RECONSTRUCTIVE
Restore tissue lost to trauma, burns, infection or cancer excision with skin grafts and flap surgery — rebuilding both the function and the appearance of the area.
THE PROMISE
Defect reconstruction using skin grafts and / or flaps – Skin grafts are often employed after serious injuries when some of the body’s skin is damaged. Flap surgery is a piece of tissue that is still attached to the body by a major artery and vein or at its base. This piece of tissue with its attached blood supply is used in reconstructive surgery by being set into a recipient site (injured area onto which a flap or graft is placed).
Skin grafting is a type of medical grafting involving the transplantation of skin. The transplanted tissue is called a skin graft. Skin grafting is often used to treat:
Skin grafts are often employed after serious injuries when some of the body’s skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: it can reduce the course of treatment needed (and time in the hospital), and it can improve the function and appearance of the area of the body which receives the skin graft.
There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy part of the body (the donor section), like peeling a potato, or a full thickness skin graft, which involves pitching and cutting skin away from the donor section. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a Cesarean section scar. For full thickness skin grafts, the donor section will often heal much more quickly than the injury and is less painful than a partial thickness skin graft.
Flap surgery is a piece of tissue that is still attached to the body by a major artery and vein or at its base. This piece of tissue with its attached blood supply is used in reconstructive surgery by being set into a recipient site (injured area onto which a flap or graft is placed). Sometimes, the flap is comprised of skin and fatty tissue only, but a flap may also include muscle from the donor site (the area from which the flap is raised).
If you have suffered tissue loss over any area of your body, you may be a candidate for flap surgery. This type of reconstructive plastic surgery is typically used to repair defects left behind after traumatic injury or mastectomy. Flap techniques can also produce excellent results in facial reconstruction after skin cancer excision.
There are as many types of flaps as there are types of injuries which might require the use of a flap. Flaps come from many different locations, and are used in many different ways to accomplish the desired result. However, flaps used for reconstructive plastic surgery can be broken down into two main categories.
In a pedicled flap, tissue is freed and rotated or moved in some manner from an adjacent area to cover the defect, yet remains attached to the body at its base and has blood vessels that enter into the flap from the donor site. The type of flap movement required determines which of the four main types of local flaps is used.
In a free flap, tissue from another area of the body is detached and transplanted to the recipient site and the blood supply is surgically reconnected to blood vessels adjacent to the wound.
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Will the reconstructed area have a noticeable scar?
Some scarring is unavoidable whenever skin is repaired, but the aim is to restore both the function and the appearance of the area as well as possible. Where a flap is moved from an adjacent site, the change can blend well with the surrounding skin; a full-thickness graft typically leaves a fine line at the donor site, similar to a Caesarean-section scar. Scars usually keep softening and fading over many months.
What happens to the donor area where skin or tissue is taken from?
The donor site is the healthy area the graft or flap is raised from. With a full-thickness graft this often heals more quickly than the original injury and tends to be less painful than a partial-thickness graft. Your surgeon chooses a donor site that gives a good match while keeping any second scar as discreet as possible.
How long does recovery take?
It varies a great deal with the size and location of the defect and the technique used, so a realistic timeline is given for your specific case. In general the graft or flap needs time to settle and its blood supply to establish, the wound is protected during early healing, and activity is built back up gradually. Larger reconstructions and those involving muscle naturally take longer than small grafts.
Will I need a general anaesthetic, and is more than one operation likely?
Reconstruction of this kind is usually carried out under general anaesthesia. Some defects are closed in a single operation, while more complex ones — or cases where healing needs to be checked at each stage — may be planned over more than one procedure. What to expect for your situation is explained clearly beforehand.
Can this be done at the same time as removing a skin cancer or after a mastectomy?
Yes — flap and graft techniques are often used to repair the defect left after skin-cancer excision or after a mastectomy, and reconstruction can sometimes be carried out at the same time as the removal. Whether to reconstruct immediately or in a later stage depends on your case and is decided with Dr. Karatzias.
What should I expect at the first consultation, and what does it cost?
At the consultation the area is assessed, your medical history and any earlier surgery are reviewed, and the most suitable graft or flap technique is discussed along with realistic expectations for healing and scarring. The cost depends on the individual treatment plan and is explained during that appointment. To arrange one, call +357 22 275522 or request a consultation through the website.
RELATED PROCEDURES
Surgically removing skin cancers while preserving appearance.
Repair and reconstruction of wounds, lacerations and trauma.
Rebuilding the breast after mastectomy.
Book a consultation with Dr. Karatzias to discuss defect reconstruction. In-person in Cyprus.
CALL +357 22 275522
Staying at the forefront of medical advancement. Dr. Karatzias is proudly accredited by leading global organizations in both Plastic Surgery and Wound Management.
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