Vasily Khrapach: “Any intervention by a surgeon is always the percentage of complications”

Any medical procedure, be it a simple dressing, injection or surgery, always comes with a certain risk of complications. A huge number of factors play a role in this matter, and no specialist can guarantee that the procedure will be completely safe. It was the problem of complications in plastic surgery that was devoted to the conference "Difficult cases in plastic surgery", which was organized by the doctor of medical sciences, a plastic surgeon of the highest category, Professor Khrapach Vasily Vasilyevich. Especially for the readers of estet-portal.com, the doctor spoke about the complications of plastic surgery and the relevance of the main topic of the conference.

Vasily Vasilyevich, tell our readers how the idea of ​​organizing such a conference came about?

This is a traditional conference, we have been doing it since 2004, because plastic surgery, especially aesthetic surgery, was becoming before my eyes, that is, this is the 70s. This is another stage in the development of plastic surgery, because purely aesthetics – this is the beginning of the 20th century. Each time the development of medical technologies, and technologies in general – this is another round of development of medicine, and in the 70s a new round began. In the 90s, we changed to minimally invasive, and in 1998 our department was created, which is now called the Department of Surgery No. 4, because our teachers saw that we needed an influx of young forces, then still young, with new directions. A department was formed under the leadership of Vladimir Grigorievich Mishalov, who opened this event today. We have formed directions: these are microvascular surgery, cardiac surgery, general surgery, laparoscopic surgery and plastic surgery. This was not really anywhere, and we were such enthusiasts who did it all. Since 2004, every 2 years we have had a big conference, well, there are one or two such small conferences, plus master classes. Plastic surgery – this is the most trainable system, and the state is not needed here, because we will do everything ourselves.

Why did you decide to raise the issue of difficult cases in plastic surgery today?

Because we have already dealt with all other cases. Our conferences are usually fairly broad, not narrowly focused. The first was devoted to the mammary gland, and it was the first conference in the CIS. We had a record – 32 countries were represented at the conference. Now, unfortunately, it is less, but our foreign colleagues have arrived, because this is now a sore point for us.

Over the years we have learned to do things to normal standards, and naturally we have a certain percentage of complications.

Plastic surgery is not advertised for obvious ethical reasons, and we can discuss this in our close circle. There is a percentage of complications, in any case, it will be. Any intervention of the surgeon – it is always the percentage of complications. Right now we have complications at the level of the appendectomy, but we need to discuss how to do even less.

In your opinion, how significant are such events for the development of aesthetic medicine in Ukraine?

There are three versions of the conference: purely academic, that is, the institute reports on its results, how it invented something new. The second kind of conference – this is when companies that enter the market are also involved in training, because we need to know what antibiotics they bring out, or what materials, what implants. They also hold conferences in which they position their materials. This is also very useful, we learn new things. Now, unfortunately, most of the information we draw, all the same, from companies that provide training. And the third kind – this is an exchange of experience, that is, surgeons gather, it can be behind the scenes. I took part in such events abroad several times, about 15 people gathered there. Or such conferences as we have here, because we have a fairly large forum, we exchange opinions. We have feedback. For example, I ask the question: who treats the prosthesis with betodin before putting it into the cavity? And buttons are pressed in the hall. It is completely anonymous, but we see that such and such a percentage does it. That is, we can recommend it, or find out what percentage of complications surgeons have, if they count. We get knowledge specific to the area. We can use American ones, but it's still different.

One of your reports is devoted to the trends in the development of plastic surgery. What trends do we see today?

Plastic art is developing very strongly, but it is already the inhabitants who know why we appeared. Here it goes like, firstly, the development of our life in general, for example, the appearance of mobile phones. We have the same thing: the materials we use, we don’t remove our stitches now, we use video cameras, endoscopic equipment, disposable underwear, after all. That is, the principle of performing the operation has absolutely changed compared to how I started 30 years ago. So I hope every two years we have something new. What's new now? Firstly, it has become popular and is not so scary for patients. Now the patients are younger.

If earlier they went for an operation out of despair, now they go out of joy.

To the extent that operations are given as a gift. Once I had a couple where the groom gave the bride a surgery as a gift. Everything would be fine if they didn't make it 3 days before the wedding. It was a lot of fun: she walked in a veil and with a plaster on her nose, and I found out after I had the operation. That is, people are not afraid. It's like going to the dentist now, people are not so afraid, technology has also developed. There is a rejuvenation, there is no fear, we give a better, let's call it, according to the market, product. The complication rate has actually decreased. I work at the department, do science, and I calculated that a lot of complications from all over Ukraine and not only come to me, because colleagues call and ask for help. I roughly see the features of the complications that occur. Now there are actually fewer complications - this is also a trend. Before we wrote

In your second report, you talk about the aesthetic complications of mammoplasty. What are they related to?

There are complications of mammoplasty. The person is alive, that is, there will be complications. They are often completely unpredictable, and the cause cannot be found. Maybe the man drank Coke, or some combination of stars, many of them do, some kind of full moon, and she has to be operated on. Then, we ourselves are a living environment with infections, not to mention the fact that patients often hide information about chronic diseases. Secondly, we are operating, and the operation is quite difficult, this is not a manicure, not a pedicure. We do not use small incisions, we hide them, we have a rather large preparation area, a very large traumatization area, because we often work in several planes, and if we compare all of this, it is hard for the body. Another thing is modern methods. Modern medical support allows you to delay this, but there is still a percentage of complications. They are divided into several types: these are general surgical complications, possibly suppuration, divergence of sutures, up to death during anesthesia. Unfortunately, several people in Ukraine fall into this list. The second type of complications – These are specific complications, specifically for plastic surgery. Let's say I'm getting silicone implants, and it's clear that complications will be associated with implants - these are specific complications for this category. They also exist, because there may be rejection, the body may not accept the implant. The third complication – associated with external influences. A person can get the flu a few years after implantation, and he begins to have a rejection reaction. This is also a normal phenomenon - the body has found a foreign body, and wants to get rid of it. This is fine, but we try to minimize it due to the fact that the implants are new and the technologies are new. And, of course, we make mistakes. You do everything right, everything is fine, but you understand that something is not right. This is the human factor, we are not robots, and this is exactly what we will discuss at the conference.