Skin
What's the difference between a graft and a flap? A graft is just the skin without a blood supply, whereas a flap is transferred with its blood supply intact. With a flap, larger amounts of tissue can be used, including muscle if required. Some reconstructions need both a flap and a graft.
The main disadvantage of a skin flap is that extra incisions are required which are sometimes quite large. Every effort is made to camouflage these incisions by placing them in the natural skin lines. Flaps may become infected or bleed like any other skin procedure. Occasionally the skin flap may breakdown.
The overall flap success rate was 92.6%. Over a third of patients (34.3%) had flap-related complications ranging from minor wound dehiscence to total flap loss.
In most medically fit patients, flap surgery which is major complex surgery is considered safe with a low complication rate.
As such there are no side effects to the surgery; however some risk factors are involved in any operation. After the surgery, patients might encounter some bleeding and swelling. The chances of developing an infection are also high. The teeth that were treated have a tendency to become more sensitive to hot and cold.
Blood vessels supplying the flap may kink or get clots, leading to bleeding and a loss of circulation. This may cause the tissue to die, leading to a partial or complete loss of the flap. This is more common in women who smoke or have recently quit. Quitting before surgery will help you to decrease the risk.
You will need to follow the following guidelines until your incisions completely heal. This is usually 6 weeks after your surgery. Your doctor will tell you how long to follow these guidelines for. Keep your surgical sites out of the sun.
Recovery from DIEP flap reconstruction
DIEP flap surgery requires a hospital stay of about five days. Recovery can take from six to eight weeks. Keep the area clean, dry, and protected, and follow your surgical team's instructions on when to start walking, stretching exercises, and regular daily activities.
You may need to have the dressing to your flap or graft site changed by your provider a couple times over 2 to 3 weeks. As the site heals, you may be able to care for it at home. Your provider will show you how to care for your wound and apply dressings. The site may become itchy as it heals.
The most obvious sign of an unhealthy skin graft is darkening skin that lacks the pink appearance of healthy skin. A dying skin graft also won't blanch or return to normal skin color when it receives pressure. If you're experiencing these symptoms near the site of your skin graft, your wound may have been compromised.
Vascular occlusion (thrombosis) remains the primary reason for flap loss, with venous thrombosis being more common than arterial occlusion. The majority of flap failures occur within the first 48 hours.
Signs of a congested (venous compromised) flap include a bluish color, increased swelling and warmth, and shortened capillary refill (<2 seconds). In the case of ischemia (arterial compromised flap), the flap will be pale in color, cold, and will have a delayed capillary refill (>3 seconds).
At first, the colour of the grafted skin may appear red or purple, but it should begin to look more like your surrounding skin over time. It can take a year or two for the appearance of the skin to settle down completely.
Where a wound is unable to be repaired using a primary closure (or secondary intention healing) a flap provides the benefit of supplying tissue of a similar appearance and thickness to that of the tissue which has been removed. This means the ultimate cosmetic result is usually superior to that of a skin graft.
Indications of skin grafting include deep second or third-degree burns, traumas, and non-healing or large wounds that will not close via primary or secondary intention.
It is common to experience some pain following gum flap surgery. Some people also get anxiety issues about their perception of pain after the surgery.
Particularly in the first few weeks after surgery, sleeping on your back, while usually wearing a surgical bra, allows the breasts to heal in a more comfortable and desirable position.
Reconstruction with an implant is simpler than other types of reconstruction. It causes less scarring because tissue isn't normally taken from other areas of the body. It gives a reasonable shape for small or medium sized breasts. The reconstructed breast doesn't change in size if you gain or lose weight.
In order to close the stomach incision, the upper abdominal tissue is stretched down to meet the lower part of the incision. The skin ends up covering the belly button, so a new hole must be created to expose it. I now have a small circular scar that surrounds my “new” (and improved) belly button.
DIEP Flap Candidacy
Your candidacy for DIEP flap can be determined through a consultation with our surgeons. Generally speaking, you may be a candidate for DIEP flap if you: Have excess tissue in your lower abdominals. Want results that typically look and feel more natural than implants.
The benefits of gingival flap surgery are clear-cut: your periodontitis will be treated and your gum health can be restored. Gum flap surgery will stop the progression of gum disease in its tracks and alleviate your pain.
Conclusions: BMI, smoking, and operative time were identified as independent risk factors for free flap failure among all flaps or within flap subsets.
Pinhole Grafting
It's minimally invasive but it does help to correct any gum recession. A small hole is made in your gum line, and when this has been done, your dentist will use special instruments to try and loosen your gums.