Baylee M. Brochu

INTRODUCTION: Fibrinogen supplementation (FS) is commonly achieved with cryoprecipitate, although the required on-demand thawing often results in delayed FS. Pathogen-reduced cryoprecipitated fibrinogen complex (INTERCEPT fibrinogen complex [IFC]), a novel product, can be stored thawed for up to 5 days, allowing for immediate availability. We hypothesized that IFC implementation at our level 1 trauma center would be associated with increased likelihood of FS, decreased mortality, and transfusion requirement (TR). METHODS: This was a retrospective review from a single level 1 trauma center from 2022 to 2024, spanning 1 year pre- and post-IFC implementation. Adults who received >900 mL of red blood cells and/or whole blood (WB) within 1 hour were included to identify patients who reached critical administration threshold, indicating significant hemorrhage, without excluding those being resuscitated primarily with WB. Multiple logistic regression assessed the independent effect of IFC implementation on the likelihood of FS and 24-hour mortality. Linear regression modeled TR. RESULTS: In 294 included patients, 24.1% received FS (21.4% pre-IFC, 26.6% post-IFC, p = 0.299). Post-IFC patients tended to be older (44 vs. 39, p = 0.011) and had blunt trauma more often (67.5% vs. 53.6%, p = 0.009), lower shock index (0.87 vs. 0.99, p = 0.004), higher rates of WB use (72.1% vs. 37.9%, p < 0.001), and lower 4-hour TR (2.0 vs. 2.4 L, p = 0.027) but similar ISS, GCS, base deficit, and hematocrit. After controlling for these differences, IFC implementation was associated with increased likelihood of FS (adjusted odds ratio, 2.45; 95% confidence interval, 1.05–5.74), but not with 24-hour mortality or 4-hour TR. Although not statistically significant, there was a trend to earlier FS (median, 67 vs. 42 minutes; p = 0.070; rates of FS within 60 minutes, 40.0% vs. 63.4%; p = 0.051). CONCLUSION: INTERCEPT fibrinogen complex implementation at our level 1 trauma center was independently associated with FS, but not mortality or TR. Hemorrhaging patients with hypofibrinogenemia, a time-sensitive predictor of mortality in trauma, may benefit from IFC. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level III.

Aim: This study aims to investigate the ability of ChatGPT to answer common patient questions related to the five most common aesthetic procedures. Methods: We asked three questions, two of which were the same across procedures, for each of the five most common plastic surgery procedures as determined by the 2022 American Society of Plastic Surgery (ASPS) Procedural Statistics Release. These were posed to ChatGPT on the same day, using the same account. Then, they were compared to the corresponding information on the ASPS website. Results: We found that ChatGPT provides accurate, organized, and grammatically correct responses to common patient questions. It was comparable to the ASPS website in terms of comprehensiveness of the complications listed across procedures. However, its responses regarding recovery time were less detailed than the corresponding ASPS articles. It included accurate information on recovery time that was unavailable on the ASPS site. For procedure-specific questions, ChatGPT was more detailed 2/5 times, less detailed 1/5 times, and provided a completely different answer than the ASPS website 2/5 times. Conclusion: This study provides support for ChatGPT’s utilization as a tool to improve the efficiency of consultations for aesthetic procedures. However, it is important to recognize ChatGPT’s limitations in answering questions in a patient/procedure-specific way. Therefore, it is not a substitute for an experienced surgeon consultation. Further research is needed to assess the reliability of ChatGPT before it can be fully recommended as an ultimate patient learning tool.

Large osseous defects resulting from trauma, tumor resection, or fracture render the inherent ability of the body to repair inadequate and necessitate the use of bone grafts to facilitate the recovery of both form and function of the bony defect sites. In the United States alone, a large number of bone graft procedures are performed yearly, making it an essential area of investigation and research. Synthetic grafts represent a potential alterative to autografts due to their patient-specific customizability, but currently lack widespread acceptance in the clinical space. Early in their development, non-autologous bone grafts composed of metals such as stainless steel and titanium alloys were favorable due to their biocompatibility, resistance to corrosion, mechanical strength, and durability. However, since their inception, bioceramics have also evolved as viable alternatives. This review aims to present an overview of the fundamental prerequisites for tissue engineering devices using bioceramics as well as to provide a comprehensive account of their historical usage and significant advancements over time. This review includes a summary of commonly used manufacturing techniques and an evaluation of their use as drug carriers and bioactive coatings—for therapeutic ion/drug release, and potential avenues to further enhance hard tissue regeneration.