Reply: Adipose Tissue–Preserved Skin Graft: Applicability and Long-Term Results
Bibliographic record
Abstract
Sir: We would like to thank Drs. Uysal and Ertas for their considerate letter regarding our article.1 Although grafts for two of the six cases that had less than 100 percent graft take were on the nose, 33 of the grafts in this case series were on the nasal region. Incomplete graft take has not been a regular occurrence in the senior author’s experience. However, the senior author speculates that incomplete graft take for the grafts on the nose is likely attributable to increased motion/shear forces on the graft, either from motion related to breathing (such as nostril flaring), facial expression, or manipulation of the nose (e.g., blowing or scratching one’s nose). The security and compressiveness of the bolster dressing become essential for grafts in movement-prone areas to minimize shear movements as much as possible; however, even with the best of bolsters, such movements may be unavoidable in a small number of cases. With respect to donor site and graft take, the senior author has not noticed any relationship between donor site and graft take. Although grafts taken from the groin did have a higher proportion of incomplete graft take (three of 30), the size of the graft was also higher when skin was taken from the groin, with a median graft size of 10 cm2 (range, 2 to 210 cm2). The median graft size of all other donor sites was 5 cm2 (range, 0.7 to 80 cm2). The median size of grafts taken from the groin with incomplete graft take was 36 cm2 (range, 5 to 210 cm2). Larger defects require larger grafts, and the groin donor site becomes the preferred site in these scenarios because of (1) easy accessibility, (2) excellent scar concealment, and (3) a relatively large abundance of skin availability that can be harvested without complication. However, although it appears that there is a relationship between the groin donor site and graft take, this relationship is likely accounted for by the fact that the risk of incomplete take increases as graft size increases and that the groin is preferentially selected for larger defects as the donor site. DISCLOSURE The authors have no financial interest to disclose. David T. W. Chiu, M.D.Department of Plastic SurgeryNew York University Langone Medical CenterNew York, N.Y. Bryan Chung, M.D., Ph.D.Department of SurgeryUniversity of British ColumbiaVancouver, British Columbia, Canada
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.014 | 0.013 |
| Insufficient payload (model declined to judge) | 0.003 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".