Name of the Procedure:

Complex Repair of Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands, and/or Feet (1.1 cm to 2.5 cm)

Summary

This procedure involves the meticulous repair and closure of complex wounds or lacerations on the forehead, cheeks, chin, mouth, neck, axillae (armpits), genitalia, hands, and/or feet that measure between 1.1 cm to 2.5 cm in size. The goal is to restore both function and cosmetic appearance.

Purpose

The procedure addresses complex injuries that require detailed reconstruction to heal properly. Goals include preventing infection, minimizing scarring, and restoring normal function and appearance to the affected area.

Indications

• Deep or jagged lacerations
• Wounds involving multiple tissue layers (skin, subcutaneous tissue, etc.)
• Injuries in cosmetically sensitive or high-movement areas
• Wounds that are difficult to close with simple suturing

Preparation

• Patients may be instructed to fast if general anesthesia is required.
• Adjustments to medications, especially blood thinners, might be necessary.
• Pre-procedure diagnostics could include blood tests and imaging studies to assess the extent of the injury.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered based on the location and complexity of the wound.
2. Cleaning and Debridement: The wound is thoroughly cleaned and any damaged tissue is removed.
3. Layered Closure: The wound is closed in multiple layers to ensure stability and minimal scarring. Sutures may be placed in deeper tissues and the skin.
4. Dressing and Bandaging: A sterile dressing is applied to protect the wound.

Tools and equipment may include sutures, needles, scalpel, forceps, and occasionally, specialized instruments for deeper tissue closure.

Duration

The procedure typically takes 30 minutes to 1 hour, depending on the complexity and size of the wound.

Setting

The procedure is usually performed in a surgical center or hospital, either on an outpatient or inpatient basis, depending on the injury's severity.

Personnel

• Surgeon (Plastic or General)
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Scarring and cosmetic dissatisfaction
• Wound dehiscence (reopening)
• Bleeding or hematoma
• Nerve damage or loss of sensation

Benefits

• Properly healed wound with minimal scarring
• Restored function and appearance
• Reduced risk of infection and other complications

Benefits are often noticeable within a few weeks as the wound heals, although complete recovery may take longer.

Recovery

• Keep the wound clean and dry.
• Follow wound care instructions, which may include changing dressings and applying antibiotic ointment.
• Restrict movement if the wound is in a high-motion area.
• Return for follow-up appointments to monitor healing.

Recovery time can range from a few days to several weeks, depending on the wound's complexity.

Alternatives

• Simple wound closure (less appropriate for complex wounds)
• Skin grafts or flaps for very large or difficult-to-close wounds
• Conservative management with dressings and ongoing monitoring (suitable for less severe cases)

Patient Experience

During the procedure, local anesthesia will minimize pain. Post-procedure, some discomfort, swelling, and bruising are expected. Pain management will be provided, typically with over-the-counter pain relievers or prescribed medication. Patients should follow all care instructions for optimal healing.