Universitat Internacional de Catalunya

Plastic, Reconstructive and Aesthetic Surgery

Plastic, Reconstructive and Aesthetic Surgery
2
10244
4
Second semester
op
Main language of instruction: Spanish

Teaching staff


Professor in charge: Prof. J. Mª Serra Renom. jms@csc.uic.es; Prof. J. Mª Serra Mestre

The Serra Doctors will be present and collaborate in all classes.

Other collaborating teachers:

-       Prof. Jose Mª Serra Renom. Hospital Quirón.

-       Prof. Jose Mª Serra Mestre. Hospital Quirón.

-       Prof. Joan Fontdevila. Hospital Clínic

-       Prof. Jesús Benito. Clínica Tres Torres.

-       Prof. Ramón Vila Rovira. Centre Mèdic Teknon.

-       Prof. Jaume Masia. Hospital Santa Creu i Sant Pau.

-       Prof. Juan Mª Viñals. Hospital de Bellvitge.

-       Prof. Carmen Higueras. Hospital Germans Trias i Pujol.

-       Prof. Jose Prat

For any questions, please request an interview by email.

E-mail: jmserra@csc.uic.es

 

Important note:

Due to the importance of the assessment that you make of the teachers to improve the quality of teaching, on the last day of class it is mandatory that all students attend with their PC to make the assessment questionnaire of the teachers, duration 15’.

Introduction

Plastic, Aesthetic and Reconstructive Surgery is that surgical specialty that deals with the alterations of the body envelope, with affectation of the form and the function or of the individual concept of the own body image, due to a manifest alteration, and has as The objective is to repair these affectations with the restoration of form and function, following criteria of proportionality and aesthetic parameters.

Their techniques are based on the transplantation and mobilization of tissue plasty, by means of grafts or flaps and implants of material, as well as injections of autologous tissues such as fat or treated as stem cells or stem cells.

The different parts of the specialty are:

  1. Treatment of burns and their sequelae.
  2. Treatment of congenital malformations of the head and neck, craniofacial or any organ that requires mobilization of the body envelope for repair. Examples: congenital malformations of the hand, external genitalia, chest, breasts, etc.
  3. Treatment of facial trauma to bone and soft tissue and all those injuries to the body envelope, which require skin delivery with plasty, is therefore a multidisciplinary specialty, with trauma, ophthalmologists, gynecologists, general surgeons ...
  4. Treatment of tumors that affect the body envelope and that require closures through cutaneous, myocutaneous or free vascularized grafts for their treatment.
  5. Reconstructive surgery of the mammary gland: Oncological, congenital and aesthetic.
  6. Surgery of the hand.
  7. Cosmetic and aging surgery. 

It is noteworthy that being the specialty that deals with the affectations of the body envelope, it is very broad and is related to many other disciplines. That is why it is a specialty of horizontal disposition and that requires the participation of plastic surgery in many "Multidisciplinary Units".

Pre-course requirements

The student must have basic knowledge of the structure and function of the human body and have passed at least the course of Surgical Pathophysiology.

Objectives

The aim of this subject is to understand the importance of body image alterations due to congenital or acquired causes and the repercussion that this affectation has for the individual himself. Likewise, in this repair, careful consideration should be given to restoring the shape of the affected or injured body structure and recovering its function, that is, the function must be restored, and at the same time that its repair does not damage , do not alter the morphology of that specific area or organ. This fact is very important in traumatic accidents, both occupational and burns and other causes, as well as cancer surgery and cosmetic surgery.

