Reconstructive surgery is a vital field focused on repairing or restoring the form and function of body parts impacted by conditions like congenital defects, developmental abnormalities, trauma, infection, tumors, or diseases.
A significant aspect of this field is reconstruction after cancer surgery, where local or perforator flaps are often used. These techniques involve transferring skin, tissue, or muscle from a healthy part of the body to the affected area.
Local flaps are segments of tissue still attached to their original blood supply and are moved to cover nearby defects.
Here are some of the most frequently used local flaps:
- Rotation Flaps: These flaps are semicircular and are rotated into the defect. They are commonly used for facial reconstructions, particularly in areas like the cheek or forehead.
- Advancement Flaps: These flaps move directly forward to fill a defect without rotation or lateral movement. They are often used for closures in relatively linear defects.
- Transposition Flaps: These flaps, like the Z-plasty, are transposed over an adjacent area to cover a defect. They are useful in areas where tissue is tight and requires relaxation for closure.
- Rhomboid (Limberg) Flaps: Designed in a diamond or rhomboid shape, these flaps are particularly useful for reconstructing defects on the trunk or limbs.
- Bilobed Flaps: This is a two-lobed flap that helps to redistribute tissue for defect closure, frequently used in nasal reconstruction.
- V-Y Advancement Flap: This flap is designed in a V-shape and advanced into a defect, then closed in a Y-shape, often used for fingertip injuries or in areas with ample loose skin.
- Island Flaps: These flaps are fully detached except at their vascular pedicle and are useful in areas requiring significant movement of tissue.
Each local flap is chosen based on the specific requirements of the defect, such as its size, depth, and location, as well as the characteristics of the surrounding skin, including elasticity and available tissue. Local flaps are preferred in many cases due to their simplicity, reliability, and the excellent match of skin color and texture they provide. They play a vital role in achieving functional and aesthetic reconstruction with minimal donor site morbidity.
Perforator flaps, a more advanced technique, involve moving skin and soft tissue from one area of the body to another, keeping the blood supply intact through small perforating vessels. These methods are crucial for restoring functionality and aesthetic appearance, particularly after cancer resections. Unlike cosmetic surgery, which aims to enhance appearance, reconstructive surgery focuses on repairing and reconstructing physical abnormalities, thereby significantly improving patients' quality of life and emotional well-being.
- ALT Flap (Anterolateral Thigh Flap): This flap uses skin and fat from the thigh, making it a versatile choice for reconstructing various body areas, including the head, neck, and extremities.
- TUG Flap (Transverse Upper Gracilis Flap): Utilized primarily for breast reconstruction, this flap takes tissue from the upper thigh, including part of the gracilis muscle.
- SGAP and IGAP Flaps (Superior and Inferior Gluteal Artery Perforator Flaps): These are used for hip and buttock area reconstructions, often in breast reconstruction, utilizing tissue from the buttock region.
- TDAP flap, or Thoracodorsal Artery Perforator flap : This method focuses on using skin and fat from the upper back, near the armpit, while preserving the underlying muscles, particularly the latissimus dorsi muscle.
- Breast Implant Removal
Explant Surgery - Microsurgery
Microscope-Assisted Operations - Skin Cancer Removal
Reconstruction After Skin Cancer - Tissue Expansion
Growing Extra Skin for Reconstruction
SEE 3D ANIMATIONS on the website www.plasticsurgery.org