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  1. Article ; Online: Reasons for Surgical Trainee Burnout in the United Kingdom.

    Mantelakis, Angelos / Horsfall, Hugo Layard

    JAMA surgery

    2023  Volume 158, Issue 8, Page(s) 890–891

    MeSH term(s) Humans ; Burnout, Professional/epidemiology ; Burnout, Psychological ; United Kingdom/epidemiology
    Language English
    Publishing date 2023-04-19
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2023.0778
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  2. Article: Developing Machine Learning Algorithms to Support Patient-centered, Value-based Carpal Tunnel Decompression Surgery.

    Mantelakis, Angelos / Khajuria, Ankur

    Plastic and reconstructive surgery. Global open

    2022  Volume 10, Issue 8, Page(s) e4494

    Language English
    Publishing date 2022-08-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000004494
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  3. Article ; Online: Evolutions in the use of Integra® and MatriDerm® in excision and reconstruction of cutaneous malignancies.

    Mantelakis, Angelos / McKean, Andrew R / Biju, Noel E / Shet, Aryan S / Geh, Jenny L C

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2024  Volume 93, Page(s) 24–27

    Language English
    Publishing date 2024-03-26
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2024.03.011
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  4. Article ; Online: The applications of machine learning in plastic and reconstructive surgery: protocol of a systematic review.

    Mantelakis, Angelos / Khajuria, Ankur

    Systematic reviews

    2020  Volume 9, Issue 1, Page(s) 44

    Abstract: Background: Machine learning, a subset of artificial intelligence, is a set of models and methods that can automatically detect patterns in vast amounts of data, extract information and use it to perform various kinds of decision-making under uncertain ... ...

    Abstract Background: Machine learning, a subset of artificial intelligence, is a set of models and methods that can automatically detect patterns in vast amounts of data, extract information and use it to perform various kinds of decision-making under uncertain conditions. This can assist surgeons in clinical decision-making by identifying patient cohorts that will benefit from surgery prior to treatment. The aim of this review is to evaluate the applications of machine learning in plastic and reconstructive surgery.
    Methods: A literature review will be undertaken of EMBASE, MEDLINE and CENTRAL (1990 up to September 2019) to identify studies relevant for the review. Studies in which machine learning has been employed in the clinical setting of plastic surgery will be included. Primary outcomes will be the evaluation of the accuracy of machine learning models in predicting a clinical diagnosis and post-surgical outcomes. Secondary outcomes will include a cost analysis of those models. This protocol has been prepared using the Preferred Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines.
    Discussion: This will be the first systematic review in available literature that summarises the published work on the applications of machine learning in plastic surgery. Our findings will provide the basis of future research in developing artificial intelligence interventions in the specialty.
    Systematic review registration: PROSPERO CRD42019140924.
    MeSH term(s) Artificial Intelligence ; Clinical Decision-Making ; Humans ; Machine Learning ; Reconstructive Surgical Procedures ; Systematic Reviews as Topic
    Language English
    Publishing date 2020-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2662257-9
    ISSN 2046-4053 ; 2046-4053
    ISSN (online) 2046-4053
    ISSN 2046-4053
    DOI 10.1186/s13643-020-01304-x
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  5. Article ; Online: Anatomical variant of physeal blood supply to the fibula.

    Mantelakis, Angelos / Mughal, Maleeha / Man, Julian / Roblin, Paul

    BMJ case reports

    2021  Volume 14, Issue 6

    Abstract: Vascularised epiphysial fibula bone transfers in the paediatric population provides a solution to growth suppression in extremity reconstruction. We report a case of an anatomical variant to the epiphysial blood supply that has never been reported in ... ...

    Abstract Vascularised epiphysial fibula bone transfers in the paediatric population provides a solution to growth suppression in extremity reconstruction. We report a case of an anatomical variant to the epiphysial blood supply that has never been reported in literature. A 6-year-old girl underwent a free vascularised fibula flap for reconstruction of her right humerous following osteosarcoma resection. While identifying and dissecting the recurrent epiphysial branch, a large branch from the peroneal artery was identified which directly entered the head of the fibula. No dominant supply from the anterior tibial (AT) vessels to the head of the fibula was seen. This led to the need for a bipedicled flap with diaphyseal supply from the AT vessels and the epiphysial transfer based on the peroneal artery. The patient made an uneventful recovery from the procedure. The same technique may be used by surgeons that may encounter this unique variant in clinical practice.
    MeSH term(s) Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/surgery ; Child ; Diaphyses ; Female ; Fibula/diagnostic imaging ; Fibula/surgery ; Free Tissue Flaps ; Humans ; Osteosarcoma/surgery ; Plastic Surgery Procedures
    Language English
    Publishing date 2021-06-07
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-240537
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  6. Article: Machine Learning Demonstrates High Accuracy for Disease Diagnosis and Prognosis in Plastic Surgery.