Competencies

  • 01 - Recognise the essential elements of the medical profession, including ethical principles, legal responsibilities and patient-centered professional skills.
  • 02 - Understand the importance of central principles, in particular of professional confidentiality for the benefit of patients, society and the profession.
  • 03 - Know how to apply the principle of social justice to professional practice and understand the ethical implications of health in a changing global context.
  • 04 - Develop professional practice with respect for patient autonomy, beliefs and culture.
  • 05 - Recognize own limitations and the need to maintain and upgrade professional skills, with particular emphasis on autonomous learning of new knowledge and skills and motivation for quality.
  • 06 - Develop professional practice with other health professionals, acquiring teamwork skills.
  • 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
  • 08 - Recognize the basis of normal human behavior and its disorders.
  • 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
  • 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
  • 11 - Understand and recognize the effects of growth, development and aging on the individual and their social environment.
  • 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
  • 13 - Obtain and develop a clinical history that contains all relevant information.
  • 14 - Perform a physical examination and a mental assessment.
  • 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
  • 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
  • 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
  • 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
  • 19 - Propose preventive measures appropriate to each clinical situation.
  • 20 - Acquire adequate clinical experience in hospitals, health centers and other health institutions under supervision, as well as basic knowledge of clinical management and patient-centered proper use of tests, drugs and other health system resources.
  • 21 - Listen carefully, obtain and synthesize relevant information about the problems affecting the patient and understand the contents of this information.
  • 22 - To write and maintain medical records and other medical documents which can be understood by third parties and are adapted to the protocols and information that is required.
  • 23 - Communicate effectively and clearly, both orally and in writing with patients, family members, media and other professionals.
  • 24 - Establish good interpersonal communication skills that enables efficient and empathetic communication with patients, relatives, media and other professionals.
  • 25 - Recognize the determinants of public health; genetic and sex-dependent lifestyle, demographic, environmental, social, economic, psychological and cultural determinants.
  • 26 - Assume role in the prevention and protection from diseases, injuries or accidents and maintenance and promotion of health, both individual and at the community level.
  • 27 - Recognize role in multidisciplinary teams, assuming leadership when appropriate, for the delivery of health care, such as interventions for health promotion.
  • 28 - Obtaining and using epidemiological data and assess trends and risks in health related decision-making.
  • 31 - Understand, critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health care information.
  • 32 - Know how to use information and communication technology in clinical, therapeutic, preventive health care and research.
  • 33 - Maintain and use records with patient data for later analysis, preserving the confidentiality of the data.
  • 34 - Ability for critical thinking, creativity and constructive skeptisim with a focus on research within professional practice.
  • 35 - Understand the importance and limitations of scientific thinking in the study, prevention and treatment of disease.
  • 36 - Be able to formulate hypotheses, collect and critically evaluate information for problem solving using the scientific method.
  • 37 - Acquire basic training for research.
  • CTI-1 - To know how to communicate effectively through written and oral communication in a foreign language that will allow them to work in an international context.
  • CTP-2 - To develop a perception and understanding of their own emotions and those of others, as well as the intelligence adjust answers.
  • CTP-3 - To develop critical thinking and reasoning as well as self-assessment skills.
  • CTS-1 - To know the principles of leadership and decision making in ordinary situations or in conflicts with and between various ethical, legal and professional elements.
  • CTS-3 - To promote and ensure respect for human rights and the principles of universal accessibility, equality, non-discrimination as well as the values of democracy and a culture of peace.

Learning outcomes

  • The student must acquire the basic knowledge of what Plastic, Reconstructive and Aesthetic Surgery consists of.
 
  • You must know how to assess a burn and see if it is medical treatment or if it requires surgical treatment. And you must know how to send it to the appropriate reference center.
 
  • You must know how to value a congenital malformation and know how to explain the reason for this malformation to parents, and also know how to refer it to the appropriate specialist and be able to support the family environment and the patient himself.
 
  • You must know how to distinguish between a pathology that requires the treatment of plastic surgery and you must distinguish from the psychological alteration due to dysmorphophobia. Dysmorphophobia must know how to diagnose it and it is a psychiatric disease. They are those patients who are obsessed and suffer great anxiety due to a perception disorder of the own body's evaluation, which is also normal. These patients should not be operated but should be treated by the psychiatrist.
 
  • You should know that when there is a significant alteration of the form, the function is also altered. For example, a nose with the tip pointing down and a very prominent back, the air makes turbulence inside causing problems of sinusitis and pharyngitis. An exaggerated blepharochalasia, that is, excess skin on the upper eyelid, causes a weight that prevents the correct elevation of the eyelid creating a ptosis, which hinders vision ...
 
