Plastic Surgery Journals Research Articles

Opportunity Costs of Internal Promotions in Plastic Surgery: Are Women Given a Fair Shot?

Background:Academic advancement in plastic surgery necessitates creation of opportunities for rising faculty, which are pivotal for women in their efforts to close prominent gender gaps in higher ranks. We study positions of academic prestige that benefit from internal nomination as surrogates for opportunities afforded to men and women seeking leadership roles.Methods:We collected the following datapoints: authors of invited discussions published in Plastic and Reconstructive Surgery from 2010 to 2019; current editorial board members of representative plastic surgery journals; recipients of society-sponsored traveling fellowships; and directors of the American Board of Plastic Surgery. Public profiles for all authors and surgeons were referenced to confirm gender identification.Results:Seven-hundred ninety-seven plastic and reconstructive surgery discussions were included, 18% of which included female first or senior authorship. Seventy-one (9%) discussions listed a female senior author. Male and female senior authors were equally as likely to collaborate with a female first co-author (25% and 26%, respectively). Only 17% of invited authors contributed to 55% of discussion articles. Women occupied 19% of journal editorial board positions, though none were editors-in-chief. American Society of Reconstructive Microsurgery, American Society of Maxiliofacial Surgeons, American Society for Surgery of the Hand, and Plastic Surgery Foundation traveling fellowships were awarded to one (3%), four (7%), five (13%), and 141 (15%) female plastic surgeons, respectively. Women comprise 26% of directors of American Board of Plastic Surgery.Conclusions:Female representation in plastic surgery is rising, but it is not mirrored across appointed positions in academia. We should strive to support advancements that allow selected prestigious positions to more accurately reflect the gender distribution within the plastic surgery community.

Global and Chinese publications in plastic surgery journals between 2010 and 2020: a bibliometric analysis.

BackgroundPlastic surgery has evolved rapidly in recent years. We performed a bibliometric analysis of plastic surgery publications from 2010 to 2020 to evaluate global developments in plastic surgery and the Chinese contribution to this field.MethodsThe 2020 Journal Citation Reports (JCR) was used to identify all plastic surgery journals; those that were available on the Web of Science database were retrieved and analyzed according to their number of published articles, citation rates, impact factors (IFs), research funding, and article references. We also determined the most popular journals for research from the 8 top-ranking countries in terms of contributed articles, including China.ResultsFrom 2010 to 2020, 55,554 articles were published in the 35 selected plastic surgery journals. China, which contributed 9.48% of these articles, was the country with the second-highest number of articles published, a number which has been increasing annually. The average IF of Chinese articles was 1.74, with an average citation count of 6.68. These figures were significantly lower than those for articles from developed countries. China contributed 1,641 articles to the 10 highest impact plastic surgery journals. The Journal of Craniofacial Surgery was the most popular in terms of contributions by China. China had the highest rate of articles supported by funding (45.30%). The top 12 research-topic clusters were obtained by analyzing the references in the articles. Emerging research-topic trends worldwide and in China included fat grafting and blindness after filler injection.ConclusionsFrom 2010 to 2020, research into plastic surgery increased continuously, both worldwide and in China. However, the quality of the Chinese articles was lower than that of other top-ranked countries. Researchers who have elected to conduct research might consider emerging trends when designing future studies.

Using the Disruptive Score to Identify Publications That Changed Plastic Surgery Practice.

The impact of academic publications is often characterized by the total number of future citations. However, this metric does not adequately characterize the true impact in terms of changing practices or paradigms. A new metric called the "disruption score" (DS) has been developed and validated in nonsurgical publications. This study aims to use the DS to identify the most disruptive publications in plastic surgery.The DS, a ratio of 2 numbers, varies between -1 and +1. Scores closer to -1 are developing papers that summarize the known literature while papers closer to +1 are disruptive-they result in a paradigm shift in the field of study. A search was performed for all articles from 1954 to 2014 in the following journals: Plastic and Reconstructive Surgery; Aesthetic Surgery Journal; Journal of Plastic, Reconstructive, and Aesthetic Surgery; Annals of Plastic Surgery; Aesthetic Plastic Surgery; Clinics in Plastic Surgery; and Plastic Surgery. The disruptive score was calculated for each article.The top 100 papers ranked by DS were examined and any editorials/viewpoints, publications with less than 26 citations, or less than 3 references were excluded because of their subjective nature and smaller academic contribution. The remaining 64 publications were analyzed for topic, study type, and citation count. A total of 32,622 articles were found with a DS range from 0.385 to 0.923. The mean score of the top 64 articles was 0.539 with an average citation count of 195 and 9 references. Plastic and Reconstructive Surgery had the most disruptive papers with 50. There were no randomized controlled trials with a majority of the studies being technical descriptions or case series. There are many ways to measure academic success, but there are fewer ways to measure the impact of academic contributions. The DS is a novel measurement that can demonstrate when an article results in a paradigm shift as opposed to just total citation count. When applied to the plastic surgery literature, the DS demonstrates that technical innovation and creativity are the most academically impactful. Future evaluations of academic success should include the DS to measure the quality of academic contributions.

