Revisiting the enduring principles of plastic surgery.

Authors

Alan D Rogers

Published in

Journal of burn care & research : official publication of the American Burn Association. Sep 19, 2025. Epub Sep 19, 2025.

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.

PMID:
40973664
Bibliographic data and abstract were imported from PubMed on 20 Sep 2025.

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