Plastic and Reconstructive Surgery: Reconstructive Surgery
Abdominal Wall Reconstruction
Often times after multiple abdominal procedures, patients are left with unsightly
scars, chronic/poor healing wounds, chronic pain, and hernias. These patients may
benefit from plastic surgery intervention to perform scar revision, panniculectomy
or other reconstructive procedures to correct these deformities.
This procedure involves reconstruction of a breast that has been removed due to
cancer or other disease. Frequently, reconstruction is possible immediately following
breast removal (mastectomy), so the patient wakes up with a breast mound already
in place, having been spared the experience of seeing herself with no breast at
all. Types of breast reconstruction offered by the University of Florida Plastic
Surgery Institute of Jacksonville include tissue expander/implant reconstruction,
and autologous tissue reconstruction (using your own tissue) including latissimus
dorsi myocutaneous flap, and rectus abdominus (TRAM) myocutaneous flap.
Decubitus Ulcer Surgery
Decubitus ulcers are wounds that develop usually when patients have a loss or decreased
level of sensation that prevents them from feeling when they have been sitting or
lying in one position too long. A wound, also known as a bed sore, starts out superficial
but becomes deeper as time goes by and can involve skin, subcutaneous tissue (fat),
and even bone. These wounds can be treated by modification of lifestyle including
obtaining a specialty bed at home which redistributes pressure so that a patient
is not putting pressure on the same area all the time, and improving nutrition.
Often times, patients may need more aggressive surgical intervention by the time
they are referred to a plastic surgeon (skin graft, muscle flap coverage of the
wound). In some instances, these patients and their wounds are poorly cared for
and need a procedure to remove dead tissue, which can be performed by a general
Typically for obese patients, panniculectomy involves removal of skin and fat below
the umbilicus (navel or bellybutton) to improve hygiene, help with yeast-type rashes,
poor mobility, etc. NO tightening of the “muscles” (fascia) is performed. Typically
these patients are observed in the hospital for 1-5 days, depending on their other
medical problems. The procedure takes 3-5 hours. Drains are placed at the time of
surgery, which may remain in place for up to a month (depending on the drainage
which is often related to the amount of tissue removed).
Split- and Full-Thickness Skin Grafts
Skin grafts require harvesting skin (the epidermis and a small amount of dermis)
from one part of the body (often the thigh) to cover a wound that would take much
longer to heal on its own without a skin graft. These grafts are used for the closure
of acute and chronic soft tissue wounds, provided bone and tendon is not exposed.