When the desired expansion has been achieved, the expander is removed and the flap is moved to the recipient site. After making the decision to use tissue expansion, the surgeon must choose the type of flap to be used. Filling is generally performed at weekly intervals, and each inflation proceeds to a point of slight discomfort or blanching of the skin overlying the implant. ![]() Inflation schedules must be individualized according to the nature and location of the deformity. At the time of tissue expander placement, a moderate volume of saline is placed, but only enough to fill the space without too much tension on the suture line. It allows the creation of skin that maintains all the skin characteristics in the area (sensation, texture, color, and hair follicles) with minimal or no donor site complications. It is a safe technique and can be used successfully for the rehabilitation of selected burn victims. Tissue expansion is an important and valuable addition to the reconstructive armamentarium of plastic and reconstructive surgeons. While grafting is a proven and effective treatment, it is important to understand that all grafts leave some scarring at both the donor and recipient sites. Sometimes, skin grafts do not take because of early complications such as infection (the most common cause of graft failure), shearing (mechanical forces that cause a graft to detach from the skin), or fluid collections underneath the graft. As with grafts used for initial treatment, recovery may take several weeks.Ī graft "takes" or is successful when new blood vessels and tissue form in the injured area. Skin grafting for burn reconstruction is a surgical procedure and is usually performed in the hospital on an inpatient basis under general anesthesia. In these reconstruction procedures, a surgeon excises (removes) an existing scar and applies a graft to the site of the removed scar. Contractures often restrict normal body movement. A contracture is a permanent shortening of the muscle, tendon or scar tissue producing deformity or distortion. Skin grafts are often used in the revision of scar contracture, which is another unfortunate consequence of burns. The grafted skin attaches to the underlying wound and effectively closes it. This skin is then placed (grafted) onto the burn wound. Skin grafts involve taking skin from unburned sites on the body (known as donor sites). However, even when this time has come, the patient-surgeon relationship may still continue and can last a lifetime.Īs with the initial treatment of severe burns, reconstructive burn procedures often require skin grafting or flap reconstruction. ![]() Burn reconstruction starts when a patient is admitted with acute burns and lasts until the patient's expectations have been reached or there is nothing else to offer. Scarring, whether it's normal or hypertrophic, contractures, loss of functional body parts, and change in the color and texture of burned skin are processes common to all burned patients that have the potential to be reconstructed.Ī realistic approach, however, is necessary to harmonize patients' expectations (which are often very high) with the likely outcomes of reconstructive surgery. As a specialist in reconstruction and burn rehabilitation, the plastic surgeon is an integral part of the burn team. ![]() Functional impairment in the head and neck region results in drooling, neck contracture, corneal exposure, nasal airway blockage, lip incompetence, inability to make facial expressions, etc. Particularly is located in the head and neck regions. Survivors, however, are often left, with functional impairment and grotesque distortion of appearance. With the opening of many specialized burn centers for acute burn injuries, death rates from severe burns have dropped significantly. Burn injuries account for over 100,000 hospital admissions per year.
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