15650 Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location

Name of the Procedure:

Transfer, Intermediate, of Any Pedicle Flap (e.g., Abdomen to Wrist, Walking Tube)

Summary

This surgical procedure involves moving a section of tissue (pedicle flap) from one part of the body, like the abdomen, to another, such as the wrist, while keeping the original blood supply intact. This is typically used to repair or reconstruct damaged areas.

Purpose

The procedure aims to restore form and function to an area affected by trauma, burns, surgery, or disease. It helps cover large wounds, provide durable tissue coverage, and improve the cosmetic and functional outcomes of the affected area.

Indications

• Large or complex wounds that cannot be closed with simple methods.
• Defects due to trauma, burns, or surgical excision (e.g., tumor removal).
• Need for reliable blood supply to the transplanted tissue.

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Pre-operative tests such as blood work, imaging studies, and possibly an electrocardiogram (ECG) are required.
• Medication adjustments, especially blood thinners, as advised by the doctor.

Procedure Description

1. Administration of anesthesia to ensure patient comfort.
2. The surgeon designs and elevates the pedicle flap from the donor site (e.g., abdomen).
3. The flap, with its blood supply intact, is tunneled or transferred to the recipient site (e.g., wrist).
4. The flap is carefully positioned and sutured into place.
5. Ensuring the blood supply is maintained during and after the transfer.
6. Closure of the donor site with primary suturing or skin grafts if needed.

Duration

Typically, this procedure takes between 2 to 4 hours, depending on the complexity and location of the flap transfer.

Setting

The procedure is performed in a hospital operating room under sterile conditions.

Personnel

• Plastic or reconstructive surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a surgical assistant or resident

Risks and Complications

• Infection at the donor or recipient site
• Bleeding or hematoma formation
• Flap necrosis (death of transferred tissue due to poor blood supply)
• Scarring or poor cosmetic outcome
• Anesthesia-related risks

Benefits

• Effective coverage and reconstruction of defects
• Improved functional and aesthetic outcomes
• Enhanced wound healing

Recovery

• Hospital stay for a few days to monitor the flap and overall recovery.
• Instructions on wound care and activity restrictions.
• Follow-up visits to check for proper healing and address any complications.
• Full recovery can take several weeks to months, depending on the individual case.

Alternatives

• Skin grafts: Suitable for less complex defects but may not provide as robust coverage.
• Local flap procedures: May be suitable for smaller defects but limited by nearby tissue availability.
• Non-surgical treatments: Dressings and wound care for smaller wounds.

Patient Experience

• Patients will be under anesthesia during the procedure, so they will not feel any pain.
• Post-operative discomfort is common and can be managed with pain medications.
• Swelling and bruising may occur around the donor and recipient sites.
• Gradual improvement in function and appearance over the recovery period with regular follow-ups.