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. Today, you can increase or decrease almost any organ, change its shape, transplant, etc.
One of the procedures performed by plastic surgeons is a skin transplant. This operation has been practiced for many years, and every year it is improved. There are cases when almost the entire skin was transplanted. Thanks to this procedure, you can not only hide defects, but also completely change the appearance.
What is a skin transplant?
Replacing a damaged area with a new skin flap is called dermoplasty. A similar operation is performed in a surgical ward. Indications for it may be different. In most cases, this 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 another, which is the site of damage.
Recently, other transplantation methods have been actively developed. In equipped clinics and research institutes, new cells are "grown" in special conditions. Due to this, the skin can be "created", and not taken from another area. This is a huge breakthrough in medicine! Currently, this method has not yet received wide distribution, nevertheless, development is ongoing in this area.
In what cases do skin grafts?
A skin grafting operation is a surgical procedure that is necessary to replace a damaged area of tissue, as well as for cosmetic purposes. Currently, a similar procedure is carried out in almost all major clinics. A skin transplant technique should be mastered by a surgeon of any specialty. Nevertheless, so that after the operation there is no cosmetic defect left, special preparation is required. Therefore, a skin transplant on the face and open areas of the body should be performed by a plastic surgeon.
Most often, such a surgical intervention is carried out only in cases of need (for health reasons). Typically, a skin transplant is required after radical surgery, massive burns, traumatic injury. In addition, such surgical intervention may be needed during plastic procedures. In some cases, people who want to transplant the skin do not want strict indications for this operation, for example, if they want to hide a scar or pigmentation of tissue. Sometimes dermoplasty is performed to change the color of the skin. Nevertheless, it is worth remembering that, like any surgical intervention, this operation has certain risks. Therefore, in most cases, it is performed only if necessary.
Indications for dermoplasty
The main indications for a skin transplant are tissue damage. Violation of the integrity can be caused by various 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 babies are more likely to have accidents at home. As a rule, children scalded with boiling water enter the trauma unit. Among the adult population, chemical burns received at the factory are more common, less often at home.
- The presence of scar tissue, which occupies a large area of the skin.
- Traumatic injury. Skin transplantation after injury 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.
- Long non-healing wound surfaces. This group of indications should include bedsores, trophic ulcers in case of vascular diseases, diabetes mellitus.
- Plastic surgery on the face, joints.
In addition, a skin transplant can be performed with dermatological diseases, birth defects. Often this operation is performed in the presence of vitiligo - depigmented tissue sites. Hyperkeratosis and large birthmarks can also be the basis for dermoplasty. In such cases, the indications are considered relative, and the operation is performed at the request of the patient in the absence of severe somatic pathologies.
What are the methods of skin transplantation?
There are 3 methods for skin transplantation. The choice of method depends on the size of the defect and its location. Note that the method of skin transplantation is chosen by the attending physician in accordance with the equipment of the clinic. Depending on where the material for transplantation came from, auto- and allodermoplasty are isolated.
A separate type of transplantation is tissue skin transplantation.
- Autodermoplasty is performed when less than 30-40% of the body area is affected. This surgical intervention refers to the transplantation of the skin from one site to another (affected). That is, the graft is taken from the same patient. Most often, a skin area is used from the buttock, back, side surface of the chest. The depth of the flaps is from 0.2 to 0.7 mm.
- Allodermoplasty is performed with massive defects. Often in this way a skin transplant is performed after a burn of the 3rd and 4th degree. 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, since the healing of own tissues is faster, and the risk of transplant rejection is significantly reduced.
Skin Transplant Preparation
Before proceeding to a skin grafting operation, it is necessary to undergo an examination. Even if the defect is not very large, it should be assessed whether there is a risk from surgery, and how high it is in a particular case. Laboratory tests are performed immediately before dermoplasty. Among them: OAK, OAM, blood biochemistry, coagulogram.
For massive injuries, when an allograft is required, more tests must be done. After all, a skin transplant 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.
Surgical Technique
Skin transplantation for burns is not carried out immediately, but after wound healing and stabilization of the patient's condition. In this case, dermoplasty is delayed. Depending on where exactly the damage to the skin is localized, how large it is in area and depth, a decision is made on the method of surgical intervention.
First of all, prepare the wound surface. For this purpose, zones of necrosis and pus are removed. Then the defective area is treated with saline. After that, the affected tissue is covered with a graft. It should be borne in mind that the skin flap taken for transplantation decreases in size over time. The edges of healthy tissue and graft are sutured. Then apply a bandage moistened with antiseptics, healing agents, dioxin ointment. This helps to avoid infection of the postoperative wound. Apply a dry dressing on top.
Features of the operation, depending on the type of dermoplasty
Depending on the depth and location of the lesion, the technique of surgery may vary slightly. For example, if a skin transplant is performed on the face, autodermoplasty is necessary. In this case, the skin flap should be split. For this purpose, the graft is taken with a special device - a dermatome. With its help, you can adjust the thickness of the cut of the skin fragment. If surgery on the face is required, cell dermoplasty can be performed.
With massive burns or injuries, the skin’s own reserves are often not enough. Therefore, allodermoplasty has to be performed. Skin transplantation on the leg with a large size of the wound surface is carried out using synthetic material - a special mesh that fixes the graft.
What complications can occur after dermoplasty?
When transplanting the skin, complications can occur. Most often this is transplant rejection. In most cases, it develops due to infection of the sutures. After autodermoplasty, rejection is less common. Another complication is bleeding from a wound.
Skin grafting: photo before and after surgery
Skin transplantation is carried out quite often. Before deciding on an operation, it is worth looking at the photo before and after surgery. In most cases, qualified doctors predict the result and provide the patient with an image that shows how the damaged area will look when the graft has taken root.
Prevention of complications of surgery
There are several risk factors for complications after a skin transplant. Among them, children's and elderly patients, the presence of somatic pathologies, low immunity.
To avoid transplant rejection, the use of hormonal preparations in the form of ointments is recommended. To prevent bleeding and inflammation, the Pyrogenal medication and antibiotics are prescribed.