Background: Mechanisms that affect access to surgical hand care appear to be complex and multifaceted. This scoping review aims to investigate the available literature describing such mechanisms and provide direction for future investigation. Methods: The methodological framework outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews was used to guide this review. In November 2021, MEDLINE and EMBASE databases were searched. A narrative summary of the characteristics and key findings of each paper is used to present the data to facilitate the integration of diverse evidence. Results: Of 471 initial studies, 49 were included in our final analysis. Of these, 33% were cohort studies; 27% reported that underinsured patients are less likely to get an appointment with a hand specialist or to receive treatment. Overburdened emergency departments accounted for the second-most reported reason (16%) for diminished access to surgical hand care. Elective procedure financial incentives, poor emergency surgical hand coverage, distance to treatment, race, and policy were also notably reported across the literature. Conclusions: This study describes the vast mechanisms that hinder access to surgical hand care and highlights their complexity. Possible solutions and policy changes that may help improve access have been described.

Background: Rhinoplasty is one of the most common cosmetic procedures performed by plastic surgeons and otolaryngologists. Previous studies have concluded that the readability of rhinoplasty information does not meet the recommended guidelines for the 8th grade reading level. In this study, we performed an updated readability analysis and a comprehensive online review of decision-making factors for patients considering rhinoplasty. Additionally, the differences between plastic surgery and otolaryngology-specific web pages were also analyzed in this study. Methods: This study analyzed 30 websites from universities and private practice webpages for decision-making factors, readability, and tone. These sites were identified by performing a depersonalized Google search using the search terms “nose job decision factors” and “rhinoplasty decision factors.” An independent t-test was performed to assess the differences between webpages. Results: A total of 30 websites were comprehensively reviewed for a comparative analysis of readability for potential rhinoplasty patients. Decision-making factors were divided into 3 categories: individual factors, goals of the procedure, and technical considerations. These categories were then further divided into subcategories. The most common decision-making factor discussed was procedural considerations (83.3%), the least common being lifestyle (10%). Additionally, only 26.7% of web pages mentioned ethnic background and skin type as potential considerations before surgery. Less than half (40%) discussed the importance of setting realistic expectations for the procedure. Of the total sites analyzed in the study, 65.5% were ENT-based, 24.1% were plastic surgery-based, 3.4% were dental/oral maxillofacial surgeons, and 6.9% were combined plastic surgeons and ENT. Statistically significant differences between ENT- and plastic surgeon-based webpages were observed. Risks and complications were more frequently discussed on ENT web pages ( P = .02). ENT sites also had more adverbs ( P = .024) and more uses of passive voice ( P = .006). Additionally, plastic surgery web pages appeared to elicit more of the emotion “disgust” after analysis utilizing IBM Watson Natural Language Understanding ( P < .001). Conclusions: This study highlights the necessity for continued improvement in the readability of webpages designed for patients considering rhinoplasty. Additionally, there were statistically significant differences between decision-making factors presented on ENT-based webpages and plastic-surgery-based webpages. This study may aid surgeons in developing websites that are more accessible, equitable to patients, and contain a more comprehensive discussion regarding key patient decision-making factors and preoperative considerations.

Obesity is a multifactorial disease that represents a substantial global health concern. As of 2016, World Health Organization (WHO) estimates over 650 million adults are obese, whilst more than 1.9 billion are overweight. Surgical interventions or lifestyle changes are typically suggested to patients who experience comorbidities as a result of their weight; however, more recently, anti-diabetic medications have been proposed, specifically sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs). This is the first systematic review to evaluate the safety, efficacy, and future role of SGLT-2 inhibitors and GLP-1RAs for weight loss in the world of aesthetic plastic surgery. Sixteen randomized controlled trials were identified that met the eligibility criteria for this systematic review and comprised data from 10,492 patients. All studies reported a decline in body weight following treatment with SGLT-2 inhibitors or GLP-1RAs ranging from 1.5 to 5 kg. Although adverse events were reported in a large proportion of patients, primarily gastrointestinal manifestations, the literature reports that these were mild to moderate in severity and tended to subside following treatment adjustment. Future research is warranted to determine the ideal SGLT-2 inhibitor or GLP-1RAs for weight loss management, and additional RCTs are necessitated to determine the efficacy and tolerability of potential combination therapies with SGLT-2 inhibitors and GLP-1RAs.