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Horch et al. Plast Aesthet Res 2017;4:185-9 Plastic and
DOI: 10.20517/2347-9264.2017.72
Aesthetic Research

www.parjournal.net
Editorial Open Access

Towards the future of plastic surgery: from

flaps to microsurgery and regenerative

medicine and biofabrication?

Raymund E. Horch , Annika Weigand , Harald Wajant , Ran An , Jia-Min Sun , Andreas Arkudas
2
3
1
1,3
1
1
1 Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen,
Friedrich-Alexander University Erlangen-Nuernberg FAU, 91054 Erlangen, Germany.
2 Division of Molecular Internal Medicine, Department of Internal Medicine II, University Hospital Würzburg, Julius-Maximilians-Universität
Würzburg, 97070 Würzburg, Germany.
3 Union Plastic and Aesthetic Hospital, Huazhong University of Science and Technology, Wuhan Union Hospital, Wuhan 430022, Hubei, China.
Correspondence to: Prof. Raymund E. Horch, Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative
Medicine, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg FAU, 91054 Erlangen, Germany.
E-mail: Raymund.horch@uk-erlangen.de
How to cite this article: Horch RE, Weigand A, Wajant H, An R, Sun JM, Arkudas A. Towards the future of plastic surgery: from flaps to microsurgery
and regenerative medicine and biofabrication? Plast Aesthet Res 2017;4:185-9.
Article history: Received: 28 Sep 2017 Accepted: 19 Oct 2017 Published: 31 Oct 2017

Plastic surgery is a specialty that is now worldwide procedures (even before the advent of anaesthesia)
recognized as its own academic discipline within today axially vascularized and perforator based
the surgical community. The roots however are flaps have replaced these often tedious and painful
as old as 600 BC when in the Sushruta Ayurveda techniques. It was the publication of the Indian method
the reconstruction of a nose with a flap from the of nose reconstruction in the Gentlemen´s magazine in
forehead was described. Plastic surgery is a problem England that replaced the random pattern flap based
solving discipline that meanwhile is an integral method that was described in Tagliacozzi’s two volume
part within modern surgical concepts. A number of book De Curtorum Chirurgia per Insitionem (1597),
groundbreaking inventions and developments from where he detailed the different surgical steps with
plastic surgery had led to relevant innovations and graphic illustrations that became a hallmark of surgical
these influenced the whole field of surgical specialities, textbooks ever since.
including the nobel prize for the first successful renal
transplantation, performed by the plastic surgeon When within the last decades the rapid development of
John Murray. Although principal details of operation microsurgery allowed for transplantation of vascularized
techniques that had been described as early as tissue to almost any part of the body this spread as
600 BC are still part of the surgical armamentarium, a fascinating extension of older surgical methods
many innovative methods have enriched the current to many other surgical specialities as well. Modern
spectrum of possibilities. Whereas over many reconstructive and oncological concepts rely on the
centuries techniques of reconstruction utilized delayed interdisciplinary character of plastic surgery making
pedicled random pattern flaps and needed multi stage our specialty an essential part of any reconstructive

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