The word "transplantation" has become very widely used and understood not only by a narrow circle of specialists. The possibilities of transplantation of various organs and tissues have been discussed for more than a decade. In plastic surgery, grafts and skin flaps are widely used today. With their help, it is possible to close large wounds that are inaccessible for primary closure with sutures without skin tension. Such surgical manipulations are very complex and time-consuming, and can only be performed by experienced specialists. What principles should plastic surgeons follow when transplanting skin flaps - read on estet-portal.com.

Skin flap transplantation: principles and indications for its implementation

A skin flap is a section of skin and subcutaneous fat, which, for certain reasons, is transferred to another place, but at the same time maintains a connection with the body through its base or vascular pedicle, thus receiving sufficient blood supply. Over time, vessels from the recipient area grow into the transplanted flap, while the nature of its blood supply changes and it begins to receive nutrition from the area in which it is located. Today, skin-fat flaps, muscle flaps covered with a skin graft, flaps from the greater omentum, flaps with atypical blood flow, and many others are widely used.

Skin flap:

  • indications for skin flap transplantation;
  • basic principles of skin flap transplantation;
  • what factors affect the possibility of transplanting long flaps.

Indications for skin flap grafting

In modern plastic surgery, skin grafting is often preferred, and there are certain indications for skin graft transplantation:

  • presence of a recipient bed with poor vascularity;
  • the need for reconstruction of the nose, cheeks, ears, eyelids and lips with their full thickness defects;
  • removal of integumentary tissues over bony prominences;
  • restoration of sensitivity of transplanted tissues due to nerve suture;
  • need for late surgical intervention through the wound to repair underlying structures.

Basic principles of skin flap transplantation

Every practicing plastic surgeon needs to keep in mind the basic principles of skin flap transplantation, which are as follows:

  • First consideration should be given to closing the defect with a skin graft, and skin grafting should be used only when indicated;
  • it is important to carefully plan the flap grafting, assessing the size of the defect and, accordingly, make a template that is transferred to the donor site;
  • it is necessary to form skin flaps of safe sizes, taking into account the anatomical features of their blood supply;
  • separation of the base of delayed, crossover, or bipedal flaps should be done in multiple steps at 2-3 day intervals;
  • it is important to take into account the lack of blood supply to the receiving bed;
  • kindling, excessive tension, pressure, infections or hematomas of the flaps should be urgently eliminated;
  • if the surgeon has doubts about the viability of the flap, it is necessary to postpone its transplantation.

What factors affect the possibility of transplanting long flaps

Quite often during plastic surgery, there is a need to use long skin flaps. The following factors influence the possibility of their formation:

  • the presence of large vessels that run along the long axis of the skin flap;
  • the location of the flaps on the neck and face of the patient, where there is always a very good blood supply;
  • use of delayed skin grafting technique;
  • use of two legged flaps,
  • the age of the patient to some extent influences: in young people, in the absence of diabetes mellitus and atherosclerosis, the length of the flaps is often longer.

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