[Plastic surgery under challenging conditions: the concept of the five F's]

This work was done essentially for the benefit of the surgeon who wishes to practice plastic surgery under challenging conditions. The questions he asks himself are most often aimed at what type of pathology he will encounter during his mission, on the operating techniques he will have to adopt and the surgical principles he will have to observe in this type of environment. This presentation tries to come up with an answer, among others, by offering a concept which could be adapted to surgical techniques under challenging conditions. The study, retrospectively, of 100 patients operated during a mission led us to suggest six techniques of reconstructive surgery. We have observed the conditions in which we can apply these different techniques and we have paid a lot of attention and reflection on the environment of our therapy. Before going on a plastic surgery mission we strongly advise the surgeon to bear in mind, in his choice of a surgical technique, the following concepts: the ultimate goal to be reached, the feasibility of the surgical practice, the safety of the technique, the familiarity of the surgical procedure and the easiness to teach of the method.