Restoration of tissue with surgical reconstruction typically involves taking tissue from one location to fill the deficit of another location, “robbing Peter to pay Paul”. Flap mobilization refers to the tissue that maintains the blood supply so that when delivered to the tissue deficit will survive and restore tissue where needed. Flaps may come from nearby tissue (local or regional flaps) or may come from tissue not attached where the blood supply is maintained by microscopically putting blood vessels together (free tissue transfer).
For wound reconstruction, the challenge is first preparation of the wound so that surgical reconstruction can be performed. Wound Bed Preparation is an important part of wound reconstruction as well as healing without surgery. Removing unhealthy tissue (debridement), controlling bacterial burden, and controlling the inflammatory response are important to allow wound progress and successful healing with or without surgery.
Wound reconstructive surgery is challenging. Often the wounds have been open for a long time (chronic wound) often described by the length of time open, but more accurately described by the lack of wound progress toward healing. Important principles such as adequate tissue perfusion (arterial ulcers), compression and edema control (venous stasis ulcers), glucose control and offloading (diabetic foot ulcers), and avoiding pressure in boney prominent areas (pressure ulcers), are the key to success with and without surgical intervention.
Wound Reconstruction is commonly performed for:
- Diabetic foot ulcers
- Venous stasis ulcers
- Arterial ulcers or non healing amputation sites
- Pressure Ulcers
- Traumatic wounds
- Non healing surgical wounds
Restoring tissue, Restoring lives, One patient at a time…..