TISSUE LOSS REPAIR: In which cases are they applied?
The goal of repairing tissue loss using plastic surgery methods is to achieve more balanced results in appearance and function while ensuring the best possible tissue healing. Plastic surgery repair methods may be necessary in conditions arising from various causes in the body.
🔹 Tissue loss occurring after surgical procedures
Tissue loss can occur after the removal of skin and soft tissue tumors. Skin grafts or flaps may be necessary for repair after extensive tumor excisions or in surgical procedures affecting functional areas such as the face, hands, and feet. Situations where we perform oncological reconstruction include:
Repair of skin loss after removal of skin cancers (BCC, SCC)
Head and neck tumors; repair of tissue defects in the mouth, jaw, and facial region.
Breast reconstruction: repairs after breast cancer treatment.
🔹 Tissue defect after trauma
In skin and soft tissue injuries where end-to-end closure is not possible, or in cases of tissue loss in functional areas, plastic surgery repairs may be necessary. The repair technique is planned according to the location and size of the injury and the need for functional restoration. Common situations we encounter include:
Deep tissue loss resulting from traffic accidents, falls, or injuries from sharp/piercing objects.
Conditions resulting in amputations or tissue loss due to workplace accidents.
These are soft tissue and bone losses resulting from gunshot wounds.
📝 For detailed information about hand tissue loss due to trauma, please visit our " Hand Tissue Loss" page.
🔹 Burns and Infections
Deep burns: Treatment and repair of burns that penetrate deep layers of the skin, causing loss of function or disfigurement, using skin grafts.
Infections (Necrotizing Fasciitis, etc.): Closing large wounds that form after infections that rapidly destroy skin and soft tissue.
🔹 Chronic wounds and pressure ulcers
In paralyzed or bedridden individuals , bedsores may require removal of dead tissue and repair of lost tissue.
In people with diabetes, uncontrolled glucose levels and neglecting foot care can lead to ulcers known as "diabetic foot." The care and repair of these ulcers are carried out using tissue repair techniques.
Radiation damage can cause scarring in areas treated with radiotherapy, and reconstruction may be necessary.
🔹 Problems related to wound healing
Scar revision may be necessary for healing problems in wounds resulting from surgery or trauma.
Scar tissue that forms after wound healing can harden or contract, leading to functional consequences; in such cases, contracture release procedures may be necessary.
📝 For comprehensive information on surgical treatments for scars, please visit our "Scar Revision" page.
🔹 Congenital Anomalies (Birth Problems)
Congenital tissue deficiencies such as cleft palate and lip, and facial clefts are treated with region-specific techniques.
In some cases of congenital tumors or adhesions, tissue repair techniques are applied.
METHODS USED IN TISSUE REPAIR
A personalized treatment plan is created by evaluating the location, size, depth, cause, and degree of functional loss of the area requiring tissue repair. The patient's general health status, age, and compliance with treatment are also carefully considered when deciding on the scope of the surgery.
1) Skin Grafts
Skin grafting (or skin patching) is the process of transferring a thin strip of skin from one part of the body to another to cover open wounds. Skin grafts are classified according to the thickness of the skin graft taken.
Split-Thickness Skin Graft: The upper layer of the skin (epidermis) and a portion of the dermis.
Full-Thickness Skin Grafting: All layers of skin (epidermis and dermis) are harvested.
📝 For detailed information, you can check out our article "What is a skin graft?" .
2) Flap repair
A flap is a procedure where not only skin but also the underlying tissues (fat, muscle, blood vessels) are transferred to another area while preserving the blood vessels.
Local flaps: Wounds are closed by sliding flaps from adjacent tissues.
Regional Flaps: These are transferred from a more distant area of the body, on a pedicle (along a vascular stalk).
Free Tissue Transfer (Microsurgery): The tissue, along with its blood vessels, is completely removed and connected to the vessels in the damaged area using microsurgical techniques. [ 1 , 2 , 3 ]
3) Repairs with Tissue Expander
In areas where there is insufficient tissue, this procedure involves placing a silicone implant under the skin and gradually inflating it to increase the volume of adjacent healthy tissue, which is then used in reconstruction. It is a preferred method for scalp burns and breast reconstruction.
4) Tissue relaxation and deformation
Abnormal healing, thickening, contraction, and shrinkage can occur in wounds resulting from trauma and surgery, especially burns. Techniques that alter tissue orientation, such as "Z-plasty" and "W-plasty," can be applied to loosen the wound and change its direction.
5) Tissue engineering and cellular therapies
Artificial skin products, stem cell therapies, and biological dressings are used to promote tissue repair, particularly in cases of severe burns or non-healing wounds.