Evaluation of "Spin" in the Abstracts of Systematic Reviews and Meta-analyses of Therapeutic Interventions Published in High-Impact Plastic Surgery Journals: A Systematic Review.

"Spin" is a form of reporting bias where there is an misappropriated presentation of study results, often overstating efficacy or understating harms. Abstracts of systematic reviews in other clinical domains have been demonstrated to employ spin, which may lead to clinical recommendations that are not justified by the literature. The objective of this study was to determine the prevalence of spin strategies in abstracts of plastic surgery systematic reviews. A literature search was conducted using MEDLINE, Embase, and CENTRAL, to identify all systematic reviews published in the top five plastic surgery journals from 2015-2021. Screening, data extraction, and spin analysis were performed by two independent reviewers. Data checking of the spin analysis was performed by a plastic surgery resident with graduate level training in clinical epidemiology. From an initial search of 826 systematic reviews, 60 systematic reviews and meta-analyses were included in this study. Various types of spin were identified in 73% of systematic review abstracts (n=44). "Conclusion claims the beneficial effect of the experimental treatment despite high risk of bias in primary studies," was the most prevalent type of spin and was identified in 63% of systematic reviews (n=38). There were no significant associations between the presence of spin and study characteristics. The present study found that 73% of abstracts in plastic surgery systematic reviews contain spin. Although systemic reviews represent the highest level of evidence, readers should be aware of types of "spin" when interpreting results and incorporating recommendations into patient care.

Impact of Predatory Journals in Plastic Surgery Literature: Researchers Beware.

Predatory journals have exploited the open access publishing model and are considered as a major threat to the integrity of scientific research. The goal of this study was to characterize predatory publishing practices in plastic surgery. To identify potentially predatory journals in the field of plastic surgery, the authors searched the Cabells' Predatory Reports and Beall's List using preidentified keywords. For presumed legitimate open access journals, the Directory of Open Access Journals (DOAJ) was queried. The characteristics of potentially predatory journals were compared to those of legitimate open access plastic surgery journals. The authors identified a total of 25 plastic surgery-focused journals. Out of the 25 potentially predatory journals, only 15 journals had articles published within the last 5 years, with a mean number of articles of 33 ± 39 (range, 2 to 159 articles). The mean number of predatory violations according to Cabells' criteria was 6.8 ± 1.4 (range, 3 to 9). Using the DOAJ database, the authors identified a total of 24 plastic surgery-related journals. Compared to potentially predatory journals, journals from the DOAJ were more likely to be indexed in PubMed (0 versus 50 percent, respectively, p < 0.0001). Time to publication was significantly higher in journals from the DOAJ (17 ± 7 versus 4 ± 1 weeks; p = 0.006). Despite higher article processing charges in the DOAJ group, this difference was not statically significant ($1425 ± $717 versus $1071 ± $1060; p = 0.13). Predatory journals are pervasive in the medical literature and plastic surgery is no exception. Plastic surgeons should practice due diligence when choosing a target journal for their articles. Journals with predatory practices should be distinguished from legitimate open access publication platforms.

The Use of Patient Photographs in Social Media and Advertising for Aesthetic and Plastic Surgery Journals.

The Use of Patient Photographs in Social Media and Advertising for Aesthetic and Plastic Surgery Journals.

Does Diversity of Authorship Matter? An Analysis of Plastic Surgery's Top 100 Articles.

