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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 to repair the tissue loss or damage. In some cases, this surgery can be a lifesaver.
Need for Reconstructive Surgery
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.
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.
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.
Techniques of Reconstructive Surgery
Several “tools” could be referred to as techniques for reconstructive surgery.
- Split-thickness skin grafts to cover the defect of skin loss in burns. This technique involves taking a partial layer of skin from a normal or noninjured area. This harvested “skin” is then placed in the area of total skin loss as a graft to provide surface coverage.
- 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.
- “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)
Recovery Process After 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.
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, such as 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.
As time passed, the term for cosmetic procedures began to be known as plastic surgery, and they were being done by surgeons trained as reconstructive surgeons. (2)
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.
Reconstructive Surgery to Repair Birth Defects
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 can now be diagnosed before birth and even operated on in utero, or before birth, with a completely normal baby and no skin scars!
Cleft lip and palate deformities have been corrected surgically for nearly a hundred years. Cleft lip surgeries are usually done within 3 months. A longer wait is needed for cleft palate repair. (3)
Reconstructive Surgery for 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 the 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.
Complications Related to 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 it usually goes on for many hours. The possibility of blood loss cannot be ruled out completely as well. So, it is better to err on the side of caution and avoid this surgery if your body cannot cope with it.
Reconstructive surgery can help repair tissue damage, congenital defects, and other kinds of physical abnormalities. This kind of surgery can greatly improve the appearance and functionality of the affected body part and may be a life-saving necessity in certain cases.
But with its benefits come certain risks and complications that must be taken into account before choosing this procedure.
Speak at length with your board-certified plastic surgeon to dispel all your apprehensions, and educate yourself about all the pros and cons of this surgery to make an informed decision. The surgery itself is not the be-all and end-all of your problems and has to be followed with proper postoperative care to make it a true success.
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