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Muscle, myocutaneous, or fasciocutaneous flap; trunk

CPT4 code

Name of the Procedure:

Muscle, Myocutaneous, or Fasciocutaneous Flap; Trunk

Summary

In this surgical procedure, tissue from the trunk, including muscle, skin, and fascia, is moved (flapped) to another part of the body. This helps cover and repair areas affected by trauma, infection, or surgical removal.

Purpose

The procedure addresses defects or injuries in the trunk that need more than a simple skin graft. The goal is to restore function and appearance, facilitating wound healing and providing necessary tissue coverage.

Indications

  • Large or complex wounds
  • Post-surgical defects (e.g., after tumor removal)
  • Chronic infections or ulcers
  • Traumatic injuries requiring extensive tissue repair
  • Patients with adequate tissue for flap donor sites

Preparation

  • Fasting for at least 8 hours before surgery
  • Stopping certain medications as advised by the surgeon
  • Undergoing blood tests, imaging scans, or other pre-operative assessments

Procedure Description

  1. Anesthesia is administered to ensure the patient is pain-free during the procedure.
  2. The surgeon identifies and marks the donor site on the trunk.
  3. An incision is made to harvest muscle, skin, and fascia.
  4. The harvested tissue is carefully moved to the defect site.
  5. The surgeon meticulously sutures the flap into place, ensuring proper blood supply.
  6. Drains may be placed to remove excess fluids.
  7. The donor and recipient sites are dressed for protection and healing.

Duration

The procedure typically takes 3-6 hours, depending on the complexity.

Setting

Performed in a hospital operating room.

Personnel

  • Lead surgeon (plastic or reconstructive surgeon)
  • Surgical assistants
  • Anesthesiologist
  • Operating room nurses

Risks and Complications

  • Bleeding and infection
  • Scarring at the donor and recipient sites
  • Partial or complete flap failure (tissue death)
  • Prolonged healing time
  • Complications from anesthesia

Benefits

  • Restoration of function and appearance
  • Improved wound healing
  • Coverage of large or complex defects
  • Enhanced quality of life

Recovery

  • Initial hospital stay of 5-7 days.
  • Wound care and dressing changes as directed.
  • Limited physical activity for 4-6 weeks.
  • Follow-up appointments to monitor healing.
  • Pain management with prescribed medications.

Alternatives

  • Skin grafts: less complex but may not provide enough coverage.
  • Synthetic or dermal substitutes: options with their own risks and benefits.
  • Conservative wound care: suitable for less severe cases.

Patient Experience

  • General anesthesia ensures no pain during the procedure.
  • Post-operative pain and discomfort managed with medications.
  • Possible swelling and bruising at donor and recipient sites.
  • Support from a healthcare team for recovery and rehabilitation.

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