Complex Wounds
Large wounds that struggle to heal on their own are frequently treated by plastic and reconstructive surgeons. Such wounds can develop as a result of prolonged pressure, major trauma, or even minor trauma in individuals with:
- Spinal cord injuries
- Impaired cognition
- Immobility
- Diabetes
- Medical conditions requiring immune suppression therapies
- Areas of radiation therapy
Treatment
For more superficial wounds, a regimen of dressings and supportive wound care may be prescribed for nurses to perform. This may also require surgical removal of non-viable or unhealthy tissue called debridement. If the wound is sufficiently large or slow to heal, a combination of surgical strategies can be employed to replace deficient tissue:
Skin Grafts
Heal by adhering to and being supported by the blood supply of the underlying wound.
Local Skin Flaps
Rearrangements of adjacent skin and fat which carry its own blood supply to cover the wound.
Regional or Distant Pedicled Tissue Flaps
Using a combination of tissues which carry their own blood supply over a distance to fill the wound.
“Free” or Autologous (Within The Same Body) Tissue Transfer
Disconnecting a tissue system and its feeding blood vessels from one part of the body and transplanting it to the area requiring reconstruction, using microsurgical techniques to connect the blood supplies.