Skin Replacement: Features of Surgery

As you know, such a branch of medicine as plastic surgery, began to develop relatively recently. Nevertheless, to date, many discoveries have been made in it. To date, you can increase or decrease almost any organ, change its shape, transplant, etc.

One of the procedures that is performed by plastic surgeons is skin transplantation. This operation has been practiced for many years, and every year it is being improved. There are cases when almost all skin has been transplanted. Thanks to this procedure, you can not only hide defects, but also completely change the appearance.

What is a skin graft?

Replacement of the damaged area with a new skin flap is called dermoplasty. A similar operation is performed in the conditions of the surgical department. Indications for it may be different. In most cases, it is damage to the skin and the inability to restore it in another way. There are several varieties of dermoplasty. The most common method is a skin transplant from one part of the body to the other, which is the site of injury.

Recently, other methods of transplantation are actively developing. In equipped clinics and research institutes, "growing" of new cells under special conditions is carried out. Thanks to this, the skin can be "created", and not taken from another area. This is a huge breakthrough in medicine! At present, such a method has not yet become widespread, nevertheless, developments in this field are being carried out.

In what cases do skin transplants occur?

A skin transplant operation is a surgical procedure that is necessary to replace a damaged tissue site, as well as for cosmetic purposes. Currently, this procedure is carried out in almost all major clinics. The technique of skin transplantation should be owned by a surgeon of any specialty. Nevertheless, to ensure that after the operation there is no cosmetic defect, special preparation is required. Therefore, a plastic surgeon must perform a skin transplant on the face and open areas of the body.

Most often, such a surgical intervention is carried out only in cases of necessity (according to vital indications). Usually, skin replacement is required after radical surgery, massive burns, traumatic injury. In addition, such a surgical procedure may be necessary during the plastic procedures. In some cases, people want to transplant the skin, who do not have strict indications for this operation, for example, if they wish to hide the scar or the pigmentation of the tissue. Sometimes dermoplasty is performed in order to change the skin color. Nevertheless, it is worth remembering that, like any surgical intervention, this operation has certain risks. Therefore in most cases it is performed only when necessary.

Indications for dermoplasty

The main indications for a skin transplant are tissue damage. Violation of integrity can be caused by different reasons. The following indications for dermoplasty are distinguished:

• Burns. This refers to a significant lesion of the skin due to exposure to high temperatures or chemicals. Dermoplasty after burns is especially common among children. This is due to the fact that kids are more prone to accidents at home. As a rule, children who are scalded by boiling water come to the trauma department. Among the adult population, chemical burns, obtained at production, are more common, more rarely in everyday life.

• The presence of scar tissue, which occupies a large area of the skin.
• Traumatic defeat. A skin transplant after getting injuries is not carried out immediately. First of all, it is necessary to stabilize the patient's condition. In some cases, dermoplasty is indicated several weeks or months after the formation of the primary scar.
• Prolonged non-healing wound surfaces. To this group of indications should be attributed bedsores, trophic ulcers in vascular diseases, diabetes.
• Plastic operations on the face, joints.

In addition, skin transplantation can be performed with dermatological diseases, birth defects. Often, this operation is performed in the presence of vitiligo - depigmented tissue sites. Hyperkeratosis and birthmarks of large sizes can also be the basis for dermoplasty. In such cases, the indications are considered relative, and the operation is performed at the patient's will in the absence of severe somatic pathologies.

What are the methods of skin transplantation?

There are 3 ways of skin transplantation. The choice of method depends on the size of the defect and its location. Note that the method of transplantation of the skin is chosen by the attending physician in accordance with the equipment of the clinic. Depending on where the material is taken for the transplant, auto- and allodermoplasty is isolated.

A separate type of transplantation is a tissue transplant of the skin.

• Autodermoplasty is performed with a lesion of less than 30-40% of the body area. Under this surgical intervention is meant the transplantation of the skin from one site to another (affected). That is, the transplant is taken from the same patient. Most often use a patch of skin with the gluteal region, the back, the lateral surface of the chest. The depth of the flaps is 0.2 to 0.7 mm.
• Allodermoplasty is performed with massive defects. Often this way, the skin is transplanted after a burn of 3 and 4 degrees. By allodermoplasty is meant the use of a donor skin flap or the use of artificial (synthetic) tissues.
• Cellular dermoplasty. This method is used only in some large clinics. It consists in the "cultivation" of skin cells in the laboratory and their use for transplantation.

At present, autodermoplasty is considered the preferred method, as the engraftment of one's own tissues is faster, and the risk of developing graft rejection is significantly reduced.

Preparing for a skin transplant

Before you begin the operation for a skin transplant, you need to undergo a checkup. Even if the defect is not very large, it should be assessed whether there is a risk of surgical intervention, and how high it is in a particular case. Immediately before dermoplasty, laboratory tests are performed. Among them: UAC, OAM, blood biochemistry, coagulogram.

In case of massive lesions, when an allograft is required, more tests must be submitted. After all, the transplantation of the skin from another person (or synthetic material) can lead to rejection. The patient is ready for a surgical procedure if the total blood protein does not exceed 60 g / l. It is also important that the hemoglobin level is within normal limits.

Surgery Technique

Skin transplantation with burns is not performed immediately, but after wound healing and stabilization of the patient's condition. In this case, the dermoplasty is delayed. Depending on where the damage to the skin is localized, how large it is in terms of area and depth, a decision is made about the method of surgical intervention.

First prepare the wound surface. To this end, remove the zones of necrosis and pus. Then the defective area is treated with saline. After this, the affected tissue is covered with a graft. It should be borne in mind that the skin flap taken for transplantation decreases with time in size. The edges of the healthy tissue and transplant are stitched. Then apply a bandage moistened with antiseptics, healing remedies, dioxin ointment. This helps to avoid infection of the postoperative wound. Above put a dry bandage.

Features of the operation depending on the type of dermoplasty

Depending on the depth and localization of the lesion, the technique of operation may be somewhat different. For example, if a skin transplant is performed on the face, autodermoplasty should be performed. In this case, the skin flap should be split. With this goal, the transplant is taken with a special device - dermatome. With its help, you can adjust the thickness of the cut of the skin fragment. If surgery is required on the face, cell dermoplasty can be performed.

With massive burns or injuries of your own skin reserves, the skin is often not enough. Therefore, it is necessary to perform allodermoplasty. Skin transplantation on the leg with a large wound surface is carried out using a synthetic material - a special mesh that fixes the graft.

What complications can occur after dermoplasty?

When the skin is transplanted, complications can occur. Most often this is the rejection of the transplant. In most cases, it develops due to infection of the sutures. After autodermoplasty, rejection is observed less often. Another complication is bleeding from the wound.

Skin Replacement: Before and After Photos

Transplantation of the skin is carried out quite often. Before deciding to surgery, it is worth seeing the photo before and after the surgery. In most cases, qualified doctors predict the result and give the patient an image that shows how the damaged area will look when the transplant has taken root.

Preventive maintenance of complications of operation

There are several risk factors for the development of complications after skin transplantation. Among them, the child's and elderly patient's age, the presence of somatic pathologies, decreased immunity.

To avoid rejection of the transplant, the use of hormonal preparations in the form of ointments is recommended. For the prevention of bleeding and inflammation appoint a medication "Pyrogenal" and antibiotics.