Background:Diversity, whether related to age, gender, ethnicity, race, geography, or experience, is increasing in all realms of medicine, including plastic surgery. Research has also become more diverse in those who conduct studies and those who participate in them. Fittingly, surgeons who produce prominent research are likely to come from diverse backgrounds. This study was designed to analyze the diversity of authorship in peer-reviewed plastic surgery journals.Methods:Using the Web of Science database, the authors identified the 100 most-cited articles from the highest-impact plastic surgery journals from January 2010 to December 2020. Author, institutional, and topic information was collected.Results:There was an average of 5.6 authors on the top 100 articles, of which 96.1% involved collaboration and 75.7% mixed-gender authorship. The average number of affiliations was 2.1, of which 51.5% involved cross-institutional collaboration, 12.6% came from both domestic and international institutions, 30.1% involved multiple specialties, and 10.7% came from both academia and private practice. Having both domestic and international authors was found to be most predictive of more citations on multiple regression, with year as a nonconfounding variable (P < 0.05), followed by mixed-gender authorship (P < 0.10).Conclusion:Impactful publications in plastic surgery come from diverse sets of authors and institutions.

The Price of Publishing: An Investigation of the Open Access Landscape in Plastic Surgery.

Open access publishing in plastic surgery has rapidly gained traction in the past decade. This study investigated the digital landscape of plastic surgery open access publishing. This was a cross-sectional bibliometric investigation of plastic surgery-focused journals. Three publication models were investigated: subscription-only journals, hybrid journals offering both paywalled and open access publishing, and open access-only journals. Eighty-two journals were investigated. In 2010, open access journals comprised 18 percent of all plastic surgery journals online, subscription journals comprised 79 percent, and hybrid journals comprised 3 percent. Conversely, in 2020, open access journals comprised 55 percent of all journals, hybrid journals comprised 45 percent, and there were no subscription-only journals. Multivariable linear regression adjusting for article type/content demonstrated that open access articles from hybrid journals [beta coefficient, 1.3; F(4, 18) = 790; p = 0.05] and high-quality open access journals [beta coefficient, 0.9; F(4, 19) = 738; p = 0.04] were significantly positively associated with number of full-text views. Although impact factor and article processing charges were positively correlated [Pearson correlation coefficient: r(25) = 0.39, p = 0.04] for open access publishing, some high-quality open access journals were found to offer fee waivers/free publishing. Lastly, level of evidence offered by articles from open access versus hybrid journals differed. Overall, this study highlighted important distinctions between trustworthy and predatory journals offering open access publishing in plastic surgery. Open access publishing in trustworthy sources offers greater visibility and is not necessarily cost-prohibitive, but some open access journals can be limited in scope (i.e., less coverage of subspecialty topics) and quality of content. Study findings were used to generate recommendations for navigating open access publishing in plastic surgery.

498 Assessing Knowledge Silos in the Craniosynostosis Literature

INTRODUCTION: The surgical treatment of craniosynostosis has traditionally been a multidisciplinary effort, involving pediatric neurosurgeons and plastic surgeons. Advances in treating this condition may result from collaboration between these two specialties, yet there exists a certain risk of sequestering clinical knowledge between the two which may limit continued progress in this regard. METHODS: During September 2020, the Scopus database was queried to identify journal articles related to craniosynostosis. Bibliometric measures were collected for each article, and a database was constructed to assess knowledge sharing between neurosurgeons and plastic surgeons. RESULTS: 5335 articles were identified. 720 (13.5%) were published in a neurosurgery journal with 499 (9.4%) published by neurosurgeons and 665 (12.5%) by neurosurgeons and plastic surgeons collaborating together. As expected, neurosurgeons published primarily (319, 63.9%) in neurosurgical journals, whereas plastic surgeons published most in plastic surgery journals (990, 65.7%). Collaborations were mostly published in plastic surgery journals (326, 49%). After normalizing for years in press, neurosurgeons were observed to be cited significantly less than plastic surgeons (p &lt;0.0001), and articles published in neurosurgery journals were cited at a lower rate than those published in plastic surgery journals. The differential association of terms used in plastic surgery versus neurosurgery article abstracts illustrates the potential sites of knowledge silo formation in the craniosynostosis literature. CONCLUSION: This study demonstrates that a distinct sequestering of knowledge exists between neurosurgeons and plastic surgeons publishing on the topic. Publications by plastic surgeons are more highly cited than by neurosurgeons. While there are certainly specialty-based topics within craniosynostosis, we recommend continued collaboration on all research fronts to avoid sequestration of knowledge and progress.

