{"title":"Revisiting the enduring principles of plastic surgery.","authors":"Alan D Rogers","doi":"10.1093/jbcr/iraf180","DOIUrl":null,"url":null,"abstract":"<p><p>The foundational principles of plastic and reconstructive surgery, from Ambroise Paré's 16th-century surgical maxims to the commandments of Gillies and the refinements of Millard, remain deeply relevant in contemporary burn and wound care. However, current trends such as algorithm-driven training, reimbursement-influenced decision-making, and a decline in regional flap use signal a drift from principle-based practice. Modern frameworks like the reconstructive elevator and matrix add nuance, but often risk overshadowing simplicity, judgment, and adaptability. Re-engaging with these time-tested philosophies may help faculty and trainees re-anchor their approach to burn surgery, complex wounds, and reconstruction, restoring the emphasis on deliberate reasoning, accurate diagnosis, and patient-centered solutions.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Burn Care & Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jbcr/iraf180","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
The foundational principles of plastic and reconstructive surgery, from Ambroise Paré's 16th-century surgical maxims to the commandments of Gillies and the refinements of Millard, remain deeply relevant in contemporary burn and wound care. However, current trends such as algorithm-driven training, reimbursement-influenced decision-making, and a decline in regional flap use signal a drift from principle-based practice. Modern frameworks like the reconstructive elevator and matrix add nuance, but often risk overshadowing simplicity, judgment, and adaptability. Re-engaging with these time-tested philosophies may help faculty and trainees re-anchor their approach to burn surgery, complex wounds, and reconstruction, restoring the emphasis on deliberate reasoning, accurate diagnosis, and patient-centered solutions.
期刊介绍:
Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.