Name of the Procedure:

Adjacent Tissue Transfer or Rearrangement, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands, and/or Feet; Defect 10.1 sq cm to 30.0 sq cm

Summary

This medical procedure involves moving skin and underlying tissues from an adjacent area to cover a defect or wound. This method is typically used for wounds ranging from 10.1 to 30.0 square centimeters in size and can be applied to various body parts, including the face, neck, armpits, genitalia, hands, and feet.

Purpose

The purpose of this procedure is to repair defects or wounds that cannot be easily closed by simple stitching. It aims to restore functionality and aesthetics to the affected area by using nearby tissue to cover the defect, ensuring better healing and minimizing scarring.

Indications

• Large or complex wounds that cannot be closed with simple sutures.
• Skin cancer removal where significant tissue has been excised.
• Traumatic injuries resulting in sizable skin loss.
• Certain congenital deformities requiring reconstruction.

Preparation

• Fasting may be required if general anesthesia is used.
• Discontinue certain medications as advised by the doctor, such as blood thinners.
• Pre-operative assessments including blood tests, imaging studies, and sometimes a biopsy of the tissue around the defect.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered.
2. Incision: The surgeon makes incisions around the defect and the adjacent donor site.
3. Tissue Transfer: Skin and underlying tissue are carefully moved to cover the wound while ensuring blood supply is maintained.
4. Suturing: The newly placed tissue is stitched into place, and the donor site is also sutured.
5. Dressing: A sterile dressing is applied to protect the wound and initial healing.

Duration

The procedure typically takes between 1 to 3 hours, depending on the complexity and size of the defect.

Setting

The procedure is performed in a hospital operating room, outpatient surgical center, or specialized clinic.

Personnel

• Plastic or reconstructive surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is required)
• Surgical assistants

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring or poor cosmetic result
• Partial or full loss of the transplanted tissue
• Asymmetry or contour irregularities
• Adverse reactions to anesthesia

Benefits

• Enhanced healing and reduced scarring
• Restoration of function and appearance of the affected area
• Higher success rate for complex wounds compared to primary closure techniques

Recovery

• Keep the surgical site clean and dry as per doctor's instructions.
• Take prescribed antibiotics and pain medication.
• Avoid strenuous activities for several weeks.
• Follow-up appointments to monitor healing and remove sutures if needed.
• Full recovery typically takes 4 to 6 weeks, although this may vary.

Alternatives

• Primary closure with stitches, suitable for smaller wounds.
• Skin grafts, which use skin from another part of the body but may have more scarring.
• Negative pressure wound therapy, primarily for non-complex wounds.

Patient Experience

During the procedure, patients under local anesthesia may feel minimal discomfort, while those under general anesthesia will be unconscious. After the procedure, patients might experience swelling, bruising, and some pain, which can be managed with prescribed pain relief. Full return to normal activities depends on individual recovery progress and adherence to post-procedure care instructions.