In the first episode of How I Operate, Ryan Sugrue is joined by Professor JP Hong, one of the leading innovators in modern reconstructive microsurgery and a pioneer of the SCIP flap.

From its origins as a modification of the traditional groin flap to its evolution into one of the most versatile perforator flaps in reconstructive surgery, Professor Hong shares the anatomical discoveries, technical refinements, and clinical insights that transformed the SCIP flap into a global workhorse. Along the way, he discusses the importance of continuous innovation, the role of ultrasound in modern flap surgery, and the principles that guide his approach to surgical problem-solving.

Key Takeaways:

• How the SCIP flap evolved from the traditional groin flap.
• The anatomical principles that improved flap reliability and reduced complications.
• Why understanding perforator anatomy remains fundamental to successful reconstruction.
• The growing role of ultrasound in flap planning and surgical decision-making.
• How incremental improvements can transform a good operation into a great one.
• Professor Hong's philosophy on innovation, teaching, and building a lasting surgical legacy.

Chapters:

00:00 – Introducing the SCIP Flap
03:20 – The Evolution of the Groin Flap
09:15 – Early Modifications and the Work of Dr Kashima
16:30 – Understanding Perforator Anatomy
24:45 – Improving Reliability Through Anatomical Research
34:20 – The Role of Veins and Flap Design
45:10 – When to Use (and Not Use) the SCIP Flap
55:35 – Ultrasound as a Microsurgical Tool
01:06:30 – SCIP Flap Design and Surgical Technique
01:25:40 – Innovation, Legacy, and Lessons for Future Surgeons

Thank you for listening to How I Operate. Brought to you by ThePlasticsFella.

If you enjoyed this episode, please follow the show, leave a rating and review, and share it with colleagues. New episodes are released bi-weekly, featuring the surgeons, innovators, and ideas that continue to shape modern plastic surgery.

Here’s a teaser from an upcoming episode where Professor JP Hong explores the SCIP flap and the evolution of modern reconstructive microsurgery. 
This upcoming podcast series is designed to go beyond textbook learning and give insight into how world experts approach operative planning, technique, and decision-making.

🎙️ Stay tuned for more details on the release!

Key Points

• Journey to Gaza: Victoria’s initial work with Ideals evolved into direct support for Gaza’s overwhelmed hospitals after 2018’s Great March of Return.
• Challenges on the Ground: Insights into working without standard surgical tools, creative solutions like vinegar for infections, and performing critical surgeries in austere conditions.
• Age-Based Injury Patterns: Patterns in pediatric injuries observed, with children aged 5-14 particularly vulnerable.
• Impact and Future of Plastics in Gaza: Advocating for support, Victoria highlights the urgent need for plastic surgery training in Gaza.

How to Help

• Ideals Charity and Donate
• Victoria Rose Interview in Vogue
• YouTube: Victoria Rose Gaza Press Conference in the UK
• The New Yorker: "The Children Who Lost Limbs in Gaza"

This conversation focuses on the viva oral exam for plastic surgery trainees, discussing preparation strategies, understanding the exam process, and the dynamics between examiners and candidates. There is a strong focus on the FRCS exam. The speakers share insights on common mistakes, the importance of higher-order thinking, and practical tips for success in the exam. They also engage in a mock exam scenario to illustrate key points and provide valuable resources for trainees.

Chapters

00:00 Introduction to the Viva Oral Exam

03:53 Preparation Strategies for the Exam

06:37 Understanding the Exam Structure

09:43 Examiner Dynamics and Candidate Interaction

13:02 Higher Order Thinking in Responses

15:51 Common Mistakes to Avoid

18:40 Mock Exam and Practical Tips

24:57 Final Thoughts and Resources

Takeaways

Preparation for the viva exam starts months in advance.

Confidence in preparation is crucial for success.

Understanding the examiner's perspective can help candidates perform better.

Higher-order thinking is essential in answering exam questions.

Practicing with peers can enhance performance and reduce anxiety.

Candidates should focus on succinct, structured answers.

Recognizing when to seek help during the exam is important.

Mock exams provide valuable experience and feedback.

Being aware of common mistakes can improve exam performance.

The viva exam is an opportunity to demonstrate clinical reasoning and decision-making skills.

Keywords

FRCS, viva oral exam, plastic surgery, exam preparation, examiner dynamics, higher order thinking, common mistakes, mock exam, surgical education

In this conversation with the Plastics Fella team, the speakers delve into essential techniques and skills required in plastic surgery, focusing on wound management, suturing, flap surgery, and advanced techniques like hemostasis and negative pressure wound therapy. They emphasize the importance of experience, confidence, and continuous learning in mastering these skills, while also sharing personal insights and anecdotes from their surgical training and practice.

Takeaways

Wound management is a fundamental skill for plastic surgeons.

Suturing techniques vary and require mastery for effective outcomes.

Flap surgery involves understanding layers and proper thinning techniques.

Negative pressure wound therapy is crucial for complex wounds.

Confidence in surgical skills develops with experience and practice.

Choosing appropriate dressings is essential for wound healing.

