n Vienna as well as in Aachen and in Zürich I participated in the acute trauma services. Besides acute cases of hand trauma and complex tissue defects I reconstructed tissue deficits and lost functions after trauma very often secondarily. Especially in facial trauma the aesthetic outcome gets high importance.

Deep and extensive injuries, but also extensive infections of the soft tissues can lead to defects in the skin or soft tissue mantle. Conspicuous, partly unstable or also functionally restrictive scars can be left behind. Particularly in the facial area, in the décolleté area or at the hands, thickened, retracted and widened scars will interfere with the aesthetic appeal, while contracted scar tissue above the joints can also restrict the range of motion. Unstable scars can meanwhile be attended by long-term scar tumours with a corresponding inflammation of the surrounding areas and unpleasant care requirements for the person concerned. A wide range of different scar correction techniques permit a marked improvement of both the appearance and functional problems caused by scars. Lost soft tissue sometimes needs to be replaced by way of a tissue transplant. In the case of minor defects, the problem can be solved by shifting tissue in the sense of local flaps or also skin grafts. Extensive deficits of the soft tissue or losses of function can often only be improved by complex, microsurgical tissue transfers, where new tissue is only relocatable over the distance if its vessels are immediately connected by microsurgery under a microscope.