14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less

Name of the Procedure:

Adjacent Tissue Transfer or Rearrangement for Defects 10 sq cm or Less on Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands, or Feet

Summary

This procedure involves moving skin and tissues from adjacent areas to cover and repair defects on specific parts of the body such as the forehead, cheeks, chin, mouth, neck, axillae (armpits), genitalia, hands, or feet. It is typically used to repair small defects measuring less than 10 square centimeters.

Purpose

This procedure addresses skin defects resulting from trauma, surgery, or conditions such as skin cancer. The goal is to restore the normal appearance and function of the affected area by using nearby healthy tissue to cover and repair the defect.

Indications

• Skin cancer removal
• Traumatic injuries
• Surgical defects
• Chronic wounds or ulcers
• Congenital skin anomalies Patients suitable for this procedure generally have small skin defects (10 sq cm or less) that need to be repaired for functional or aesthetic reasons.

Preparation

• Patients might need to fast for a certain period before the procedure (usually 6-8 hours)
• Medication adjustments, such as stopping blood thinners
• Preoperative evaluation including blood tests and imaging studies if necessary
• Detailed discussion with the surgeon about the procedure, risks, and benefits

Procedure Description

1. The patient is usually given local anesthesia to numb the area.
2. The surgeon plans the transfer by marking the healthy adjacent tissue.
3. An incision is made around the defect and the adjacent tissue to be moved.
4. The healthy tissue is carefully lifted, rotated, or moved to cover the defect.
5. Sutures are used to secure the transferred tissue in place and close any incisions.
6. A dressing is applied to protect the area and promote healing.

Duration

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

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Board-certified plastic or reconstructive surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist (if general anesthesia is required)

Risks and Complications

• Infection
• Bleeding
• Scarring
• Tissue necrosis (death of the transferred tissue)
• Poor cosmetic or functional outcomes
• Allergic reactions to anesthesia

Benefits

• Improved appearance and function of the affected area
• Minimal scarring compared to larger repairs
• Quick recovery due to the use of local tissues
• High success rate for small defects

Recovery

• Keep the area clean and dry
• Follow-up appointments for suture removal and evaluation
• Pain management, usually with over-the-counter pain relievers
• Avoid strenuous activities until cleared by the surgeon
• Full recovery typically within 2-4 weeks

Alternatives

• Skin grafting: Taking skin from another part of the body to cover the defect
• Synthetic tissue substitutes
• Direct wound closure: Pulling the wound edges together, if feasible
• Pros and Cons: Skin grafting might be more suitable for larger defects but can leave more noticeable scars; synthetic substitutes might take longer to integrate and heal.

Patient Experience

• The patient will be under local anesthesia and should not feel pain during the procedure.
• Some discomfort, swelling, and bruising can occur after the procedure.
• Pain is usually manageable with prescribed pain relief methods.
• Patients can typically return to normal activities within a few days, with full recovery over a few weeks.