PURE

About us

PURE


Plastic and Reconstructive Surgery Utrecht Research & Education (PURE) is a foundation with the goal to improve the three pillars of our department: the clinic, research and education. Doing this, we cover all aspects of Plastic Surgery and phases of research, from 'bench to bedside'. Our national and international collaborations make it possible to perform lots of laboratory and clinical studies, as well as providing courses for international surgeons (to be).

Founded on the 1st of September in 1949, the Department of Plastic and Reconstructive Surgery at UMC Utrecht has been one of the innovative and expertise departments for Plastic, Reconstructive and Hand Surgery.

Over the years, UMC Utrecht’s Department of Plastic and Reconstructive Surgery has been home to many distinguished plastic surgeons whose skillful hands and insightful vision have advanced the field. The department’s commitment to education and research have led to a broad and inclusive residency program, including reconstructive microsurgery, hand surgery, peripheral nerve surgery, pediatric plastic surgery and esthetic surgery.
Plastic and Reconstructive Surgery is a field that inherently thrives on interdisciplinary collaboration. Working together with various surgical specialties is vital to improve patient outcomes and the standard of care. Beyond our hospital, we have established a network of national and international partnerships that enrich our patient care protocols and expand our research horizons. These collaborations are essential, not only for the sharing of knowledge and expertise but also for fostering innovations that shape the future of surgery.

Research & Education Foundation

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Research is an ongoing process, improving patient care along the way. We focus on research in both clinical settings as well as fundamental research. Plastic surgery has many of areas of interest, all with conditions for which many questions remain to be answered and for which we can and must improve the treatment. This is done by research, led by our own researchers and clinicians. For this, new, large and well-organized studies are needed.

Research is enabled through funding, which may be sourced from government bodies, the private sector, and contributions from patients. The purpose of PURE is to stimulate and enable impactful research. 

Areas of interest

Nerve Problems (e.g. Pain)

Nerve pain, also called neuralgia or neuropathic pain, can have many causes, such as nerve injury, neuromas, nerve compression or nerve damage caused by a systemic disease. Symptoms can vary from a stabbing pain in the middle of the night to chronic prickling, tingling, or burning sensation.  Uncontrolled nerve pain can have an impact on daily activities and thereby the quality of life. Though treatments are available and  symptoms may improve after medication or surgery, there is still a significant proportion of patients with persistent symptoms. Depending on the type of neuropathy, revision surgery may be needed. In the patients without improvement, medication may be needed. Opioids are widely prescribed for chronic pain, including neuropathic pain, despite growing evidence of long-term harm. This underlines the need for more research into the last-resort surgical options for nerve injury, nerve compression and neuroma’s.

Diabetic Sensory Polyneuropathy

Diabetes mellitus (DM) is a highly prevalent metabolic disorder, affecting approximately 9.3% of the global population in 2019 and is expected to rise even further. With the increasing incidence of DM, an increase in diabetes-related complications is expected, resulting in more years lived in disability. One of the most critical and frequent complications of DM is diabetic sensorimotor polyneuropathy (DSP), which may lead to disabling neuropathic pain, sensory phenomena and decreased sensibility. Therefore, this is the main driver to diabetic foot complications, such as ulceration and Charcot neuroarthropathy, frequently resulting in lower-limb amputation and mortality. Historically, DSP is believed to be an irreversible condition. However, published studies have highlighted the reversibility of DSP associated complaints using peripheral nerve decompression, in the light of the ‘double crush’ hypothesis. This is reflected in the increased awareness and referral rates to surgeons. However, to successfully integrate lower extremity nerve surgery into clinical practice, more research on optimal patient selection and long-term outcomes is necessary. 

Craniofacial Anomalies

Cleft palate is not a life-threatening condition, but the impact can be enormous for children and their parents. Hundreds of children are born with it every year. Depending on the severity and type of cleft (lip, jaw, and/or palate split), children and their parents may experience significant difficulties due to the number of surgeries and hospital visits. Additionally, a substantial part of children with a cleft palate also have nasal speech, leading to poor intelligibility and eventually a significant impact on their daily life. These speech problems may even lead to additional surgeries. Research into the best surgical technique and the correct timing of the operation should prevent unnecessary operations and make the treatment plan better and more cost-effective.

Hand and Wrist Arthritis

Arthritis affecting the hands and wrists is not immediately life-endangering, yet its influence on daily life can be profound. Annually, countless individuals are diagnosed with this condition. The severity of arthritis can vary, with some experiencing minor discomfort while others face significant mobility challenges. This variability necessitates multiple medical consultations and possibly several treatments or surgical interventions. Furthermore, many sufferers of hand and wrist arthritis encounter persistent pain, which can severely limit their ability to perform everyday tasks, ultimately diminishing their quality of life. Ongoing research aimed at optimizing treatment methods and improving intervention strategies is crucial to enhancing outcomes for those affected, potentially reducing the need for invasive procedures and improving overall patient well-being.

Hand and Foot Anomalies

Hand and foot anomalies encompass a range of congenital conditions that can significantly affect individuals from birth. These anomalies vary widely, from minor deformities that may go unnoticed to severe malformations that impact functionality and appearance. Each year, numerous infants are diagnosed with such irregularities, which can lead to a variety of challenges throughout their lives. The treatment for these conditions often involves a combination of surgery, physical therapy, and sometimes prosthetics, depending on the severity and nature of the anomaly. For many affected, this can mean frequent medical appointments and multiple surgical interventions to improve mobility, function, and aesthetic appearance. Continuous research and advances in medical techniques are vital to develop more effective and less invasive treatment options, aiming to enhance the quality of life for those with hand and foot anomalies and to provide support to their families.

Breast Reconstruction

Breast reconstruction is a medical procedure aimed at restoring the breast’s shape and appearance following mastectomy or lumpectomy. This surgery is significant for many who undergo it, profoundly affecting their physical and psychological recovery. Each year, a substantial number of individuals opt for breast reconstruction, which can be performed using various techniques, including implants or tissue from other parts of the body. The process often involves multiple surgeries and a lengthy recovery period, emphasizing the importance of personalized care and treatment planning. Advances in surgical techniques continue to improve the outcomes and options available, making the procedures more effective and adaptable to individual needs. Research in this field is crucial, striving to enhance surgical methods and recovery processes, thereby minimizing complications and improving the overall well-being of patients undergoing breast reconstruction.

Lymphedema

Lymphedema occurs when fluid accumulates due to lymphatic system dysfunction, often as a result of medical treatments like lymph node removal in cancer therapy. Breast cancer surgery can cause lymphedema in the upper extremity (i.e., arm, wrist), while other cancer surgeries may lead to lymphedema in the lower extremity (i.e., leg, ankle, foot). This condition impairs mobility, causes discomfort, and adversely affects quality of life, including mental health and social interactions. Fortunately, emerging microsurgical interventions using lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) show promising outcomes in patients with lymphedema. Microsurgical interventions do not involve the same long-term costs and time-consuming trajectory that physical therapy or compression therapy entail. Furthermore, microsurgery addresses the underlying cause of lymphedema by restoring function in damaged lymphatic vessels. Researching the impact of lymphedema and identifying patients at greatest risk for developing this condition is crucial to understanding the scope of the problem. Improved insights into long-term clinical outcomes after lymphatic microsurgery could greatly influence shared decision-making between patients and physicians.