Characterizing the Effect of the COVID-19 Pandemic on the Plastic Surgery Literature.

The coronavirus disease of 2019 (COVID-19) pandemic has dramatically impacted the plastic surgery community across the globe, and it has been the center of discussion in public and private discourse throughout the year.1 Given this deep interest in the COVID-19 pandemic, we hypothesized that articles related to the COVID-19 pandemic in the plastic surgery literature would garner higher levels of attention than other articles. Using the Journal Citation Reports, 15 plastic surgery journals with the highest impact factor in 2019 were selected and all articles published in these journals in 2020 were extracted.2 For the 6815 articles identified, number of citations accrued and Altmetric score, which is a weighted calculation of the attention an article receives online, were recorded.3 COVID-19–related articles were identified by searching titles for “COVID,” “SARS,” “pandemic,” “corona,” “COVID-19,” or “SARS-CoV-2,” resulting in a total of 220 articles (3.2 percent). The Kruskal-Wallis test was used to assess Altmetric score and citations for COVID-19–related versus non–COVID-19 articles. For the COVID-19–related articles, we also assessed whether Altmetric score and citations varied by the type of article (commentary, original article, or guidelines), subspecialty of plastic surgery to which the article pertained, and the quarter of the year in which it was published. Despite the pandemic being a hot topic of discussion, the majority (n = 137, 62 percent) of COVID-19–related articles had an Almetric score of zero, meaning they were not disseminated at all on social media, news outlets, or other electronic forms of media. When compared to non–COVID-19 articles, however, COVID-19–related articles had a higher average Altmetric score (2.1 versus 1.4, p < 0.001, Fig. 1). Of the COVID-19–related articles, original articles had higher Altmetric scores as compared to editorials and guidelines (3.8 versus 1.3 and 1.5, respectively, p < 0.001). There was no association between Altmetric score and specialty (p = 0.24) or quarter of publication (p = 0.40).Fig. 1.: Altmetric score by article type. COVID-19–related articles had higher Altmetric scores than non–COVID-19 articles.COVID-19–related articles accrued a total of 247 citations, with an average of 1.1 citations per article, which is higher than the 0.2 citations non–COVID-19 articles accrued (p < 0.001) (Fig. 2). Among the COVID-19–related articles, over 65 percent of articles had zero citations and four articles alone accounted for 24 percent of all citations. Articles published earlier in the year had more citations than those published later (p < 0.001), which is expected as it takes time for articles to accrue citations. There was no association between number of citations and specialty (p = 0.16) or article type (p = 0.27).Fig. 2.: Number of citations by article type. COVID-19–related articles accrued more citations than non–COVID-19 articles.The high levels of interest in the COVID-19 pandemic were reflected in the plastic surgery literature. Altmetric score, a surrogate for interest and influence, was higher for COVID-19–related articles and highest for studies that analyzed original data.1 Impact, as measured by citations, was also higher for COVID-19–related articles, suggesting there was increased discussion among academics about the pandemic and its ramifications on plastic surgery. The impact and influence of the COVID-19 pandemic were felt by the plastic surgery community worldwide and also depicted in the literature. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.

Reproducible Research Practices in the Plastic Surgery Literature.

Reproducible research-defined as the ability to replicate a study with its published materials and procedures-is integral to ensuring the validity of published studies and promoting scientific advancement. The primary aim of this study was to quantitatively evaluate the reproducibility and transparency of research in the plastic surgery literature. A cross-sectional study was performed. Articles published in 12 plastic surgery journals over a 5-year period were randomly selected. Reproducibility-related and transparency-related variables were blindly and independently collected by two reviewers using previously published methods. Descriptive statistics and univariate analysis were performed for outcomes of interest. The initial search yielded 18,461 publications, from which 400 were randomly selected. A total of 397 publications met inclusion criteria, of which 203 were empirical studies eligible for analysis of reproducibility-related and transparency-related variables. Among the empirical studies, most did not have a data availability statement (97.0 percent; 95 percent CI, 93.7 to 98.9). Only seven (3.4 percent; 95 percent CI, 1.4 to 7.0) were linked to an accessible protocol, four (2.0 percent; 95 percent CI, 0.5 to 5.0) were preregistered, and no studies provided analysis scripts or claimed to replicate another study. Of the 202 studies evaluated for material availability, only 17 (8.4 percent; 95 percent CI, 5.0 to 13.1) had a material availability statement. There is an evident lack of reproducible research practices in plastic surgery literature. The majority of plastic surgery publications do not provide information and raw materials necessary to reproduce empirical studies. Increasing awareness at the individual and institutional levels can improve research quality and transparency.