Debridement is a nuanced skill that requires careful decision-making.

Understanding hemostasis is vital in managing surgical bleeds.

Finger replantation encompasses multiple surgical skills and techniques.

Continuous learning and adaptation are key to surgical success.

Chapters

00:00 Introduction and Conference Plans

01:06 Key Surgical Techniques in Plastic Surgery

01:44 Wound Management Techniques

06:32 Suturing Techniques and Tissue Handling

12:47 Flap Techniques and Layer Recognition

23:20 Unique Techniques and Final Thoughts

40:01 Behind the 'Fella Jingle.wav

The team from thePlasticsFella also discusses the potential of building a community forum for plastic surgeons to exchange ideas, along with the exciting debate on whether the the Plastics Fella platform should develop an app for its members.

Whether you're preparing for your FRCS exam, looking for continuing education resources, or aiming to stay ahead in the field, this episode has you covered with fresh insights into the resources you didn’t know you needed!

Key Topics Discussed:

• Journals: JPRAS, BSH, PRS, PRS Global Open
• Textbooks: Essentials of Plastic Surgery, Graben Smith's Plastic Surgery
• Online learning platforms: Plastic Surgery Key, Microsurgeon.org
• Social media: How Instagram and Twitter are transforming plastic surgery education
• The importance of community-driven learning and case discussion forums with thePlasticsFella
• The debate over building an app for the Plastics Fella

Chapters: 00:00 - Introduction and Missing Team Member
02:03 - Best Learning Resources in Plastic Surgery
13:27 - Online Platforms: Plastic Surgery Key and Microsurgeon.org
19:33 - Social Media for Plastic Surgery Learning
21:19 - Instagram vs. Twitter for Learning
26:33 - The Value of Face-to-Face Learning
34:12 - Courses and Conferences
38:59 - App Development: Should the Plastics Fella Build One?
42:23 - Building a Community for Surgeons with thePlasticsFella

Takeaways:

• Journals like JPRAS and BSH are must-reads for plastic surgery trainees.
• Essential textbooks such as Essentials of Plastic Surgery provide in-depth knowledge.
• Online platforms and social media offer new ways to stay updated in plastic surgery.
• thePlasticsFella community fosters collaboration and case discussions for plastic surgeons.
• There’s a growing debate on whether the Plastics Fella should build an app for its members.

Keywords for SEO:
Plastic surgery, learning resources, plastic surgery journals, plastic surgery textbooks, online learning, Instagram, Twitter, plastic surgery education, FRCS exam prep, plastic surgery apps, plastic surgery forums, thePlasticsFella, the Plastics Fella, plastic surgery community.

Keywords

skin grafts, donor sites, full thickness, split thickness, raising, thinning, closure, tumescence, instruments, skin grafting, tie-over dressings, quilting, bolster dressings, Kaltostat, honey-based dressings, complications, follow-up visits

Keywords

skin grafts, donor sites, full thickness, split thickness, raising, thinning, closure, tumescence, instruments, skin grafting, tie-over dressings, quilting, bolster dressings, Kaltostat, honey-based dressings, complications, follow-up visits

Further reading:

• Surgical Trial Training Course

• RSTN

• HAWAII Trial

• https://x.com/HawaiiTrial

  
  

Keywords: plastic surgery, research design, randomization, ethics, funding, publication, clinical equipoise, PICO framework, data management, Redcap, academic publishing, open access, time management, informed consent

The team meeting begins with introductions and welcomes from team members located in different parts of the world. The meeting covers a variety of topics including test prep essentials, clinical discussions, and a quiz competition. Technical issues and casual banter add a light-hearted tone to the meeting. The conversation covers a range of topics including a quiz, the use of flashcards in medical education, and the surgical approach to flexor tenosynovitis. The quiz involves participants making sounds with their mouths and answering questions related to medical history. The discussion on flashcards explores their effectiveness, creation, and use in medical education. The surgical approach to flexor tenosynovitis is discussed, highlighting the lack of consensus and the importance of aggressive management. The conversation covers the topic of irrigation and suturing in plastic surgery, with a focus on the choice of irrigation solution and the debate between absorbable and non-absorbable sutures. The participants share their experiences and preferences, highlighting the importance of patient comfort, aesthetic outcomes, and surgical technique.

Chapters

00:00 Global Team Collaboration and Introductions

03:12 Test Prep Essentials and Clinical Discussions

14:30 Quiz Competition and Technical Issues

24:37 The Power of Flashcards in Medical Education

45:01 Surgical Approaches to Flexor Tenosynovitis

51:53 The Choice of Irrigation Solution in Plastic Surgery

01:05:10 The Great Debate: Absorbable vs. Non-Absorbable Sutures

01:17:06 Regional Variations in Surgical Practices

Keywords

team meeting, introductions, test prep, clinical discussions, quiz competition, technical issues, banter, quiz, medical history, flashcards, medical education, surgical approach, flexor tenosynovitis, evidence-based practice, plastic surgery, irrigation, sutures, absorbable sutures, non-absorbable sutures, patient comfort, aesthetic outcomes, surgical technique