Standortbestimmung – Status quo der plastisch-rekonstruktiven Chirurgie aus der Sicht der Handchirurgie

Modern plastic-reconstructive surgery, much like hand surgery, repres a young and fast-developing surgical discipline. The principles of plastic surgery originate in the developmental stages of surgery and have considerable influence on hand surgery. Microsurgery, free or pedicled transfer of tissue, peripheral nerve surgery, plexus surgery, tendon transfers, arthroplasty, vascularized bone transfers, or toe to thumb transplants, are all performed while considering plastic surgical principles and represent just a part of plastic surgical techniques which are daily applied in hand-surgical routine. They emphasize the intimate relationship and the mutual influence between the two disciplines. The future of plastic surgery is likely to include composite tissue allotransplantation, flap prefabrication, virtual surgical planning, application of growth factors to influence bone growth, fracture healing, angiogenesis, tendon healing or wound healing. Furthermore, the field of tissue engineering is likely to introduce novel materials, such as nerve conduits. All of the above may have direct influence on hand surgery and, therefore, the future of plastic and hand surgery is at least as intricately intertwined as was their past. They will remain related through the characteristics that led to their development: innovation, creativity, diversity and the search for individualized solutions.