Describe how tissues are used

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Describe how tissues are used when there is a partient who underdoes plastic surgery or restructing of a body part.  Please provide sources

Jun 15th, 2015

Thank you for the opportunity to help you with your question!

Plastic and reconstructive surgery  requires requires either grafting or using a flap to reconstruct tissues

Please let me know if you need any clarification. I'm always happy to answer your questions.
Jun 15th, 2015

I am appreciative of your prompt answer.  Here is the actual question and I believe I need 3 types of tissues that can be harvested.

Our Veterans that are returning home after being at war have some unique problems that need to be faced. Describe the different types of tissues (3) that can be harvested from one area of a patient to be used to augment or restructure other parts of the body during plastic surgery, and describe how these tissues are used.

Jun 15th, 2015

Skin loss - flaps and grafts

· Autograft = graft from one part of body to another in the same individual

· Allograft = graft from one individual to another in the same species

· Xenograft = graft from one species to another


· A skin graft is an autograft

· Can be partial or full thickness depending on the amount of dermis taken


· Contains epidermis and superficial part of dermis

· Usually taken from donor site with dermatome or Humby knife

· Donor site epithelium grows back from sweat glands and hair follicles

· Graft can be 'meshed' to increase the area that can be covered

· Excess skin can be stored in fridge and reused for up to 3 weeks

· Partial-thickness grafts can not be used on infected wounds

· Not suitable for covering bone, tendon or cartilage

· Cosmetic result is often not good


· Contains epidermis and all of dermis

· Can only be used to cover small defects

· Good cosmetic results can be obtained

· Donor site needs to be closed with primary suture or partial thickness graft

· Common donor sites include the postauricular skin and supraclavicular fossa


· Classified according to blood supply


· Receives blood supply from segmental anastomotic or axial artery

· Examples include advancement and rotation flaps

An advancement flap

A rotation flap


· Receives blood supply from a direct cutaneous arteries

· Examples include:

o Iliofemoral island flap supplied by superficial circumflex iliac artery

o Lateral forehead flap supplied superficial temporal artery

o Deltopectoral island flap supplied by perforating branches of internal mammary artery

· Survival of all flaps depends on it receiving an adequate blood supply

· Depend on length of flap in relationship to its base

· Blood supply can be improved by the use of 'delaying' techniques

· The flap is partially raised and replaced prior to use

· Encourages the flap to increase its blood supply through the pedicle


· Frequently raised from abdomen or inner arm

· Parallel skin incisions allow tube of skin to be formed

· Skin defect is then closed

· The length of the tube should not be greater than twice the base

· Long axis of tube should parallel the direction of the cutaneous blood vessels

· Good means of delaying tissue transfer over a long distance

· Produces a good cosmetic result


· In most parts of the body the skin receives its blood supply from the underlying muscle

· Muscle, fascia and overlying skin can therefore be moved as one unit

· The survives on major blood vessel supplying the muscle

· Examples include

o Latissimus dorsi flap supplied by thoracodorsal artery

o Transverse rectus abdominis supplied by superior epigastric artery

· Allow tissue transfer to poorly vascularised areas

· Bone can also be transferred for osseous reconstruction

· Flaps usually have no sensation


· Microvascular techniques allow the anastomosis of arteries and veins

· Myocutaneous flaps can therefore be detached from blood supply

· Can be transferred to other parts of body

· Examples include the free transverse rectus abdominis flap


· Skin can be gradually stretched to accommodate a greater area

· If skin loss is anticipated it is possible to expand adjacent skin prior to operation

· Tissue expanders can be placed subcutaneously in collapsed state

· Over several weeks can be inflated with saline through a subcutaneous port

· Expanded skin can be used to cover defect and tissue expander removed

Jun 15th, 2015

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