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KEY POINTS

Key Points

  • image It is critical to understand the physiologic basis and rationale of wound healing in order to further assimilate surgical and nonsurgical care of wounds and methods of wound care.

  • image Understanding the reconstructive choices in tissue repair cases is critical for any surgeon. The principles of soft tissue and skin repair are important for the reconstruction of defects, whether in a trauma situation of after excision of lesions.

  • image Children with cleft and craniofacial differences have complex medical, surgical, and social needs. Coordinated, interdisciplinary team care is crucial to success.

  • image Robin sequence, characterized by micrognathia, glossoptosis, and airway obstruction, can be managed with prone positioning, tongue-lip adhesion, mandibular distraction osteogenesis, or tracheostomy.

  • image The first-line treatment for high-risk hemangiomas is oral propranolol, which can induce rapid involution and has a more favorable side effect profile than systemic steroids.

  • image The coordination of care for patients in a trauma department is an important part of a surgeon’s role, whether that role be as a trauma emergency department surgeon or a surgeon in practice.

  • image The careful evaluation of a patient in a polytrauma involves a thorough assessment of internal and soft tissue injuries, planning of care, and the appropriate triage of reconstructive procedures. As a leader in a trauma bay of the trauma service, the surgeon typically assumes a captain’s role in decision-making.

  • image Principles of oncologic reconstruction have evolved significantly, and a deeper understanding of these reconstructive choices is essential for a surgeon who is often the first point of contact for cancer patients and responsible for making critical referrals.

  • image The combined work of general surgeons and reconstructive plastic surgeons has revolutionized the care of abdominal wall defects, including ventral hernias, repair after tumor ablation, and bariatric surgery.

  • image Any critical care unit or a medical surgical team that takes care of debilitated patients needs a detailed understanding of pressure sores, including their etiology and the reconstructive options that are available to these patients.

INTRODUCTION

Plastic and reconstructive surgery is a unique subspecialty of surgery that consists of a set of techniques intended to modify the amount, position, quality, or organization of tissues in order to restore function and appearance. The name of the field is derived from the Greek word plastikos, which means “to mold.” An object is considered plastic if its shape can be modified without destruction. In this sense, all human tissues have some degree of plasticity. They can be nondestructively modified if the surgeon adheres to certain principles. Understanding and applying these principles to solve clinical problems is the essence of plastic and reconstructive surgery. Although informal references to this type of surgery can be found in the modern literature as early as the 17th century, American surgeon John Staige Davis published the first textbook dedicated to the field in 1919, entitled Plastic Surgery—Its Principles and Practice. He coined the term that we have used to refer to the specialty ever since. Science has ...

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