Background: Artificial intelligence (AI) and large language models (LLMs) are increasingly used in healthcare, with applications in clinical decision-making and workflow optimization. In head and neck surgery, postoperative rehabilitation is a complex, multidisciplinary process requiring personalized care. This study evaluates the feasibility of using LLMs to generate tailored rehabilitation programs for patients undergoing major head and neck surgical procedures. Methods: Ten hypothetical head and neck surgical clinical scenarios were developed, representing oncologic resections with complex reconstructions. Four LLMs, ChatGPT-4o, DeepSeek V3, Gemini 2, and Copilot, were prompted with identical queries to generate rehabilitation plans. Three senior clinicians independently assessed their quality, accuracy, and clinical relevance using a five-point Likert scale. Readability and quality metrics, including the DISCERN score, Flesch Reading Ease, Flesch–Kincaid Grade Level, and Coleman–Liau Index, were applied. Results: ChatGPT-4o achieved the highest clinical relevance (Likert mean of 4.90 ± 0.32), followed by DeepSeek V3 (4.00 ± 0.82) and Gemini 2 (3.90 ± 0.74), while Copilot underperformed (2.70 ± 0.82). Gemini 2 produced the most readable content. A statistical analysis confirmed significant differences across the models (p < 0.001). Conclusions: LLMs can generate rehabilitation programs with varying quality and readability. ChatGPT-4o produced the most clinically relevant plans, while Gemini 2 generated more readable content. AI-generated rehabilitation plans may complement existing protocols, but further clinical validation is necessary to assess their impact on patient outcomes.

Background: Burn injuries require accurate assessment for effective management, and artificial intelligence (AI) is gaining attention in burn care for diagnosis, treatment planning, and decision support. This study compares the effectiveness of AI-driven models with experienced plastic surgeons in burn assessment and management. Methods: Ten anonymized burn images of varying severity and anatomical location were selected from publicly available databases. Three AI systems (ChatGPT-4o, Claude, and Kimi AI) analyzed these images, generating clinical descriptions and management plans. Three experienced plastic surgeons reviewed the same images to establish a clinical reference standard and evaluated AI-generated recommendations using a five-point Likert scale for accuracy, relevance, and appropriateness. Statistical analyses, including Cohen’s kappa coefficient, assessed inter-rater reliability and comparative accuracy. Results: AI models showed high diagnostic agreement with clinicians, with ChatGPT-4o achieving the highest Likert ratings. However, treatment recommendations varied in specificity, occasionally lacking individualized considerations. Readability scores indicated that AI-generated outputs were more comprehensible than the traditional medical literature, though some recommendations were overly simplistic. Cohen’s kappa coefficient suggested moderate to high inter-rater agreement among human evaluators. Conclusions: While AI-driven models demonstrate strong diagnostic accuracy and readability, further refinements are needed to improve treatment specificity and personalization. This study highlights AI’s potential as a supplementary tool in burn management while emphasizing the need for clinical oversight to ensure safe and individualized patient care.