    Mantelakis, Angelos / Assael, Yannis / Sorooshian, Parviz / Khajuria, Ankur

    Plastic and reconstructive surgery. Global open

    2021  Volume 9, Issue 6, Page(s) e3638

    Abstract: Introduction: Machine learning (ML) is a set of models and methods that can detect patterns in vast amounts of data and use this information to perform various kinds of decision-making under uncertain conditions. This review explores the current role of ...

    Abstract Introduction: Machine learning (ML) is a set of models and methods that can detect patterns in vast amounts of data and use this information to perform various kinds of decision-making under uncertain conditions. This review explores the current role of this technology in plastic surgery by outlining the applications in clinical practice, diagnostic and prognostic accuracies, and proposed future direction for clinical applications and research.
    Methods: EMBASE, MEDLINE, CENTRAL and ClinicalTrials.gov were searched from 1990 to 2020. Any clinical studies (including case reports) which present the diagnostic and prognostic accuracies of machine learning models in the clinical setting of plastic surgery were included. Data collected were clinical indication, model utilised, reported accuracies, and comparison with clinical evaluation.
    Results: The database identified 1181 articles, of which 51 articles were included in this review. The clinical utility of these algorithms was to assist clinicians in diagnosis prediction (n=22), outcome prediction (n=21) and pre-operative planning (n=8). The mean accuracy is 88.80%, 86.11% and 80.28% respectively. The most commonly used models were neural networks (n=31), support vector machines (n=13), decision trees/random forests (n=10) and logistic regression (n=9).
    Conclusions: ML has demonstrated high accuracies in diagnosis and prognostication of burn patients, congenital or acquired facial deformities, and in cosmetic surgery. There are no studies comparing ML to clinician's performance. Future research can be enhanced using larger datasets or utilising data augmentation, employing novel deep learning models, and applying these to other subspecialties of plastic surgery.
    Language English
    Publishing date 2021-06-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000003638
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  7. Article ; Online: Are Antibiotics Needed in Septorhinoplasty? An Evidence-Based Approach.

    Mantelakis, Angelos / Argiris, Konstantinos / Joshi, Anil / D'Souza, Alwyn Ray

    Facial plastic surgery : FPS

    2022  Volume 39, Issue 6, Page(s) 686–690

    Abstract: The use of prophylactic antibiotics in the context of septorhinoplasty (SRP) is a frequently debated topic among plastic surgeons. Most surgeons routinely use antibiotics to prevent the dreaded physical and psychological morbidity of postoperative ... ...

    Abstract The use of prophylactic antibiotics in the context of septorhinoplasty (SRP) is a frequently debated topic among plastic surgeons. Most surgeons routinely use antibiotics to prevent the dreaded physical and psychological morbidity of postoperative infections, although this practice is controversial. With antimicrobial resistance becoming a global threat, however, optimizing antibiotic prescribing is essential. The current evidence would suggest that the rate of postoperative infection is low and routine antibiotic use is unnecessary in SRP surgery. Rates range from 0.5 to 2% in simple SRP surgery, majority of which are minor nasal infections which respond to oral antibiotics and do not require hospital admission. In cases of complex SRP, defined as revision cases or where grafts or implants have been utilized, infection rates can be much higher with an incidence of 7 to 11%, and as such utilization of antibiotics is reasonable. When considering the regime to be utilized, a single preoperative dose of intravenous antibiotics has the same efficacy in reducing the incident of postoperative infection as a postoperative 7-day course of oral antibiotics. In the authors' practice, all patients receive a single intravenous dose of antibiotics on induction, and in the case of utilization of a graft from a nonnasal site, this is complimented with an oral course of postoperative antibiotics. With this approach, infections rates are at the lowest range of available published literature.
    MeSH term(s) Humans ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; Postoperative Complications/prevention & control ; Rhinoplasty/adverse effects ; Surgical Wound Infection/prevention & control
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-08-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 630090-x
    ISSN 1098-8793 ; 0736-6825
    ISSN (online) 1098-8793
    ISSN 0736-6825
    DOI 10.1055/a-1920-0876
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  8. Article ; Online: An alternative approach to the intraoperative Indocyanine Green angiography (ICGA) in reconstructive surgery.

