Whatever is best for the patient is a proper surgical principle, without any specialized classification; hence, the subject, "Plastic Surgical Principles," may be open to some interpretation. Concentration of types of patients and study of them and of results of their treatment, however, may lead to establishment of procedures that will prove the most beneficial.
In the repair of all injuries, as of those considered here, the basic surgical need is to do the reverse of what the accident did. This essentially means sorting out, cleaning, and putting back together displaced, torn, and avulsed soft tissue and displaced and broken bone, with preservation of all possible viable parts.
If severe facial injuries can be repaired soon after the accident, the best results are obtained and less secondary correction will be necessary. If, however, there is too much general shock, too much brain damage, a fractured cervical vertebra with possible cord
BROWN JB, FRYER MP. Plastic Surgical Principles in Farm, Industrial, and Traffic AccidentsFacial Injuries. AMA Arch Surg. 1956;72(5):780-787. doi:10.1001/archsurg.1956.01270230044006