Page:Plastic surgery.djvu/34

 CHAPTER II

GENERAL CONSIDERATIONS

The utilization of those skilled in well-established medical and surgical specialties in the care of sick and wounded soldiers, has been successfully demonstrated to the medical organizations of the various armies for the first time during the present great world war. In the Medical Corps of our own Army in all previous wars, and even up to the last two years, specialties were not recognized as such, and an officer of the Medical Corps whether professionally equipped or not, was too often assigned to take care of cases requiring the attention of a highly trained specialist. To my mind the recognition of the specialist in the Medical Corps of the Army is a great step forward, as it insures the soldier the best care in every kind of injury or illness. For many years as I have become more and more familiar with the intricacies of plastic surgery, I have urged, in spite of much opposition, that this be made a surgical speciality, and the war has demonstrated beyond a doubt the need of this as a special branch. There are large hospitals in all the warring countries devoted entirely to plastic surgery of the face, and in our own organization, under the Section of Surgery of the Head, there is a subdivision of Facial Plastic and Oral Surgery, to deal with reconstructive work on the face. This is all very well as far as it goes, but it must be understood that reconstructive work on the face, although vitally important, is only a part of plastic surgery, and that plastic and reconstructive work is as necessary and is just as important on other parts of the body. Except for the vastly greater number of cases and the greater prevalence of injuries and destruction of the bony framework, the real plastic and reconstructive work on war wounds differs not a great deal from that done in civil practice. By plastic and reconstructive surgery is meant that branch of surgery which deals with the repair of defects and malformations, whether congenital or acquired, and with the restoration of function and the improvement of appearance. This is accomplished chiefly by the transfer of tissue, either from the immediate neighborhood, or from some 12