  • You must know the two parts of the specialty, the Reconstructive Surgery that is dedicated to congenital alterations of the head and neck, cleft lip, palatal fissure, craniofacial malformations, the hand, the body, traumatic injuries, burns, oncological leaks ... and Aesthetic Surgery that deals with those morphological affectations of the body envelope that due to their proportionality, or disharmonic growth with excess and redundancy of tissues, cause suffering by having a disharmonic body image and also alters the function of the affected area.
 
  • You must know how to value that repair surgery and cosmetic surgery cannot go separately, you have to get a good repair of the function and a good repair of the morphology of the affected area.

Syllabus

TEMARY:

Unit 1. Introduction and history of Plastic, Reconstructive and Aesthetic Surgery. Grafts and Flaps. Local and remote plasty.

Unit 2. Thermal, electrical and chemical burns. Latest Techniques in the Treatment of Burns. Skin culture. Use of skin substitutes. Integra®.

Unit 3. Craniofacial congenital malformations. Harelip. Palatal fissure.

Unit 4. Head and Neck Reconstruction with Microsurgical Techniques. Drilling Flaps. Face transplant.

Unit 5. Lipofilling for facial reconstruction.

Unit 6. Nasal reconstruction.

Unit 7. Rhinoplasty: Open and Closed Technique.

Unit 8. Aesthetic Surgery of the Scalp.

Unit 9. Oculoplastic: Ectropion, Entropion, Ptosis.

Unit 10. Aesthetic Blepharoplasty.

Unit 11. Facial Rejuvenation: Endoscopic Lifting. Cervical and Facelift. Inverted SMAS flap. Applications of Botulinum Toxin in Plastic and Aesthetic Surgery.

Unit 12. Liposuction. Liposculpture.

Unit 13. Plastic Surgery in Morbid Obesity. Aesthetic abdominoplasty.

Unit 14. Breast Augmentation. Breast reduction. Lipofilling in breast surgery.

Unit 15: Surgical Treatment of Facial Cutaneous Tumors.

Unit 16: Reconstruction of upper and lower extremities. Local plasty at distances with microsurgical techniques.

Unit 17: Oncoplastic Surgery in breast surgery.

Unit 18: Latest advances in breast reconstruction. DIEP flap, SGAP ... Microsurgery of lymphatic vessels to treat lymphedema.

Topic 19: Aesthetic medicine techniques for facial rejuvenation

2 ABP:

- Reconstructive Surgery

- Plastic surgery

PRACTICES:

Attendance at live surgery at the Quirón Hospital in Barcelona. Attendance is compulsory to pass the course.

Teaching and learning activities

In person



The Lecture is the stage in which a teacher transmits knowledge in a classroom to the entire group of students. The format, however, allows the introduction of activities in small groups within the classroom and the deployment of strategies that encourage the active participation of students.

The Case Method consists of the process of solving clinical cases or those of the profession. They are group activities that are resolved with the active participation of the teacher after the deliberation of the students.

The Problem Based Learning has similarities to the case method but differs in that students are held accountable for finding the solution to the problem. The teacher acts as a tutor who facilitates the learning process based on his metacognitive abilities. It is also done in groups.

Laboratory of practices. The practice consists of attending one morning the broadcast of live surgery from the Operating Room to the Classroom. This practice is carried out at the Quirón Hospital.

Evaluation systems and criteria

In person



In order to pass this subject, you will have to pass the exam, a written test, which will be done at the end of the course. This exam will have the value of 70% of the final grade, 20% will be the evaluation carried out with the participation in the ABP, and the remaining 10% with the participation in the live surgery with the appropriate questions to the surgery that is done.

The 2nd call for evaluation will consist of a written test.

Attendance at all classes is mandatory.

Bibliography and resources

  • Neligan P.C. Plastic Surgery. Ed. Elsevier. Saunders. New York. 2013 (5 volumes)
 
  • Seckel B.R. Danger Zonez facial. Quality Medical Publishing. Inc. Sant. Louis 1994.
 
  • Grabb, W., Aston, S., Smith, J. Grabb and Smith’s Plastic Surgery. Lippincott Williams and Wilkins. Philadelphia.
 
  • Serra-Renom J.M., Vila R. Reconstructive Microsurgery. Ed. Salvat.
 
  • Serra- Renom J.M., Vila R. Endoscopy in Plastic and Aesthetic Surgery. Ed. Masson.