Propensity Scoring in Plastic Surgery Research: An Analysis and Best Practice Guide.

Summary:Randomized controlled trials, though considered the gold standard in clinical research, are often not feasible in plastic surgery research. Instead, researchers rely heavily on observational studies, leading to potential issues with confounding and selection bias. Propensity scoring—a statistical technique that estimates a patient’s likelihood of having received the exposure of interest—can improve the comparability of study groups by either guiding the selection of study participants or generating a covariate that can be adjusted for in multivariate analyses. In this study, we conducted a comprehensive review of research articles published in three major plastic surgery journals (Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive, & Aesthetic Surgery, and Annals of Plastic Surgery) to determine the utilization of propensity scoring methods in plastic surgery research from August 2018 to August 2020. We found that propensity scoring was used in only eight (0.8%) of 971 research articles, none of which fully reported all components of their propensity scoring methodology. We provide a brief overview of propensity score techniques and recommend guidelines for accurate reporting of propensity scoring methods for plastic surgery research. Improved understanding of propensity scoring may encourage plastic surgery researchers to incorporate the method in their own work and improve plastic surgeons’ ability to understand and analyze future research studies that utilize propensity score methods.

Meet the Founding Resident Ambassador: John M. Le, DDS, MD

We are happy to continue adopting the best global publishing experience and traditions into the new year of 2022. To start off, we are honored to adopt the progressive tradition held by Plastic and Reconstructive Surgery (PRS) journal. As a phenomenal journal with more than 75 years of publishing developments, PRS serves as a trailblazer for the Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology. The PRS Editorial Board founded the Resident Ambassador position in 2014 after an unofficial Resident Advisory Board (RAB) meeting of four residents at the 2013 Annual Meeting.2 And now after 7 years, the PRS and PRS Global RAB includes more than 70 members across the world with six PRS and PRS Global Open Resident Ambassadors.2 The RAB serves both PRS and their daughter journal – Plastic and Reconstructive Surgery Global Open (PRS Global Open). The key missions for the members of the RAB are to participate in three of five activities: (1) the PRS journal club on Facebook, (2) the PRS Grand Rounds (a multipronged and multitopic live lectures with question-and-answer series)2 via Facebook, (3) creation of PRS promoting videos on their own social media pages, (4) supporting PRS and PRS Global Open as a peer-reviewers, and (5) voting on the journal’s social media pages. The search for a true leader to take on the role as the Founding Resident Ambassador for the Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology was an uneasy task. After an extensive search, we are honored to start a collaboration with an oral and maxillofacial surgery (OMS) resident from the state of Alabama in the United States of America. John M. Le, DDS, MD and his colleagues in the Department of Oral and Maxillofacial Surgery at the University of Alabama at Birmingham have made a serious impact on global oral and maxillofacial surgery specialty. Moreover, their article contribution to our journal in 2020 made a huge influence by attracting an international community of readers to our journal, making us enormously proud. The masterpiece was dedicated to the use of zygomatic implants for restoration of complex nasal defects. Thereby, the current academic achievements and research activities of Dr. Le serves as a model for other OMS residents in training. In general, his clinical interests include, but is not limited to head, neck and oral oncology and reconstructive surgery.

Publication Times and Integrated Plastic Surgery Applicant Planning.

