What are flaps in plastic surgery?
Flaps are skin and subcutaneous tissue with an intact blood supply moved to cover an adjacent tissue defect. They are used in reconstructive surgery (usually performed by plastic surgeons). The kind tissue injury or defect the surgeon aims to correct determines which of three different techniques they use
- advancement flaps,
- rotational flaps or
- transposition flaps.
Many variations and modifications of transposition flaps exist. Similar to other flaps, transposition flaps may be further modified and adjusted to accommodate individual situations.
What is transposition flap surgery?
Transpositional flap surgery is a reconstructive surgery which uses transposition flaps. A transposition flap is a flap rotated to cover an intervening area of normal skin to be placed in its recipient site.
Transpositional flaps exploit skin elasticity at a site distant to the surgical defect and redirect the tension of closure, meaning the sutures or other closure techniques don’t pull the wound together at a weak part in the tissue. They are generally smaller and move more freely and are common in facial reconstruction.
What is rotational flap surgery?
Rotation flaps are flaps in which the tissue is rotated on a pivot point to cover a primary defect. Rotation flaps fill one defect by creating another defect that may be closed with less tension.
What is advancement flap surgery?
This reconstructive surgery uses flaps that involve advancement of adjacent tissue to cover a primary tissue defect.
What are the advantages of transposition flap surgery?
Transpositional flap surgery
- Accomplishes redistribution and redirection of tension.
- Tends to use smaller areas of tissue than advancement and rotation flaps.
- Results in more aesthetically pleasing scars that tend to be easy to hide.
What are the types of transposition flaps and their uses?
Many different types of transposition flaps exist, though the most used types include the following:
- Classic rhombic flap to cover rhombus-shaped defects
- Modified rhombic flaps to close defects with acute angles
- Banner-type flaps for closure of postsurgical defects of the nasal dorsum
- Tunneled transposition flap for closure of wide defects and preserving aesthetic appearance
Who should not get transposition flap surgery?
Transpositional flap surgery may not be an option for people who
What are the complications of transitional flap surgery?
- Dehiscence: A cut made during the procedure separates or ruptures after it has been sutured.
- Flap necrosis (tissue death) due to excessive tension or postoperative infection
- Pincushioning, or the trapdoor phenomenon: The puffing up or out-pouching of a flap above the surrounding skin surface. Pincushioning may occur because of
- excess subcutaneous fat under the flap,
- fluid accumulation,
- oversized flaps, or
- a failure to establish contact between the undersurface of the flap and the recipient bed (lack of contact inhibition), which pushes up the flap center.
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propofolPropofol is an intravenous anesthetic drug used for general anesthesia and sedation during surgical procedures. Common side effects of propofol include injection site burning, stinging or pain; low blood pressure (hypotension), reduced cardiac output, elevated blood pressure (hypertension), pause in breathing (apnea), lung impairment (respiratory acidosis), impaired movement, high level of emulsified fats in the blood (hyperlipidemia), and high triglyceride level in blood (hypertriglyceridemia). Abuse of propofol can cause death and other injuries.
How Long Does It Take to Recover from TRAM Flap Surgery?TRAM stands for Transverse Rectus Abdominis Myocutaneous, a muscle and tissue of the lower abdomen between the waist and pubic bone. TRAM flap surgery uses the flap (graft) from this skin, fat, and the TRAM muscles for breast reconstruction. TRAM flap surgery is done for various conditions, including for patients who have undergone breast removal surgery (mastectomy) as part of breast cancer.
What Is the Difference Between Sedation and General Anesthesia?Sedation is medically induced temporary depression of consciousness prior to procedures that cause pain or discomfort to patients. Pain relieving medications (analgesics) are also usually administered as an adjunct to sedation. General anesthesia induces full unconsciousness with a breathing machine necessary.
succinylcholineSuccinylcholine is a skeletal muscle relaxant used for medical procedures done under general anesthesia, including tracheal intubation, mechanical ventilation, and surgeries. Common side effects of succinylcholine include postoperative muscle pain, jaw rigidity, muscle twitch (fasciculation), respiratory depression, cessation of breathing (apnea), low or high blood pressure (hypotension or hypertension), irregular heart rhythms (cardiac arrhythmias), slow or rapid heartbeat (bradycardia or tachycardia), cardiac arrest, increase in intraocular pressure (IOP), high blood potassium levels (hyperkalemia), severe life-threatening drug reaction with excessively high temperature (malignant hyperthermia), salivary gland enlargement, excessive salivation, rash, hypersensitivity reactions, and others.
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