Principles of plastic surgery



Plastic surgery techniques



Classification of WOUNDS



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Healing time and chronicity



Types of problem involning the plastic surgeon
Aetiology defect
Example
Congenital abnormity
Cleft lip and palate
Congenital hand abnormalies
Trauma
Lover limb soft tissue loss
Hand injury
Pressure sore – decubitus ulcer
Burns
Extensive skin loss
Neoplasma
Skin cancer
Intraoral cancerexcision and recontruction
Brest reconstruction following mastectomy
Degenerative process
Rheumatoid hand deformities
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Skin Graft
•Skin grafting is a surgical procedure that involves removing skin from one area of the body and
moving it, or transplanting it, to a different area of the body

Why are skin grafts done

Skin grafting is a surgical procedure that involves removing skin from one area of the body and
moving it, or transplanting it, to a different area of the body.
Skin grafts are performed in a hospital. Most skin grafts are done using general anesthesia, which
means you’ll be asleep throughout the procedure and won’t feel any pain

Advances in skin grafting and treatment of cutaneous wounds
•
Bryan K. Sun,

Types of skin grafts
•There are two basic types of skin grafts: split-thickness and full-thickness grafts.
•A split-thickness graft involves removing the top layer of the skin — the epidermis — as well as a
portion of the deeper layer of the skin, called the dermis.
•Split-thickness skin grafts are usually harvested from the front or outer thigh, abdomen,
buttocks, or back. Split-thickness grafts are used to cover large areas. These grafts tend to be
fragile and typically have a shiny or smooth appearance.
•

Types of skin grafts
•A full-thickness graft involves removing all of the epidermis and dermis from the donor site.
–These are usually taken from the abdomen, groin, forearm, or area above the clavicle (collarbone).
–They tend to be smaller pieces of skin, as the donor site from where it’s harvested is usually
pulled together and closed in a straight-line incision with stitches or staples.
•Full-thickness grafts are generally used for small wounds on highly visible parts of the body,
such as the face.
•Unlike split-thickness grafts, full-thickness grafts blend in well with the skin around them and
tend to have a better cosmetic outcome.
•

Flap
•Flap surgery is a technique in plastic and Reconstructive surgery where any type of tissue is
lifted from a donor site and moved to a recipient site with an intact blood supply. This is
distinct from a graft, which does not have an intact blood supply and therefore relies on growth of
new blood vessels.
•Local flaps
•Regional flaps
•Distant flaps
•

Flap classifications by tissue type



Flap classifications by Vascular
•Classification based on blood supply to the flap:
•Axial flaps are supplied by a named artery and vein. This allows for a larger area to be freed
from surrounding and underlying tissue, leaving only a small pedicle containing the vessels.
–Reverse-flow flaps are a type of axial flap in which the supply artery is cut on one end and blood
is supplied by backwards flow from the other direction.
•Random flaps are simpler and have no named blood supply.
•Pedicled flaps remain attached to the donor site via a pedicle that contains the blood supply.

Tissue expansion
•Skin expansion is a common surgical procedure to grow extra skin through controlled mechanical
overstretch. It creates skin that matches the color, texture, and thickness of the surrounding
tissue, while minimizing scars and risk of rejection

Ablative Techniques
•These techniques involve creating a uniform wounding of the top layer of the skin, which when
heals, grows back uniform and firmer.
•There are two very common Ablative Techniques, which are used by the majority of the plastic
surgeons
–CO2 Laser – this has been used for a long time for treatment of issues like scars, wrinkles, warts
etc.
–Erbium Laser – this is a comparatively newer procedure used for treatment of deep lines, wrinkles
on not just the face, but also on the neck, hands and feet.
•

Aesthetic or plastic cosmetic surgery