Integrated plastic surgery is one of the most competitive residencies, with 57% of applicants matching in 2021.1 Research productivity is a shared feature of applicants with matched US MD seniors producing 19.1 abstracts, presentations, and publications compared with 11.5 for unmatched seniors in 2020.1 This reflects a substantial increase from only 3.4 for matched applicants in 2007.2 In this Viewpoint, we will analyze publication times in a major plastic surgery journal pre and post-pandemic, with the goal of determining how early applicants must start plastics research to be competitive, taking these contemporary publication cycle times into account. As per Chawla et al, 35 articles published between January 1, 2019, and November 1, 2021, in Plastic and Reconstructive Surgery were chosen at random. Plastic and Reconstructive Surgery was selected as it is the highest impact factor journal in the specialty with an impact factor of 4.763. One original research article per monthly issue was reviewed. Articles accepted before March 2020 were categorized as “pre-COVID,” between March 2020 and August 2020 as “quarantine,” and September 2020 to the present as “postquarantine.” Two-tailed T-testing assessed differences. Mean submission-to-acceptance time significantly increased from 30.97 weeks pre-COVID to 56.80 weeks postquarantine (P < 0.05), whereas acceptance-to-publication time significantly decreased from 32.67 to 25.59 weeks (see Table 1). Table 1. - Mean Submission-to-acceptance and Acceptance-to-publication Times for January 2019 to November 2021 Issues of Plastic and Reconstructive Surgery Mean Submission-to-acceptance Time, wk (SD) Mean Acceptance-to-publication Time, wk (SD) Pre-COVID (n = 21) 30.97 (10.24) 32.67 (8.26) Quarantine (n = 6) 38.10 (9.79) 29.64 (4.80) Postquarantine (n = 8) 56.80 (21.46)* 25.59 (4.34)* *Significant (P < 0.05) difference between value and respective pre-COVID value. Submission-to-acceptance times were analyzed separately from submission-to-publication times, as applicants can list accepted work as publications in ERAS and PSCA applications. Further, in 2018, Plastic and Reconstructive Surgery was found to have a mean acceptance-to-publication time of 25.8 weeks, longer than the mean among all plastic surgery journals in 2018 of 10.32 weeks.3 The same study reported a mean submission-to-acceptance time of 23.3 weeks for Plastic and Reconstructive Surgery and 21 weeks for all plastic surgery journals, suggesting this metric is more generalizable. Overall, our data suggest that article submission-to-acceptance time postquarantine is greater than 1 year. This trend is supported by a selection of general journals, which demonstrated a significantly longer submission-to-acceptance time postquarantine compared with articles from 2019 at 91.35 and 75.79 days, respectively.4 This trend is exacerbated in plastic surgery journals, which significantly lag compared to other surgical subspecialty journals with median submission-to-publication time in 2018 of 208 days versus 22.1, respectively.3 With Step 1 transitioning from numerical to pass/fail scoring in 2022, further emphasis will be placed on research.5 We recommend expressing an interest in plastic surgery 2 years before applications are due. This is early M2 year for the average US senior and allows sufficient time to start multiple research projects and go through the submission-to-acceptance process in the postquarantine era. Further, we recommend research-related gap years be taken at least 2 years before the application cycle, if applicable (between M2 and M3 year) to allow for maximum publication productivity. A final consideration is for the applicant to look at publication cycle metrics/turnaround times of target journals before submission to best evaluate how these mesh with application cycle deadlines. DISCLOSURE The authors have no financial interests to declare in relation to the content of this article.

Navigating the Gray of Academic Publication: Avoiding Predatory Publishers and Creating Your "Whitelist".

Academic publishing has undergone a transition from print-based, subscription access journals targeted toward physicians and scientists to the widely accessible, open access (OA) format made possible by the Internet. The objectives of OA broadly include audience expansion and improved public access to publicly funded research, reduction of limitations on content reuse and alteration, and prompt turnaround from submission to publication. Despite well-intended founding principles, unexpected disadvantages of the OA model have arisen including the emergence of predatory journals, which exploit the author-pays publishing model with the deceptive promise of reputable publishing platforms. Predatory journals can be difficult to discern from the legitimate yet unsophisticated novice journal, which represents a destructive influence on the credibility of surgeons and scientists within many specialties. As an author, when the highly reputable, "whitelisted" journals in our field are not available or interested in the scope of our work, how can we ensure authenticity of those journals that exist in the gray area between legitimate and illegitimate? Given these questions, the goal of this article is to demystify the history and selected issues that surround academic publication including content access, licensing, indexing, and journal metrics. With this background, we then evaluate highly visible OA journals in plastic and reconstructive surgery and build a basic framework, which authors can use to evaluate a journal for legitimacy and visibility.

The Author Truncation "et al." in Article References: An Anachronism That Needs to Change.

