Background: Postoperative bed rest is considered essential after free flap reconstruction of the lower limb to ensure microsurgical success, but prolonged inactivity can lead to physical deconditioning and psychosocial challenges, even in otherwise healthy patients. While early mobilization protocols improve physical recovery, their impact on psychological wellbeing remains underexplored. This review evaluates the current literature on postoperative protocols in microvascular lower extremity reconstruction, focusing on both physical and mental health outcomes, and explores potential strategies for optimizing recovery. Methods: A systematic review was conducted following the PRISMA guidelines to search PubMed, Cochrane Library, and Embase databases. Studies were included if they explicitly described postoperative immobilization or mobilization protocols and their impact on recovery outcomes, including complications and psychological effects. Results: Sixteen studies met the inclusion criteria, highlighting the potential of early mobilization protocols in reducing complications such as pneumonia, deep vein thrombosis, and prolonged hospital stays. Structured mobilization strategies, such as early dangling and perfusion-controlled mobilization, demonstrated improved microcirculatory adaptation and enhanced recovery outcomes. However, limited to no research addressed psychological resilience and the impact of immobility on patient mental health. Conclusions: Early mobilization protocols significantly improve physical outcomes after free flap surgery, but the psychological and mental effects of postoperative bed rest remain insufficiently studied. Adapting strategies from space medicine, including structured routines, cognitive training, and social engagement, offers promising avenues for enhancing recovery. Future research should focus on integrating physical and psychological interventions into comprehensive, evidence-based recovery protocols to optimize patient outcomes.

Background and Objectives: Providing high-quality care for patients in hand surgery is an everyday endeavor. However, the quality of life (QoL) and working conditions of hand surgeons ensuring these high-quality services need to be investigated. The aim of this study was to evaluate the QoL and working conditions of Swiss hand surgeons. Materials and Methods: A national survey with Swiss hand surgeons was conducted. Standardized questionnaires were completed anonymously online. Core topics included working conditions, QoL, satisfaction with the profession, and aspects of private life. Results: A total of 250 hand surgeons were invited to participate, of which 110 (44.0%) completed the questionnaire. Among all participants, 43.6% stated that they are on call 4–7 days per month, versus 8.2% never being on call. Overall, 84.0% of the residents, 50.0% of the senior physicians, 27.6% of the physicians in leading positions, and 40.6% of the senior consultants/practice owners, as well as 55.1% of the female and 44.3% of the male respondents, felt stressed by their job, even during holidays and leisure time. Out of all participants, 85.4% felt that work affects private relationships negatively. Despite the reported stress, 89.1% would choose hand surgery as a profession again. Less on-call duty (29.1%) and better pay (26.4%) are the most prioritized factors for attractiveness of a position at a hospital. Conclusions: The QoL of Swiss hand surgeons is negatively affected by their workload and working hours. Residents, senior physicians and female surgeons suffer significantly more often from depression, burnout or chronic fatigue in comparison to leading positions, senior consultants/practice owners and male surgeons. Better pay or less on-call duty would make the work more attractive in acute care hospitals.

Fingers of sport climbers are exposed to high mechanical loads. This work focuses on the fingers of a 52-year-old active elite climber who was the first in mankind to master 8B (V13), 8B+ (V14) and 8C (V15) graded boulders, bringing lifelong high-intensity loads to his hands. It is therefore hypothesized that he belongs to a small group of people with the highest accumulative loads to their fingers in the climbing scene. Fingers were analyzed by means of ultrasonography, X-rays and physical examination. Soft tissue and bone adaptations, as well as the onset of osteoarthritis and finger stiffness, were found, especially in digit III, the longest and therefore most loaded digit. Finally, this article aims to provide an overview of the current literature in this field. In conclusion, elite sport climbing results in soft tissue and bone adaptations in the fingers, and the literature provides evidence that these adaptations increase over one’s career. However, at later stages, radiographic and clinical signs of osteoarthritis, especially in the middle finger, seem to occur, although they may not be symptomatic.

Background: While the well-being and working conditions of healthcare professionals are increasingly scrutinized, there remains a critical research gap regarding the quality of life and job satisfaction of plastic surgeons in Switzerland. No prior national study has systematically examined these aspects within this specialty. Objective: This study aims to address this gap by evaluating workload, career satisfaction, and quality of life among Swiss plastic surgeons and trainees, thereby providing evidence to inform systemic improvements in the profession. Methods: A national, multilingual online survey was distributed to all members of the Swiss Society for Plastic Surgery and the Association of Young Plastic Surgeons. A total of 102 plastic surgeons responded (response rate: 22.7%). The survey assessed contractual versus actual working hours, work performed during personal time, mental health indicators (e.g., burnout), and career satisfaction. Descriptive and correlational analyses were conducted. Results: The respondents reported an average of 58 actual versus 49 contractual working hours per week, with an additional 8.1 h spent working during leisure time. Burnout symptoms were present in 29%, and 63% experienced work-related stress during their free time. While 42% wished to reduce their workload, 88.7% would still choose the profession again. Career satisfaction averaged 3.66/5, although 35% rated their salary as inadequate. Notably, 79.8% reported work negatively affecting private relationships, despite 82.65% feeling supported by their environment. Conclusion: This first nationwide assessment highlights the high workload and psychological strain faced by Swiss plastic surgeons. Key priorities include targeted burnout prevention, structural workload reduction, enhanced support for work–life integration (especially among women and younger surgeons), and improved compensation. These measures are essential to sustain the well-being of practitioners and ensure long-term quality in surgical care.

Background: Carpometacarpal (CMC-I) arthritis is a frequent and disabling condition. Standard surgical options include trapeziectomy and prosthetic arthroplasty. While quantitative outcomes have been widely studied, little is known about patient perspectives regarding function, aesthetics, and rehabilitation. Methods: We conducted semi-structured interviews with ten patients who had undergone trapeziectomy on one side and prosthesis implantation on the contralateral side. Interviews were performed ≥6 months postoperatively, audio-recorded, transcribed verbatim, and analyzed thematically following Braun and Clarke’s framework. Researcher triangulation and member checking were applied to enhance trustworthiness. Results: Four overarching themes were identified. (1) Strength: Most patients reported greater strength and endurance on the prosthetic side, though both hands were generally adequate for daily activities. (2) Rehabilitation: Recovery after prosthesis implantation was described as markedly faster and less burdensome, with reduced need for therapy compared to trapeziectomy. (3) Aesthetics: Trapeziectomy was often associated with dissatisfaction due to thumb shortening and collapse, while prostheses were perceived as restoring a more natural appearance. (4) Surgical preference: When asked which procedure they would hypothetically choose again, all participants favored prosthesis implantation, citing superior function, faster recovery, and more favorable aesthetics. Conclusions: Patients who experienced both procedures consistently preferred prosthesis implantation. Their narratives highlight dimensions beyond standard clinical scores, including rehabilitation burden, appearance, and psychosocial impact. Incorporating patient-reported outcomes into surgical counseling is essential to align treatment of CMC-I arthritis with patient priorities and to support shared decision-making.