Name of the Procedure:

Adjacent Tissue Transfer or Rearrangement, Trunk (Defect 10 sq cm or Less)

Summary

Adjacent tissue transfer or rearrangement for the trunk involves moving nearby healthy skin and tissue to cover a defect (injury or surgical site) that is 10 square centimeters or less. This helps promote healing and restore appearance and function.

Purpose

This procedure addresses skin defects resulting from trauma, surgery, or certain medical conditions like cancer excision. The goal is to repair and reconstruct the affected area, enhancing both the physical appearance and functional integrity of the skin.

Indications

• Skin defects due to surgery (e.g., removal of skin cancer)
• Traumatic injuries to the trunk
• Chronic wounds or ulcers
• Congenital defects

Patients suitable for this procedure typically have localized defects on the trunk that cannot be closed with simple suturing.

Preparation

• Pre-procedure fasting as instructed by the physician
• Adjustment or temporary discontinuation of certain medications (e.g., blood thinners)
• Pre-operative diagnostic tests, including blood work and possibly imaging studies
• Thorough medical history and physical examination

Procedure Description

1. Administration of local or general anesthesia, based on the extent of the defect and patient needs.
2. Cleaning and sterilizing the surgical site.
3. Making precise incisions around the defect and adjacent healthy tissue.
4. Gently lifting and transferring or rearranging the adjacent tissue to cover the defect.
5. Suturing the transferred tissue into place to ensure optimal alignment and healing.
6. Applying dressings or bandages to protect the area.

Instruments used may include scalpels, surgical scissors, forceps, and suturing materials.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the defect and the type of anesthesia used.

Setting

This procedure is commonly performed in a hospital operating room, outpatient clinic, or dedicated surgical center.

Personnel

• Surgeons specialized in dermatology or plastic surgery
• Surgical nurses
• Anesthesiologists or nurse anesthetists, if general anesthesia is used

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring
• Tissue necrosis or failure of the transferred tissue to integrate properly
• Temporary or permanent changes in sensation

Benefits

• Effective closure of the defect, promoting healing
• Improved cosmetic appearance
• Restoration of normal function in the affected area
• Benefits can generally be seen soon after healing begins, with significant improvement over a few weeks.

Recovery

• Follow all post-operative care instructions, including wound care and any prescribed medications
• Limit physical activity to avoid stress on the surgical site
• Attend follow-up appointments for wound assessment and suture removal, if necessary
• Full recovery typically takes a few weeks, though complete healing and optimal cosmetic results may take longer.

Alternatives

• Primary closure (suturing the wound directly, if feasible)
• Skin grafting
• Use of artificial skin substitutes
• Pros of adjacent tissue transfer include better cosmetic outcomes and functional restoration, while cons might include the complexity and longer procedure time compared to primary closure.

Patient Experience

During the procedure, patients will generally be under anesthesia and will not feel pain. Post-operatively, patients might experience discomfort, swelling, and minor pain at the surgical site, which can be managed with prescribed pain medications and proper wound care. The care team will provide specific instructions to ensure comfort and support healing.