Background: Valuable research requires contribution from many experts; however, the "et al." truncation often keeps all individuals from being acknowledged. The adoption of a new citation rule (list all authors up to 30, followed by et al.) would allow more authors to be acknowledged. The purpose of this study was to (1) explore the citation styles of the top 10 Plastic Surgery, Surgery, and Medical journals and (2) compare the number of extra pages required, and the number of additional authors acknowledged when the "new rule" is implemented. Methods: The top 10 journals in Plastic Surgery, Surgery, and Medicine were identified. The citation styles used in each of the journals were reviewed and the reference list from a recently published article was extracted. The original reference list was used to create an Extended Reference List using the new rule. Results: Most journals implemented "et al." when seven or more authors were listed. Ten articles required additional pages to accommodate the Extended Reference List. When the "et al." truncation was introduced after 30 authors, there was an almost 100% chance of all authors being included. The adoption of this rule rarely resulted in the need for additional pages, especially within Plastic Surgery. Conclusions: In a time of electronic publishing, where constraints such as article and journal page length should not be important factors, all authors should be recognized. The use of the "et al." truncation should be discouraged by all individuals involved in the production and publication of research. Scenario You are asked by the Editor-in-Chief of your specialty's journal to review an article in your area of expertise. You gladly accept the task. One of the questions you are required to answer in your review is whether the authors of the submitted manuscript have missed any important articles in their references. As you are the recognized expert in this field, you glance at the references to see if a key article you published 3 years earlier has been included. The first author of that article was a junior resident in your service and the research was done under your supervision. To their credit, the authors included the said article, but you are dismayed that the reference does not include your name. It includes only the names of the first three authors, all junior residents in your service. Your name, and the names of many others, are lost in the et al. truncation.

Trends in Female Plastic Surgery Resident Authorship - Signs of Changing Times?

Gender discrepancies exist in academia for leadership positions, advancement opportunities, and research. As of 2019, the ratio of total male-to-female attending plastic and reconstructive surgeons was 4.8:1. However, the ratio of male-to-female residents in integrated plastic surgery programs fell to 1.3:1, indicating rising female representation. With more balanced gender distributions of residents, the authors sought to determine whether this translates to greater equality of opportunities and achievements. Specifically, this study compares the academic productivity of male and female integrated plastic surgery residents. A list of integrated plastic surgery residency programs was obtained from the Accreditation Council for Graduate Medical Education website and ranked by reputation using the Doximity Residency Navigator. Integrated plastic surgery residents from 2019 to 2020 were identified via program websites and social media accounts. Works published during residency were identified through PubMed and Scopus from July 1 of each resident's intern year through August 10, 2020. Demographic variables for residents, including training class and medical school, as well as for programs, including geographic region, Doximity ranking, and medical school affiliation, were collected. Medical schools were ranked according to US News by research. Research productivity was assessed through the number of total research articles with authorship position (first, second, or last), the number of articles published in plastic surgery journals with the highest impact factors (Plastic and Reconstructive Surgery and Aesthetic Surgery Journal), and H-indices. Chi-Squared tests and Mann-Whitney U-tests were used to make comparisons between male and female residents (α = 0.05). In total, 931 residents in 81 integrated plastic surgery programs were identified, including 534 (57.4%) male and 397 (42.6%) female residents. There were no differences between male and female residents in terms of training year or program geography. Female residents were more likely to come from a top-50 medical school than males (54.7% vs. 48.1%, p = 0.049). There were no significant differences in gender distribution of residents from top-20 programs or programs affiliated with a top-20 medical school. The median (IQR) number of publications in total, and for each gender, was 3 (1-6). There was no difference in the number of total publications by training year by gender, besides the second-year resident class where male residents had a median (IQR) of 2 (1-4) compared to 1 (0-3) (p = 0.028). Male and female residents did not differ with regards to authorship position or proportion of times publishing in top journals. The distribution of H-indices for male residents was slightly higher than female residents (p = 0.003), but the median (IQR) was the same at 3 (1-5). Currently, male and female integrated plastic surgery residents have similar levels of academic productivity. This suggests that female representation is slowly increasing along the pipeline in academia, representing a paradigm shift from previous trends of gender inequality in plastic surgery.

