Overview of modern surgery

Although it is sometimes difficult to determine when a medical procedure is considered surgery,a medical treatment that involves a cutting of a patient's live tissue (e.g., hair and nails are dead tissue) is usually considered surgery of some sort. A medical procedure involving a drilling of live tissue in a body would often be considered surgery, but mere piercing of a body is not necessarily surgery since piercing is often done for taking samples or draining fluids from or injecting materials into the body, or setting up intravenous drip, and usually does not require suturing to close the pierced opening. Even if a medical procedure or treatment does not include cutting or drilling of live tissue in a body, it may be considered surgery, if it involves common surgical procedure or a setting, such as use of an operating room or table in a hospital, anesthesia, ntiseptic conditions, typical surgical instruments, and suturing or stapling. Surgery is considered an invasive procedure. Examples of surgery without cutting the body may include debridement or closing (suturing or stapling) an open wound or applying skin grafts if done under typical surgical conditions. Many types of more complicated or involved surgery are obviously considered surgery, since they involve common surgical procedure or setting as mentioned above. A medical procedure may be surgery even if not all of the typical surgical conditions or procedures mentioned above are used.

Replantation

Replantation is the reattachment of a completely detached body part. Fingers and thumbs are the most common but the ear, scalp, nose, arm and penis have all been replanted. Generally replantation involves restoring blood flow through arteries and veins, restoring the bony skeleton and connecting tendons and nerves as equired.

Initially, when the techniques were developed to make replantation possible, success was defined in terms of a survival of the amputated part alone. However, as more experience was gained in this field, surgeons specializing in replantation began to understand that survival of the amputated piece was not enough to ensure success of the replant. In this way, functional demands of the amputated specimen became paramount in guiding which amputated pieces should and should not be replanted. Additional concerns about the patients ability to tolerate the long rehabilitation process that is necessary after replantation both on physical and psychological
levels also became important. So, when fingers are amputated, for instance, a replantation surgeon must seriously consider the contribution of the finger to the overall function of the hand. In this way, every attempt will be made to salvage an amputated thumb, since a great deal of hand function is dependent on the thumb, while an index finger or small finger may not be replanted, depending on the individual needs of the patient and the ability of the patient to tolerate a long surgery and a long course of rehabilitation.


However, if an amputated specimen is not able to be replanted to its original location entirely, this does not mean that the specimen is unreplantable. In fact, replantation surgeons have learned that only a piece or a portion may be necessary to obtain a functional result, or especially in the case of multply amputated fingers, a finger or fingers may be transposed to a more useful location to obtain a more functional result. This concept is called "spare parts" surgery.

Techniques and procedures

Common techniques used in plastic surgery are:

* incision
* excision
* microsurgery
* chemosurgery
* electrosurgery
* laser surgery
* dermabrasion
* liposuction

In plastic surgery the transfer of skin tissue (skin grafting) is one of the most common procedures. (In traditional surgery a “graft” is a piece of living tissue, organ, etc., that is transplanted.

* Autografts: Skin grafts taken from the recipient. If absent or deficient of natural tissue, alternatives can be:
o Cultured Sheets of epithelial cells in vitro.
o Synthetic compounds (e.g., Integra--a 2 layered dermal substitute consisting superficially of silicone and deeply of bovine tendon collagen with glycosaminoglycans).
* Allografts: Skin grafts taken from a donor of the same species.
* Xenografts: Skin grafts taken from a donor of a different species.

Usually, good results are expected from plastic surgery that emphasizes:

* Careful planning of incisions so that they fall in the line of natural skin folds or lines.
* Appropriate choice of wound closure.
* Use of best available suture materials.
* Early removal of exposed sutures so that the wound is held closed by buried sutures.

Bleeding

Before modern surgical developments, there was a very real
threat that a patient would bleed to death before treatment, or
during the operation. cauterization (fusing a wound closed with extreme heat)
was successful but limited - it was destructive, painful and in the long term had
very poor outcomes. Ligatures, or material used to tie off severed blood vessels,
are believed to have originated with Ambroise Pare (sometimes spelled "Ambrose"[5])
during the 16th century, but were highly dangerous until infection risk was brought
under control - at the time of its discovery, the concept of infection did not exist.
Finally, early 20th century research into blood groups allowed the first effective blood
transfusions.

Techniques used in plastic surgery

Among the techniques which are commonly used in plastic surgery are:

• Incision.
• Excision.
• Chemosurgery.
• Electrosurgery.
• Laser surgery.
• Dermabrasion.
• Liposuction.

plastic surgery

Plastic surgery is a specialty that uses surgical techniques to change the appearance and function of a person's body. Some of these operations are called "cosmetic", and others are called "reconstructive".

The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with the synthetic polymer material known as plastic.

SURGERY

Surgery (from the Greek χειρουργική meaning "hand work") is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. Surgeons may be physicians, dentists, or veterinarians who specialize in surgery.

A surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentists, or veterinarians