| BURNS
& TREATMENTS
Skin grafts. This treatment is often used for burn patients, when
skin is removed from one area of the body and transplanted to another.
There are two types of skin graft: split- thickness grafts in which
just a few layers of deep skin are transplanted and full-thickness
grafts, which involve all of the dermis.
During a skin graft, a special skin-cutting instrument known as
a dermatone removes the skin from an area (the donor site) usually
hidden by clothing such as the buttocks or inner thigh. Once removed,
the graft is placed on the area in need of covering and held in
place by a dressing and a few stitches. The donor site is also covered
with a dressing to prevent infection from occurring. Recovery time
from a split-thickness skin graft is generally fairly rapid, often
less than three weeks. For full-thickness skin graft patients the
recovery time is a few weeks longer. Aside from burn patients, skin
grafts can also be used during breast or nose reconstruction.
Microsurgery. Have you lost a toe, ear, finger, or even a lip?
Microsurgery may allow for those to be re-attached. Simply stated,
it is a procedure in which the surgeon uses a microscope for surgical
assistance in reconstructive procedures. By using a microscope,
the surgeon can actually sew tiny blood vessels or nerves, allowing
him or her to repair damaged nerves and arteries. This may also
be a method to relieve facial paralysis or reconstruct breasts.
Microsurgery is frequently used with other surgical procedures such
as the free-flap procedure.
Free flap procedure. A free flap procedure is often performed
during breast reconstruction or following surgery to remove head
or neck cancer. During the procedure, muscle, skin or bone are transferred
along with the original blood supply from one area of the body (donor
site) to the surgical site in order to reconstruct the area. The
procedure often involves the use of microsurgery. Healing of the
surgical site can be slow and require frequent wound care. Total
recovery may take six to eight weeks or longer.
Tissue expansion. Tissue expansion is a medical procedure that
enables your body to "grow" extra skin for use in reconstructive
procedures. This is accomplished by inserting an instrument known
as a "balloon expander" under the skin near the area in
need of repair. Over time, this balloon will be gradually filled
with saline solution (salt water), slowly causing the skin to stretch
and grow.
Once enough extra skin has been grown, it is then used to correct
or reconstruct a damaged body part. This procedure is especially
common for breast reconstruction.
Tissue expansion has many advantages in that the skin color and
texture are a near perfect match for the area in which it is needed
and there is little scarring since there is no removal of skin from
one area to another. The major drawback to tissue expansion is the
length of the procedure, which can be as long as four months. During
this period, as the balloon expander grows, the bulge under the
skin grows with it. This bulge may be desirable for a breast reconstruction
patient; however, for patients undergoing this procedure for scalp
repair, the bulge may be uncomfortably noticeable.
What Happens After Surgery for Wound Treatment?
For any surgery involving the removal and transplantation of skin,
it is extremely important that you follow the general instructions
and guidelines for the care of your wound once you are sent home.
Daily Activity
Remember: your energy level will decrease when you return home compared
to when you were in the hospital. Patients often report being more
tired and easily fatigued when at home than while they were in the
hospital. You may find it helpful to set up a regular routine, but
remember to pace yourself. If you are tired, take time to rest.
Do not overdo it.
Skin Changes
Be patient with your healing! As you continue to heal, you will
notice changes in the color, appearance and feeling of your skin
at the surgical site. You also may notice numbness, a tingling sensation
or minimal feeling around your incisions. This is normal. These
sensations will continue to improve over the next few months.
Perfusion and Circulation
It is important to monitor perfusion (passage of fluid) and circulation
of the wound site. Avoid wearing clothing that constricts or applies
pressure around your wound. Also, your doctor may give you a additional
instructions to help with circulation to the wound.
Signs of Infection At the Surgical Site
The following are signs indicating that there may be an infection
at the surgical site. Notify your physician right away if you experience
any of the following symptoms:
White pimples or blisters around incision lines
An increase in redness, tenderness or swelling of the surgical site.
Drainage from the incision line. (Occasionally, a small amount of
bloody or clear yellow-tinged fluid may drain.
A marked or sudden increase in pain not relieved by the pain medication.
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