On the origin of our specialty: the conceptual thinking in plastic reconstructive surgery 

In this article, the authors raise the question who and what has given plastic reconstructive surgery its major intellectual impetus.As a starting point of their search, they define the appearance of what distinguishes plastic surgery from other surgical specialties. This is that plastic reconstructive surgery does not have an anatomical orientation but is problem oriented: the problem of a tissue defect all over the body. This orientation goes with another way of thinking, the conceptual thinking of how to devise operative solutions for a certain defect in a certain patient. Their quest has led them to the nineteenth century where they identified the starting point in the works of the Russian surgeon Julius Szymanowski. He described, elaborately and explicitly, the conceptual thinking that leads a reconstructive surgeon to all available operative solutions. His contemporaries unfortunately did not understand his message. Nevertheless, plastic reconstructive surgery proliferated in the one and a half century that followed and developed many concepts that form the intellectual armamentarium to devise appropriate operative procedures for defects on or in the human body.

Level of evidence: Not gradable