General aspects

chirurgia plastica


The term "plastic" derives from the greek 'model' and indicates that this surgery is aimed at correction of defects and therefore the appearance of the outer structure of the individual. Character peculiar plastic surgery is the overriding importance of choice reparative diagnosis: This fact offers no difficulty because it is normally paid to external problems, easily identifiable by the surgeon, while the choice of the type of surgery, especially when we need more than one, creates the problem of its planning over months or even year old. This particular aspect of plastic surgery was suggestively called "surgery four dimensions "meaning as the fourth dimension time over which should always be considered the result. As time passes, in fact, two phenomena occur fundamental and inescapable: the patient evolves to the natural aging, changing the appearance and structure of tissue and body tissues traumatized by the Act undergo surgery the metabolic changes, especially vascular type, with consequent alterations in appearance and biological behavior.

The scar that fatally residual intervention evolves also, inevitably changing the end result. Another feature of the plastic surgery is that of not being surgery organ or district but of the whole body. The single plastic surgeon identifies certainly the scope within which prefers to operate, but in its most general sense, the plastic surgery is not anatomic or technical know borders to achieve her goal: bring what appears diverted within the confines of normality, with restoration of function that this anomaly can be determined, having as parameter guiding the quintessence of normality, "supernormality", in a word "Beauty".

Lesions affecting the plastic surgeon are of two kinds:

• congenital lesions, due to deviations of the normal embryonic development and therefore already present at birth;

• injuries acquired during the course of life, from birth onwards.

Historical notes

The psychological boost to the correction of abnormalities in body, both for reasons pathological is simply aesthetic, explains the ancient origins of plastic surgery. The first report of surgical interventions of this type is in fact the one contained in the papyrus of Smith dating back to 3000 BC. More concrete are descriptions of reconstructions of the nasal tip contained in the codes Veda, previous 800 BC: As in India, the law provided for the amputation of the nose to thieves and adulteress, was described the use of a skin flap rotated from the front of reparative purposes. This solution, still valid today, is known as "Indian method". Descriptions later, after a long period of silence that covers the Greek, Roman, Arab and medieval, dating back to 1400 A.D. when Antonio Branca Catania became famous for his method of reconstruction of the nose using a skin flap transferred from the arm with a series of operations. Around the same time the fame of the brothers Vianeo Tropea spread throughout Europe for a similar method of reconstruction of the nose; they worked, like the Branch, with great secrecy for fear that they be removed from the secret proceedings. Failed But to prevent that with a subterfuge he came into possession a knight from Bologna who, back to his city, described in detail the method to Gaspare Tagliacozzi, professor of anatomy at Bologna. These exposed him in 1597 in a treaty which is the first description technically valid and complete with a plastic surgery and is considered the work of this basic discipline. One can then place in that time the true birth of plastic surgery, although in Then, for a long period, it returned in the silence. It is indeed understandable that a surgical material, dedicated to problems generally do not strictly vital and indispensable, has found insurmountable difficulties to develop in the absence of notions of anesthesia, antisepsis and appropriate technical means. Only in the second half of the 800 are found descriptions of new techniques and solutions. Surgery Modern plastic knows a definitive development and acquires a precise definition because of thousands of maimed survivors of the First World War to be reinserted in the life sociale. Tra First and Second World War are opened in all countries care centers and rehabilitation. in the Forties surgical advances, notably the introduction into clinical practice of antibiotics and anesthesia with endotracheal intubation, also open to plastic surgery new development opportunities and new fields of action. From plastic surgery originated related disciplines, in which the median skills of other surgical specialties, whose body of doctrine has now developed to the point of cost-Tuire authentic new skills; remember in especially hand surgery, which combine expertise and orthopedic and plastic maxillofacial surgery, where melt plastic and dental skills. a deep change is derived, in the last 15 years, from the application of microsurgical techniques. These methods have assumed a major role in the treatment, in the emergency or urgency, vascular or nerve trauma, especially of the limbs as well as in the realization of reconstructive projects not otherwise feasible. A recent innovation armory technician the plastic surgeon is the use of endoscopy, through which you can run some interventions greatly reducing the size of the scars. Can be glimpsed, for a future now next, exciting developments related to the biosynthesis of anatomical structures intended for autologous transplantation with microsurgical techniques, reducing more and more the use of healthy donor areas within the same organism. For many years now plastic surgery has abandoned secrets and mysterious aspects of a alchemy surgery and has become specialist subject in its own right with hospital activity and university, graduate schools, technical own original evolving.