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The primary aim of reconstructive surgery is to mend damaged or destroyed tissue so that the affected body part can regain its full or maximum function.
This is typically done by transferring healthy tissue from another part of the body to the affected site, in order to repair the tissue loss or damage. In some cases, this surgery can be a lifesaver.
Why are reconstructive surgeries done?
The term “reconstructive” means to restore, rebuild, or repair something that has been damaged or destroyed. The reason for doing reconstruction is to restore function that had been lost or compromised to an individual because of injury or medical loss of tissues.
What is the technique involved in reconstructive surgery?
Several “tools” could be referred to as techniques for reconstructive surgery.
In the case of a skin burn with skin loss, split-thickness skin grafts are usually used to cover the defect of skin loss. That technique involves taking a partial layer of skin from a normal or non-injured area. This harvested “skin” is then placed in the area of total skin loss as a graft to provide surface coverage.
Other techniques for reconstruction could be raising a three-sided “flap” of full-thickness skin and the underlying tissue with blood vessels to then rotate to adjacent areas that have a total loss due to injury, excision for cancers, etc.
Other aspects of reconstruction may involve “borrowing” a section of bone to use in restoring bone removed for surgical reasons. An example is to harvest a rib bone to use in reconstructing a section of a jawbone removed in cancer surgery. (1)
What is the difference between reconstructive and plastic surgery?
People of all ages can require reconstructive surgery for a whole variety of different conditions, such as birth defects, physical trauma, wounds/injuries, tumors, developmental abnormalities and other physical deformities that obstruct proper functioning of the concerned body part.
Some people may even opt for this procedure for cosmetic reasons, i.e. to correct or reconstruct physical defects, scars or wounds that are otherwise harmless but attract attention due to their deformed appearance.
Reconstructive surgery can be performed anywhere on the body, from the top of your head to the tip of your toe. Some of the most commonly performed operations are breast reconstruction, cleft lip palate repair, burn, scar revision, hand surgery, and skin cancer-related surgery.
The word “plastic” refers to molding, reshaping, or rearranging.
The medical specialty of “plastic surgery” originated after World War ll. General surgeons, orthopedic surgeons, and dentists who served in actual war hospitals met again to develop and improve methods of restoring form and function in soldiers who survived injuries so severe that no one before could have survived.
As time progressed, the plastic surgical techniques were incorporated into civilian surgical procedures to improve the appearance of the nose, protruding chins, sagging or small breasts, etc. These surgeries for cosmetic reasons were done by surgeons trained as plastic surgeons.
Under what circumstances does reconstructive surgery become a necessity?
Reconstructive surgery includes surgery done to restore function after an injury or surgical procedure that led to a missing tissue or organ structure. Examples include a portion of a hand or arm lost in an injury, a missing breast or disfigured face after cancer surgery, or scar tissue from severe burns that prevents the joints from moving.
How long is the healing process after reconstructive surgery?
Healing after an injury (and surgery is a planned injury) has several phases.
The immediate surgical healing usually takes 10-14 days as scar forms to hold repaired tissue edges together. The scar then softens and becomes pliable over another 6 weeks or so.
However, incremental improvement to approach normal skin occurs for 2 years more. Bone grafts need several months to become strongly “welded” into place.
Some reconstructions need a series of surgeries done months apart to get the final best improvement. This is not uncommon after severe burns or after cancer surgeries.
Is reconstructive surgery good for all cancer patients?
Some forms of cancer, such as blood cell cancers (leukemia, for example), would not need reconstruction surgically.
The goal of reconstructive surgery is to restore function to as nearly normal as possible. So, if cancer has been deemed “cured” and surgical procedures are available to restore better function, if the age and health of the affected individual permit, and if tissues are available, then reconstructive surgery is an option.
Can all birth defects be corrected by reconstructive surgery?
Today, surgical tools (microscopes, cultured skin implants, etc.) have advanced to the extent that nearly all congenital disabilities can be corrected by surgery.
Congenital heart valve defects are now able to be diagnosed before birth and even operated on in utero, or before birth, with completely normal baby and no skin scars!
Cleft lip and palate deformities have been having surgical corrections for nearly a hundred years. Cleft lip surgeries are usually done by 3 months. A longer wait is needed for cleft palate repair. (3)
Are there any underlying medical conditions that can complicate reconstructive surgery?
If an individual suffers from any medical condition that cannot afford the use of anesthesia, significant blood loss, or extended operation time, reconstructive surgery is not for him/her.
Reconstructive surgery is an invasive and extensive operation that can only be performed after sedating the patient and usually goes on for many hours.
The possibility of blood loss cannot be ruled out completely as well. So, it is better to err at the side of caution and avoid this surgery if your body cannot cope with it.
Do all third-degree burns require reconstructive surgery?
By definition, a third-degree burn is a complete loss of viable skin in the burned area. The size of the burn area and the location of the burn may not require surgical excision and reconstruction.
If the burn is in an area of skin over a joint or bony prominence, function will almost always be compromised if skin coverage is not reconstructed or repaired.
In what cases is reconstructive surgery considered lifesaving?
Reconstructive surgery to keep the airway open (mouth, jaw, or bronchial tube problems) or correct heart valve problems and even surgeries done after severe trauma to the liver, abdomen, or head may be necessary to save a life.