Peculiarities of planning a skin flap transplant surgery

Plastic surgery – This is a field of medicine that deals with the correction of various human cosmetic defects. Very often, the concept of plastic surgery is generalized, believing that such operations are performed only in order to eliminate age-related changes and other shortcomings in appearance. But it is plastic surgeons who work wonders, returning a normal appearance to people whose appearance has been disfigured as a result of various injuries and injuries. One of the methods of correction of large skin wounds is the grafting of a skin flap, which helps to close the wound without causing tension on its edges. Learn more about how skin flaps are used in modern plastic surgery.

Skin flap transplantation: what is important to consider before the operation

It is important to understand the difference between a skin graft and a skin flap that is used to graft and close a wound. In the first case, a section of the dermis and epidermis is completely separated from the area from which it is taken. Skin flap – this is a section of the dermis and epidermis that moves to the area of ​​the defect, maintaining a connection with the donor bed due to the preservation of the vascular pedicle. With the help of the preserved vessels, the flap is supplied with blood until the vessels from the area into which it was transferred grow into it. Today, grafts are used more often in plastic surgery, but there are situations in which a skin flap graft is more preferable.

Flap of skin:

• When is a skin graft used?
• skin graft planning: template creation;
• characteristics of skin flaps in the postoperative period.

 

When is skin graft used

Skin grafting has its own indications and is performed to achieve the following goals:

• for closing wounds with poor blood supply to the surrounding tissues;
• for reconstruction of facial structures: eyelids, nose, cheeks and lips;
• for the correction of defects with the loss of various structures that require transplantation of complex tissue complexes;
• if it is necessary to create a sufficient layer of soft tissues over the bony prominences;
• to restore sensitivity in the reconstruction area;
• skin grafting is necessary in situations where surgical interventions are planned in the future on deeper structures in the area of ​​the wound.

 

Skin graft planning: template creation

Planning the skin flap grafting is a very important point that determines the success of the entire surgical intervention. It is important to choose the most appropriate option from all available donor sites and flap transfer options. It is imperative to clean a wound that is infected and, in some cases, close it with a skin graft prior to flap grafting. Planning a skin flap involves creating a template. The boundaries of the existing defect are transferred to a piece of matter, after which the template is applied to the donor site, holding the future flap at the base. Thus, the surgeon can assess how the defect will close, whether there will be any tension or kinks in the flap, whether there is enough tissue for closure.

Characteristics of skin flaps in the postoperative period

At the stage of planning a surgical intervention for transplantation of a skin flap, it is also important to understand what characteristics of skin flaps are observed in the postoperative period. It is important to highlight the following points:

• the color and texture of the flaps are preserved with minimal changes after surgery, so it is important to carefully select the donor site, especially for facial reconstruction;
• flap thickness: skin flaps taken from the trunk may be too thick and differ from the tissue around the recipient site. The flap can be made thinner by removing the subcutaneous tissue, but preserving the subdermal plexus;
• hair growth and sebaceous gland function are preserved on the transplanted flap;
• flap sensitivity and sweating disappear immediately after flap transplantation, but recover over a period of six weeks to three years;
• flap growth: skin flaps grow in proportion to the growth of the entire body of the patient.