Aspinall Cassandra L
J Craniofac Surg. 2010 Sep;21(5):1330-4. doi: 10.1097/SCS.0b013e3181ef2a5b.
Working with child patients and their families in the practice of plastic and reconstructive surgery is rewarding and risky. Technical training is understandably intensive. However, the importance of the work that is needed before an operation does not always attract the same attention. Surgery that is done to change a child's body results in a change in that person's identity and cannot be taken lightly. A review of the overall benefit and burden of both the untreated condition and the proposed changes must be considered to support a change so that it does not damage an individual's identity development. By taking the time to understand what the patient's perspective is, surgical change can become a process that a person is part of, instead of it being something that is done to them. This helps to set up a situation where the change will be directly beneficial to the patient, and that change will be sustained over a long period. When evaluating surgical options with children, the influences and pressures that exist within families and throughout society must also be considered. A young child and his/her future must not get lost in the difficult negotiations between parents/guardians, surgeons, and society. By taking more time to consider the tremendous meaning that your work has outside the operating room and in the context of who the patient is becoming, you will have a greater chance of not just enhancing someone's appearance, but also improving his/her quality of life.
在小儿整形外科实践中与儿童患者及其家庭合作，既有益处也有风险。技术培训强度大是可以理解的。然而，手术前所需工作的重要性并不总是能吸引同样多的关注。改变儿童身体的手术会导致其身份认同的改变，不能掉以轻心。必须考虑对未治疗状况和提议改变的总体益处和负担进行评估，以支持这种改变，使其不会损害个人的身份认同发展。通过花时间了解患者的观点，手术改变可以成为一个患者参与其中的过程，而不是强加于他们的事情。这有助于营造一种情况，即这种改变将直接有益于患者，并且这种改变将长期持续。在评估针对儿童的手术方案时，还必须考虑家庭和整个社会中存在的影响和压力。一个幼儿及其未来绝不能在父母/监护人、外科医生和社会之间艰难的协商中被忽视。通过花更多时间思考你的工作在手术室之外以及在患者成长背景下所具有的重大意义，你不仅更有可能改善某人的外貌，还更有可能提高其生活质量。