Background: Hand surgery is increasingly transitioning from hospital operating theatres to outpatient settings, requiring anaesthetic methods that are efficient, cost-effective, and patient-centred. Traditional anaesthesia, such as general anaesthesia, poses challenges including prolonged recovery and physiological stress. Novel strategies, such as Wide-Awake Local Anaesthesia No Tourniquet (WALANT), ultrasound-guided distal nerve blocks, and adjunctive approaches (vapocoolant spray, patient-controlled regional analgesia, cryoanalgesia, jet injectors), have emerged to address these limitations. This narrative review consolidates current evidence regarding the efficacy, applicability, and economic implications of these evolving anaesthesia techniques. Methods: A literature search was conducted across MEDLINE, Embase, CENTRAL, and Scopus databases up to 1 June 2025. Inclusion criteria were English-language original studies on WALANT, vapocoolant sprays, ultrasound-guided distal nerve blocks, or emerging adjunctive anaesthesia methods applicable to hand and upper limb surgery. Exclusion criteria included non-English publications and those without original clinical data. Two independent reviewers screened and selected studies, ensuring relevance and methodological quality. Results: WALANT can provide high patient satisfaction, cost savings of 70–85%, and allow for real-time functional testing during surgery. Ultrasound-guided nerve blocks provided targeted analgesia, preserved elbow function, reduced the need for sedation, and improved perioperative efficiency. Adjuncts such as vapocoolant sprays significantly decreased needle-injection discomfort, offering quick and economical analgesia for superficial procedures. Other emerging adjuncts, including patient-controlled regional anaesthesia (PCRA), cryoanalgesia, and jet injectors, offered additional patient-tailored pain management options, although with higher resource demands. Conclusions: The review highlights the transformative potential of WALANT and adjunctive techniques to enhance efficiency, patient experience, and cost-effectiveness in hand surgery. Despite clear benefits, optimal application requires tailored patient selection, clinician familiarity, and consideration of procedure-specific demands.

Introduction: Surgery using local anaesthetic without sedation outside of a formal operating theatre is particularly applicable to plastic surgery. This paper reviews the benefits and pitfalls of a minor procedure room as a novel solution to tackling the emergency and elective surgery caseload in a tertiary metropolitan plastic surgery unit. Methods: From February 2022 until February 2023 local anaesthetic only procedures were undertaken in a minor procedure room. Patients included ranged from 18 to 88 years of age. Outcomes included complications and procedure failure requiring repeat procedure in an operating theatre. Estimated cost savings were calculated according to staff wages and do not account for consumables. Estimated duration of minor procedure room operation was one hour per case. Results: Overall, 350 patients (285 male, 65 female) underwent local anaesthetic only procedures in the minor procedure room. The mean age of patients was 42. There were 309 hand/upper limb cases, 31 general plastic surgery cases, two skin cancer excisions and eight lower limb cases. There were no complications and no procedure failures. The average cost saved per procedure is estimated to be AU$486 with an average reduction of 44 theatre sessions per year. Conclusion: A minor procedure room for local anaesthetic only surgery can generate significant cost and time savings for a hospital when implemented and managed appropriately. This model has been successful in our institution and can likely be replicated in other centres.

Introduction: In July 2022 a new Medicare Benefits Schedule (MBS) item number 30175 was created for a radical abdominoplasty with rectus diastasis repair. To qualify for this benefit and attain a significant reduction in their out-of-pocket surgical cost, patients are required to undergo preoperative radiological assessment of their rectus diastasis with a measured inter-rectal distance (IRD) of 3 cm or more. This study examines the relationship between preoperative radiological evaluation of the IRD and intraoperative measurements for patients undergoing abdominal wall procedures with rectus diastasis repair. Methods: This study included patients aged 18 years and older who underwent abdominal skin procedures with rectus diastasis repair from March 2022 to April 2024. Preoperative ultrasound assessed the IRD, defined as the distance between the medial edges of the rectus abdominus muscle, with maximum IRD values recorded. Intraoperative IRD measurements were taken at the reported radiological IRD locations using a sterile ruler. Paired t-tests were employed for statistical analysis. Results: The study involved 27 female patients with a median age of 52 years. Preoperative ultrasound consistently underestimated the IRD (mean = 31.9 mm, SD = 9.6) compared to intraoperative measurements (mean = 39.4 mm, SD = 10.2), with a mean difference of 7.43 mm (p = 0.003). Discussion: Ultrasound is a reliable diagnostic tool, however, its accuracy in measuring IRD has come under scrutiny in the wake of the introduction of MBS item number 30175. Speculative explanations for the discrepancy between radiological and intraoperative measurements are discussed including measurement bias, anatomical factors and mechanical factors. Conclusion: Preoperative ultrasound significantly underestimates the IRD compared to in vivo findings in patients with rectus diastasis. Surgeons should anticipate finding larger in vivo diastasis compared to preoperative radiological values.