The omental free flap is a valuable option for reconstructive efforts in nearly all anatomic regions. This is a result of its inherent anatomy and vascularity, and its angiogenic, immunogenic, and lymphatic properties.

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The plastic surgery team provides invaluable support to other services in a tertiary teaching hospital. Its input allows for more complex surgical procedures to be performed safely and for complications of surgery to be managed successfully. Clearly, plastic surgery plays a critical role at academic medical centers in the United States.

Background Physician attire has been shown to impact patients’ perceptions of their provider with regards to professionalism, competency, and trustworthiness in various surgical subspecialties, except in plastic and reconstructive surgery. Objectives This study aims to address this knowledge gap and obtain objective information regarding patients’ preferences. Methods A survey was distributed to adult, English-speaking participants in the U.S. using Amazon MTurk platform from February 2020 to December 2020. Participants were asked to evaluate six attires (scrubs, scrubs w/ white coat, formal attire, formal attire w/ white coat, casual, casual w/ white coat) in terms of professionalism, competency, and trustworthiness for male and female plastic surgeons during their first encounter in clinic using a 5-point Likert scale. Results A total of 316 responses were obtained, which consists of 43.4% men and 56.6% women. Mean age of participants was 53.2 years. The highest scores across all metrics of professionalism, competency, trustworthiness, willingness to share information, confidence in the provider, and confidence in surgical outcomes were given to the formal attire with white coat group with average scores of 4.85, 4.71, 4.69, 4.73, 4.79, 4.72, respectively. The lowest scores across all metrics belonged to the casual attire group with scores of 3.36, 3.29, 3.31, 3.39, 3.29, 3.20, respectively. Patients preferred formal attires for young plastic surgeons (p=0.039). Conclusions Our study suggests that physician attire impacts patients’ perception of plastic surgeons with regards to their professionalism, competency, and trustworthiness. White coats continue to remain a powerful entity in clinical settings given that attires with white coats were consistently ranked higher.

Dear Editor:We would like to share with the readers a unique case we had to deal with of aseptic abscess. Aseptic abscesses were first described 25 years ago by Andre et al. in a patient who presented with unexplainable abscesses that did not respond to antibiotics but improved when given steroid treatment. Research until date has shown a relationship between aseptic abscess and inflammatory bowel disease (IBD) and neutrophilic dermatoses of which largest study has been a case series. Our review of literature only revealed a total of 50 cases reported until date.Here, we would like report a case of sterile abscess in a 48-year-old female with quiescent Crohn's disease, presenting with failure to thrive that resolved after drainage and steroid treatment. She reported 1-month history of weakness, fever, and poor appetite. She also noted coughing and associated pain in the right lower chest. Her Crohn's disease had been under control more than 15 years without the need for treatment. On admission, her laboratory exam showed a white blood cell (WBC) count of 14 (×10 9 /L). She was worked up for fever of unknown origin. Upon abdominal imaging, a hypo-attenuating mass, measuring 3.8×2.5×2.4 cm, located in the left hepatic lobe was present. Nonspecific abdominal adenopathy was also discovered. An abscess was suspected and the patient was started on broad-spectrum antibiotic therapy. Aspiration was then performed, which removed 15 cc of purulent material from the lesion. The cultures of the aspirate were negative. The patient's clinical status did not improve, and her antibiotic therapy was discontinued. Steroid therapy was started, and the patient's status greatly improved. She was discharged 4 days after steroid therapy was begun. A repeat ultrasound 3 weeks later showed resolution of the abscess.It is well known that an aseptic abscess can be an extraintestinal manifestation of those diagnosed with inflammatory bowel disease. These lesions occur in 30-40 % of patients diagnosed with IBD and are the initial symptom in 10 % of presenting cases. Aseptic abscess and neutrophilic dermatoses have similar pathophysiology and can be reported in concurrence for those with IBD. We found that of the total 50 reported cases until date, 58 % cases involved the spleen followed closely by the lymph nodes and liver, respectively. The majority (>90 %) abscess are steroid responsive though have a relapse.Of particular note are summaries of reports in the literature of aseptic abscesses occurring in patients with Crohn's disease and ulcerative colitis that are mentioned below.