Plastic surgery

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Plastic surgery is a medical specialty concerned with the correction or restoration of form and function.

Plastic surgery also includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns.

Hand Surgery

The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (commonly from the tip of the hand to the shoulder). The procedures may also be performed by an Orthopaedic surgeon who has a sub-speciality in upper limb.

Plastic surgeons and orthopaedic surgeons receive significant training in hand surgery, with some continuing on to do an additional one year hand fellowship.

Plastic surgeons are particularly well suited to handle traumatic hand and digit amputations that require a "replant" operation. Orthopaedic surgeons are trained to reconstruct all aspects to salvage the appendage: tendons, muscle, bone and are therefore particularly well suited to handle complex fractures of the hand and injuries to the carpal bones that alter the mechanics of the wrist.

Hand surgeons perform a wide variety of operations such as fracture repairs, releases, transfer and repairs of tendons and reconstruction of injuries, rheumatoid deformities and congenital defects. They also perform microsurgical reattachment of amputated digits and limbs, microsurgical reconstruction of soft tissues and bone, nerve reconstruction, and surgery to improve function in paralysed upper limbs.

Microsurgery

Microsurgery is a general term for surgery requiring an operating microscope. The two main areas where this has been utlised by plastic surgeons is as follows:

  • Free tissue transfer - where a viable piece of tissue is used to repair a damaged one after trauma such as a car accident, or for reconstruction following a cancer resection
  • Replantation - where an amputed or severed body part is reattached ensuring restoration of blood flow through arteries and veins, bony skeleton, connecting tendons and nerves as required

Reconstructive surgery

As it sounds, it is the attempted restoration of the anatomy or the function of the body part to normal. Reconstructive plastic surgeons use the concept of a reconstructive ladder to manage increasingly complex wounds. This ranges from very simple techniques such as primary closure and dressings to more complex skin grafts, tissue expansion and free flaps.