    Mantelakis, Angelos / Sapountzis, Stamatis

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2018  Volume 72, Issue 1, Page(s) 137–171

    MeSH term(s) Adult ; Angiography/methods ; Back ; Breast Neoplasms/surgery ; Coloring Agents ; Female ; Humans ; Indocyanine Green ; Infrared Rays ; Intraoperative Care/methods ; Laparoscopy/methods ; Male ; Melanoma/surgery ; Middle Aged ; Reconstructive Surgical Procedures/methods ; Skin Neoplasms/surgery ; Surgical Flaps/blood supply ; Tibial Fractures/surgery
    Chemical Substances Coloring Agents ; Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2018-09-23
    Publishing country Netherlands
    Document type Case Reports ; Letter
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2018.09.009
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  9. Article ; Online: Use of Novel Decellularized Cadaveric Dermis (DCELL) in Single-Stage Resection and Reconstruction of Nonmelanomatous Skin Cancer of the Head and Neck.

    Mantelakis, Angelos / Kostantinos, Argiris / D'Souza, Alwyn / Joshi, Anil

    Facial plastic surgery : FPS

    2021  Volume 37, Issue 5, Page(s) 599–605

    Abstract: Reconstructive options in nonmelanomatous skin tumors of the head and neck region are limited in the frail, elderly patient group, where split skin thickness or full thickness grafts may not be a viable option. This study examines the use decellularized ... ...

    Abstract Reconstructive options in nonmelanomatous skin tumors of the head and neck region are limited in the frail, elderly patient group, where split skin thickness or full thickness grafts may not be a viable option. This study examines the use decellularized cadaveric dermis (DCELL), an acellular dermis product produced in the United Kingdom for the reconstruction of these skin defects. This was a single-center, prospective study of patients undergoing single stage wide local excision of nonmelanomatous skin cancer and reconstruction with decellularized dermis. Our inclusion criteria included any patient that required a curative excision but had risk factors where conventional local flap or free tissue transfer could have a potential adverse outcome. Thirty-seven wounds were treated with DCELL in 31 patients. Mean age was 81.6 years (range 61-94 years) and at the time of operation, 25 patients (80.7%) were ASA 3 or above. The scalp was the most common anatomical area operated on (
    MeSH term(s) Acellular Dermis ; Aged ; Aged, 80 and over ; Cadaver ; Head and Neck Neoplasms/surgery ; Humans ; Middle Aged ; Prospective Studies ; Reconstructive Surgical Procedures ; Skin Neoplasms/surgery ; Skin Transplantation
    Language English
    Publishing date 2021-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 630090-x
    ISSN 1098-8793 ; 0736-6825
    ISSN (online) 1098-8793
    ISSN 0736-6825
    DOI 10.1055/s-0041-1725163
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  10. Article ; Online: The management of partial extensor tendon lacerations of the hand and forearm: A systematic review.

    Dickson, Kathryn / Mantelakis, Angelos / Reed, Alistair J M / Izadi, David / Wade, Ryckie G / Wormald, Justin / Furniss, Dominic

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2023  Volume 85, Page(s) 34–43

    Abstract: Injuries to the extensor mechanism of the hand and forearm are common and cause significant functional disability. Complete tendon lacerations are managed with surgical repair, whereas selected partial tendon injuries may be managed without repair but ... ...

    Abstract Injuries to the extensor mechanism of the hand and forearm are common and cause significant functional disability. Complete tendon lacerations are managed with surgical repair, whereas selected partial tendon injuries may be managed without repair but with splinting and physiotherapy alone. There is limited evidence to support the management of partial lacerations, in particular the decision of whether to repair or not. We aimed to systematically review the literature to determine the optimal management of partial extensor tendon lacerations in the hand and forearm. A protocol for the systematic review was developed prospectively and registered with PROSPERO (CRD42021250431). PubMed, EMBASE, clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1990 to 27/05/2022. 4565 studies were screened, of which 88 underwent full text review. Five studies were included, one randomised control trial and four cohort studies. One study examined outcomes of partial lacerations treated without repair; the other four studies examined outcomes following repair. Pinch and grip strength and time to return to work were similar regardless of management. Adverse outcomes were reported for patients undergoing surgical repair; none were observed in those managed without repair. Meta-analysis was precluded by study heterogeneity and high risk of bias. There is limited evidence to support the management of partial extensor tendon lacerations, with some low-quality evidence that non-operative management of selected partial lacerations is safe. There is a pressing need for pragmatic, multicentre randomised trials to assess the cost-effectiveness of current treatments.
    MeSH term(s) Humans ; Forearm/surgery ; Hand ; Lacerations/surgery ; Tendon Injuries/surgery ; Tendons/surgery
    Language English
    Publishing date 2023-06-09
    Publishing country Netherlands
    Document type Journal Article ; Systematic Review
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2023.06.004
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