ESPRAS Survey on Continuing Education in Plastic, Reconstructive and Aesthetic Surgery in Europe

Background Specialty training in plastic, reconstructive and aesthetic surgery is a prerequisite for safe and effective provision of care. The aim of this study was to assess and portray similarities and differences in the continuing education and specialization in plastic surgery in Europe. Material and Methods A detailed questionnaire was designed and distributed utilizing an online survey administration software. Questions addressed core items regarding continuing education and specialization in plastic surgery in Europe. Participants were addressed directly via the European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS). All participants had detailed knowledge of the organization and management of plastic surgical training in their respective country. Results The survey was completed by 29 participants from 23 European countries. During specialization, plastic surgeons in Europe are trained in advanced tissue transfer and repair and aesthetic principles in all parts of the human body and within several subspecialties. Moreover, rotations in intensive as well as emergency care are compulsory in most European countries. Board certification is only provided for surgeons who have had multiple years of training regulated by a national board, who provide evidence of individually performed operative procedures in several anatomical regions and subspecialties, and who pass a final oral and/or written examination. Conclusion Board certified plastic surgeons meet the highest degree of qualification, are trained in all parts of the body and in the management of complications. The standard of continuing education and qualification of European plastic surgeons is high, providing an excellent level of plastic surgical care throughout Europe

À propos du traitement des fentes labio-palatines et autres dysmorphies : idéal technique et réalisme thérapeutique

Les résultats d'un métier manuel dépendent de la qualité de ses techniques, adaptées à leur objet et minutieusement réalisées. La technique qui permet d'obtenir le meilleur résultat est jugée idéale et devient un modèle théoriquement applicable à tout objet identique. Mais, si nous travaillons apparemment sur des objets semblables : fente labio-palatine, classe II, classe III... en réalité, nous soignons des sujets, des patients tous différents les uns des autres. Cette différence tient aux contraintes qui sont propres à chaque patient, contraintes liées aux réactions aléatoires de ses tissus, à sa capacité d'accepter et de supporter les risques, les souffrances, les effets sensorimoteurs de la dysmorphie et du traitement, enfin à ses disponibilités de temps et d'argent. Toute technique thérapeutique doit tenir compte de ces réalités qui nous obligent parfois à adapter l'idéal technique à la singularité du patient, adaptation qui définit le «réalisme thérapeutique». La négligence de ces contraintes peut expliquer le paradoxe d'un excellent résultat technique qui pourtant ne satisfait pas le patient, ou celui d'un médiocre résultat technique qui néanmoins satisfait le patient : son appréciation constitue le «résultat thérapeutique», Jugement Dernier du résultat technique