1112 The 100 Most Influential Papers in Nail Bed Injury: A Bibliometric Analysis

Abstract Aim Nail bed injuries are the commonest paediatric hand injuries. Optimal management is essential to restoring form and function of the nail and fingertip, however high-level evidence of nail bed injury management is lacking, leading to large discrepancies in clinical practice. This paper evaluates the 100 most cited papers in nail bed injury and analyses their study characteristics to assess current research focus and evidence levels. Method A Web of Science search was carried out using the search term “nail bed injury”. All article types were included, and no language or publication date restrictions were applied. Results were ranked by overall citation number. All abstracts were screened for study relevance and the top 100 eligible studies were analysed for study type, main study theme, journal, and year of publication. Result The three most common study types included retrospective studies (n = 33), literature reviews (n = 25), case reports/series (n = 20). The three main study themes included evaluation of repair techniques (n = 72), aetiology and epidemiology of nail bed injuries (n = 12), and anatomical assessments (n = 7). The most frequently represented journals include Journal of Hand Surgery (n = 30), Plastic and Reconstructive Surgery (n = 7) and Hand Clinics (n = 4). Conclusions The most influential papers in nail bed injury are those describing repair techniques. There remains a lack of high level evidence with most papers presenting level 3-5 evidence. This paper demonstrates a continued need for more higher level robust evidence in the field of nail bed injuries.

Need for Speed: Investigating Publication Times and Impact Factors of Plastic Surgery Journals.

Background:Prolonged publishing time in scientific journals can be discouraging for researchers because earlier publication can mean a higher h-index and more academic opportunities. In this study, we evaluated the publication time for articles in plastic surgery journals compared with journals in surgery and medicine. We also assessed correlations between publication speed and journal impact factors (IFs).Methods:The overall indexes of all plastic surgery journals were compared with journals in the discipline of surgery and medicine. In addition, we evaluated original articles published in all plastic surgical journals and the highest-ranking journals from various surgical subspecialties listed in the 2018 Journal Citation Report, assessing the time intervals from submission to publication, submission to acceptance, and acceptance to publication. Correlation between time interval and journal IF were analyzed.Results:A total of 18 plastic surgery journals were compared with 210 surgical journals. Our study found that the IFs of journals significantly affect submission-to-acceptance times of the articles (P < 0.05, Wilcoxon test). The median submission-to-publication time for all plastic surgery and all surgical journals was 29.7 weeks (IQR, 12.1 and 35.8) and 22.1 days (IQR,18.8 and 36.8), respectively.Conclusions:There is a significant submission to publication time lag in plastic surgery journals when compared with other nonplastic-surgery journals. There was a positive correlation between submission-to publication time and IF for plastic surgery journals but a negative correlation for surgery journals (Spearman Correlation). In the last 14 years, plastic surgery journals have remained slow in publishing articles.

An Evaluation of Racial Diversity in Craniofacial Surgery Literature.

Implicit bias can lead to discrimination of certain populations within healthcare. Representation in medical literature is no exception and it is hypothesized that images with lighter skin tone are more prevalent than darker skin tones in craniofacial literature. Clinical photographs and figure graphics from 5 journals were examined for pre-defined years. Annals of Plastic Surgery, Aesthetic Surgery Journal, Journal of Craniofacial Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, and Plastic and Reconstructive Surgery journals were reviewed. All craniofacial-focused articles containing at least one color image depicting human skin were included. 10,477 images and 627 graphics were evaluated using the Fitzpatrick scale as a guide. Most journals trended toward broader inclusion of nonwhite photographs and graphics over time. In 2016, 47% of articles published in Journal of Craniofacial Surgery included nonwhite images compared to Annals of Plastic Surgery (16%), Aesthetic Surgery Journal (40%), Journal of Plastic, Reconstructive and Aesthetic Surgery (25%), and Plastic and Reconstructive Surgery (7%). Comparison of domestic and international publications demonstrated that author's country of origin impacted the percentage of nonwhite clinical photographs for most journals. Comparisons of publications by country demonstrated increased diversity in Asia and the Middle East for clinical photographs but not graphics. The frequency of nonwhite figure graphics was staggeringly low, identified in only 18 articles across all journals and years. Craniofacial literature more commonly reflects white skin tones. The trend over time suggests increasing inclusion of racial diversity in clinical photographs; however, figure graphics remain less racially diverse. Time, country of origin, and publishing journal appear to play a role.