Flap surgeries
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Flap Surgeries in HSR Layout
Flap surgery is a type of plastic surgery that uses tissues from another part of the body to close open wounds while having its own blood supply.
Open wounds are an open invitation for bacteria. Loss of fluid takes place from these wounds. Therefore, the wound should be covered at the earliest with tissue obtained from another site.
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Types of Flap Surgery
Free flap
The flap with its blood vessel is disconnected and then attached to a blood vessel at a recipient site
Local Flaps
Local flaps are used from adjacent tissues. However, they can only be used for small to medium sized defects, and only locally. Depending on the way it is moved into the recipient site, the flap may be referred to as advancement (moves directly forward with no lateral movement), rotation (rotates around a pivot point to be positioned into an adjacent defect) or transposition flap (moves laterally in relation to a pivot point to be positioned into an adjacent defect)
Pedicled flap
Flap that has its blood supply with at least one artery and one vein.
Regional Flaps
Regional flaps which are obtained from tissues that are close by but not immediately next to the recipient site. The flap is moved either over or under intact tissue to reach the recipient site. Once new blood vessels are formed from the donor site, the original blood supply can be cut off.
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What are the general principles that need to be followed for a flap surgery?
- Replace like for like – Replace lost tissue with a similar kind like muscle for muscle or hairless skin for hairless skin.
- Think of reconstruction in terms of units – It is the way in which the borders between units come together and interact rather than just the borders themselves
- Always have a pattern and a back up plan – Once in the operating room, keep an open mind and be ready to adjust the surgical plan as the situation dictates.
- Steal from Peter to play Paul – Do not make mistake of merely advancing tissue to the deficient area unless this can be done completely without tension. Tension affects the blood supply of the advanced tissue which can result in flap failure.
- Do not forget the donor area – Donor areas should not be used continuously rather should be reevaluated and thought about other reconstructive options to avoid deformity or disability at the donor site.