based spending plans unique to a small number of participants with SID: housing, health care and education. Conclusions: Financial distress and food insecurity did not enhance overall motivation to quit, while smokers with SID were less motivated to quit. Most low-income smokers, including those with SID, did not plan to use their tobacco money on household essentials after quitting.

Purpose: Non/minimally irradiated Cadaveric Costal Cartilage (NCCC) is commonly used for grafts in nasal reconstruction; however, no information exists on its use in total ear reconstruction for type III microtia. In this case series we describe preliminary results from the novel use of NCCC for auricular framework construction in 7 ear reconstructions. Methods: Patients requiring total ear reconstruction from August 2020 to October 2021 were eligible and underwent ear reconstruction using NCCC from MTF Biologics (Edison, NJ). Patients were evaluated for surgical site infection, skin necrosis, cartilage exposure, warping, and resorption during regular follow up visits. Results: Seven ears were reconstructed using NCCC across 5 patients with type III microtia. Patients ranged from 5 to 51 years old at the time of surgery. Follow up time ranged from 12 to 78 weeks (mean: 46 wk). No patients experienced surgical site infections or significant cartilage resorption. All procedures were done outpatient, total time under anesthesia was <90 minutes in 5/7 cases and postoperative narcotics for pain management were not needed in 5/7 cases. Complications included minor skin necrosis that was repaired via primary closure, construct exposure in the immediate postoperative period, which was successfully salvaged with a local flap, and explantation of one construct after reconstruction for a complicated revision surgery involving a previous temporoparietal fascial flap. Conclusion: NCCC serves as an immediately available alternative to alloplastic and autologous materials for construction of auricular frameworks during ear reconstruction. Longer follow up times and a larger sample size will further elucidate long-term efficacy.

Objective Allogeneic cadaveric costal cartilage is commonly used for grafts in nasal reconstruction surgery; however, limited information exists on its use in total ear reconstruction for microtia. In this case series, we describe the novel use of cadaveric cartilage for auricular framework construction in ear reconstruction and review preliminary histologic findings. Methods Patients requiring primary complete reconstruction of the auricle from August 2020 to December 2021 were eligible and underwent ear reconstruction using cadaveric costal cartilage. Patients were evaluated for surgical site infection, skin necrosis, cartilage resorption, and cartilage exposure during regular follow-up visits. Two cartilage samples were taken after 2 separate second-stage surgeries done 52 weeks after first-stage reconstruction. These samples were stained with hematoxylin and eosin as well as safranin-O and examined under light microscopy. Results A total of 12 ear reconstruction procedures using cadaveric costal cartilage were performed across 11 patients; 10 of 12 ears had type III microtia and 2 of 12 ears had type IV microtia. Patients ranged from 4 to 25 years old at the time of surgery, with an average age of 10.7 years. Follow-up time ranged from 1.6 to 25.4 months, with a mean follow-up time of 11.2 months. No patients experienced any visibly significant cartilage warping. Two patients experienced minor construct exposure, which were successfully salvaged. Two patients experienced surgical site infections, one lead to resorption requiring framework replacement. Preliminary histologic analysis of the 2 samples taken 1 year after implantation showed viable chondrocytes with no evidence of immunologic rejection or any local inflammation or host foreign body response. Conclusions Cadaveric costal cartilage serves as a viable alternative to autologous cartilage and other alloplastic biomaterials for construction of auricular frameworks in primary microtia reconstruction. Resorption secondary to infection and construct exposure remain potential risks. Longer follow-up times and a larger sample size are needed for assessment of long-term efficacy.

Background: Many parents seek otoplasty for their school age children but fear having to undergo general anesthesia (GA). In our experience, otoplasty can safely be performed in an officebased setting under local anesthesia (LA). There is a gap in the literature regarding pediatric otoplasty under LA. Methods: All children aged 5 to 10 who underwent otoplasty between 2017 and 2021 were included in a retrospective review. Demographics, operative techniques, complications, recurrences, and reoperation rates were collected. Surveys were provided 3 months after treatment to assess parental satisfaction and anxiety. Results were compared between patients who received otoplasty under GA and LA. Results: A total of 13 patients (6 male, 7 female), with a mean age of 7 years (ranging 5-10) underwent otoplasty under LA. Tweleve children (6 male, 6 female), with a mean age of 5 years (ranging 4-7) underwent otoplasty under GA. The only complications seen were 3 minor conchal bowl hematomas that were aspirated, each retrieving <1 mL of blood; no revisions were necessary. The LA subgroup was more likely to repeat otoplasty under identical conditions (P = 0.025). Postoperatively, mean parental anxiety scores between the LA and GA subgroups were significantly different (1.4 ± 1.1 versus 4.8 ± 2.7, P = 0.0005). Lastly, the mean satisfaction scores between the LA and GA subgroups were marginally different (3.83 ± 0.58 versus 3.17 ± 1.03, P = 0.063). Conclusion: Pediatric otoplasty under LA is a safe and feasible operation for patients between 5 and 10 years of age.