What is plastic surgery
Plastic surgery has two main components: reconstructive plastic surgery which is all about restoring appearance and function to the human body after illness or accident and aesthetic (often called “cosmetic”) plastic surgery which is done to change the appearance from choice.
Although you hear people mostly talking about cosmetic plastic surgery, the main work of nearly all plastic surgeons is reconstructive: covering all aspects of wound healing and reconstruction after congenital, acquired and traumatic problems, with aesthetic surgery playing a smaller but important part in their working week.
History of Plastic Surgery
The specialty developed from its ancient Egyptian origins more than three thousand years ago. It progressed geographically, as knowledge disseminated, including northern India at about 600 BC, Sicily in the 15th century Renaissance, Germany in the 19th century, and finally Britain in the two world wars. Modern plastic surgery in Great Britain was formalised by Sir Harold Gillies by the creation of the British Association of Plastic Surgeons in 1946 following pioneering work by him and others such as McIndoe, Kilner, Mowlem, and Barron on casualties from the first and second world wars. The specialty slowly evolved to one treating a wide range of conditions and anatomical areas.
The Department of Plastic and Reconstructive Surgery cares for the people of Devon and Cornwall by providing a wide range of Plastic Surgery services across the two counties. As one of only two such centres in the Peninsula, the service is responsible for a catchment of 1.2 million people. Tertiary services for the Peninsula population of 1.7 million require specialist input from Plastic Surgery.
The service at Derriford Hospital provides a plastic, reconstructive and hand surgery service for both adults and children with a large proportion of activity focused around management of skin cancer, soft tissue sarcoma, breast reconstruction and hand surgery. University Hospital Plymouth is a designated Trauma Centre and Burn Facility. The department plays an essential role in supporting a wide range of other services within UHP and from other Trusts, including perineal reconstruction with colorectal surgery and chest wall reconstruction with Cardiothoracic Surgery. Paediatric urogenital reconstruction and congenital hand Surgery services are delivered in a self-contained paediatric surgical unit.
The Unit provides a tertiary service for Cornwall, the Isles of Scilly, Plymouth District and South & West Devon; a population of 1.2 million. The Unit covers the whole spectrum of plastic and reconstructive surgery with the exception of craniofacial surgery and cleft surgery.
- Sarcoma surgery and reconstruction
- Head and neck reconstruction
- Hand surgery
- Breast reconstruction
- Paediatric plastic surgery
- Thoracic reconstruction
- Perineal reconstruction
The department contributes to the management of trauma in several ways. There is a plastic surgery trauma service that looks after:
- Hand injuries including fractures
- Soft tissue injuries of other areas of the body
In addition to this, plastic surgery contributes to the management of major trauma patients particularly in combination with orthopaedic surgery but also with neurosurgery, ENT surgery and maxillofacial surgery.
There are 8 middle-grade or registrar doctors and 5 junior doctors.
The role of the present nursing and therapy staff has been extended to contribute much more to service provision through the development of nurse led and therapy led follow up. The Sarcoma service is supported by a Nurse Consultant and Clinical Nurse Specialists who see and follow up sarcoma and skin cancer patients. Senior nurse Trauma Co-ordinators see referrals and facilitate the management of trauma patients
Inpatient facilities include Lynher Ward; an adult ward situated on Level 5 of the main hospital building. Its 30 beds are distributed between single rooms, two, four and six bedded bays. A dedicated Plastic Surgery Trauma Clinic, where trauma referrals are seen each weekday morning and a dedicated Plastic Surgery Dressings Clinic are situated on Level 4.
The paediatric ward is Woodcock Ward, on Level 12 of the main hospital block, accommodates mixed speciality surgical paediatric patients.
Most surgical procedures are undertaken in the two designated Plastic Surgery Theatres in the main Hospital, Tavistock hospital and in Rowan’s House on the Derriford site. There are six dedicated Plastic Surgery trauma lists throughout the week, including Saturday mornings.
The unit works in close collaboration with Physiotherapy and Occupational therapists who provide hand therapy, splinting and pressure garment services.
The Department of Plastic and Reconstructive Surgery collaborates with various specialities within the Trust. There are a number of joint clinics held with members of other specialties:
- Head and Neck Combined Clinic
Held within the ENT Department occurring on a weekly basis, in conjunction with the Maxillo-Facial and ENT departments, Speech Therapy, Prosthetics and Dieticians.
- Joint Sarcoma Clinic
This is a monthly clinic held in the Oncology Department, in conjunction with Oncology.
- Skin Cancer Clinic
This weekly clinic is held in conjunction with the Dermatology department.
- Breast reconstruction clinic
Surgical Oncology (Soft Tissue Sarcoma).
Hand surgery and microvascular surgery.
Paediatric Plastic Surgery, Skin malignancy, Vascular anomalies.
Sarcoma, lower limb trauma
Skin cancer, burns
Skin cancer, head and neck reconstruction
Miss J Hughes
Sarcoma, lower limb trauma, hand surgery
|Mr A Armstrong
|Adult and paediatric plastic surgery
Nurse Consultant (Sarcoma)
Advanced Nurse Practitioners for Trauma
Advanced Nurse Practitioner for Burns
Clinical Nurse Specialists (Sarcoma and Skin Cancer)