470329282-Types-of-reconstructive-cosmetic-surgery.pptx

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1. Types of reconstructive & cosmetic surgery Submitted to _ Mrs.Bindu Submitted by – Shruti Paul Roll no 92

2. INTRODUCTION ABOUT PLASTIC SURGERY Plastic surgery is the surgical subspeciality that concentrates on the restoration of function & form to body structures damage by trauma ,transformed by aging process ,changed by disease process(such as skin cancer)or malformed as a result of congenital defects.

3. TYPES Plastic surgery can be divided into 2 major areas 1 Aesthetic (cosmetic) 2 Reconstructive

4. AESTHETIC (COSMETIC) PLASTIC SURGERY Aesthetic plastic surgery improves physical features that are already within normal range. It is performed for changing that result from aging, alter inherited features or because of client’s personal desire.

5. RECONSTRUCTIVE SURGERY Reconstructive surgery attempts to restore a more normal appearance or function in a person who has an abnormal body part or in whom a body part is missing. The abnormality may be a result of injury or disease, it may be congenital or may be the cause of other medical problems.

6. Types of Reconstructive Surgery 1 Skin Grafts 2 Flaps 3 Chemical face peeling 4 Dermabrasion 5 Facial reconstructive surgery

7. SKIN GRAFTS Skin grafting is a technique in which a section of skin is detached from its own blood supply & transferred as free tissue to a distant site. Skin grafting can be used to repair almost any type of wound.It is one of the common form.

8. Skin grafts are commonly used to repair defects that’s results from excision of skin tumors ,to cover areas denuded of skin (burns)& to cover wounds in which insufficent skin is available to permit wound closure .

9. TYPES OF SKIN GRAFTS Autografts Allograft s Xenografts Autograft is tissue obtained from pt’s own skin Allograft is a tissue obtained from a donor of the same species. These grafts are also called allogenic or homograft.

10. A full thickness graft consists of epidermis and the entire dermis without the underlying fat.It is used to cover wounds that are too large to be closed directly. DONOR SITE The donor is selected with several criteria in mind; Achieving the closset possible color match. Matching the texture and hair bearing qualities. Obtaining the thickest possible skin graft.

11. Xenograft or heterograft is tissue from another species. A graft may be a split thickness or full thickness graft depending on the amount of dermis is included in the specimen. A split thickness graft can be cut at various thickness & is commonly used to cover large wounds.

12. GRAFT APPLICATION A graft is obtained by a variety of instruments; Razor blades,skin grafting knives,electric or air powdered dermatomes. The skin graft is taken from the donor site & applied to the desired site, called recipient site. For a graft to survive & be effective ,certain conditions must be met : The graft must be in close contact with its bed to avoid accumulation of blood or fluid The graft must be fixed firmly The area must be free of infection

13. FLAPS A flap is a segment of tissue that remains attached to one end while the other end is moved to recipient area. A flap differs from a graft in that a portion of tissue is attached to its original site & retains it’s blood supply. Flaps may consist of skin ,mucosa ,muscle ,adipose tissue & bone. They are used for wound coverage & provide bulk especially when bone ,tendon ,blood vessels or nerve tissue is exposed.

14. SKIN FLAPS Skin flaps are sections of skin rotated from origin to cover a defect . Common uses of skin flaps to construct a neck after excision of cancer or the face. These are used to close the pressure ulcers on pelvis

15. MUSCULOCUTANEOUS FLAPS Flaps containing both muscle and skin are called musculocutaneous flaps. They are commonly used to fill in defects where muscle is missing or where muscle can provide ample blood flow to heal osteomyelitis. These flaps are named by muscle of origin.

16. FREE FLAPS A striking advance in reconstructive surgery is the use of free flaps or free tissue transfer by microvascular techniques. Free flaps are harvested from one area of the body to reconstruct a defect in a distant area. The donor tissue ( skin,muscle,bone ) is detachedfrom its blood supply at the donor site and deattached by microvascular anastomosis to arteries & veins at recipient site.

17. CHEMICAL FACE PEELING Chemical face peeling is a technique that involves applying a chemical mixture to the face for superficial destruction of the epidermis & upper layers of dermis treats free wrinkles, keratoses & pigment problems. It is specially useful for wrinkles at the upper & lower lip, forehead & periorbital areas. Pretreatment may consist of cleansing the face and hair before the procedure with a hexacholorophene detergent. The type of chemical depends on the planned depth of peel. A phenol based chemical in an oil water emulsion is commonly used because it produces a controlled, predictable chemical burn.

18. COMPLICATIONS Complications include pigment changes,infection,milia ( i.e small inclusion cysts that disappear after several months), scarring,atrophy,sensitivity changes. MANAGEMENT Chemic al face peeling is performed in the physician office or in outpatient department. After 6 to 8 hours ,the face becomes edimatous and the eyelids usually swell. The patient should be reassured that this reaction is expected and normal.

19. The patient is cautioned to move the mouth as little as possible so that the tape continous to adhere to the skin. The head of the bed is elevated and liquids are administered through a straw. Burning sensation and discomfort subside after the first 12 to 24 hours. By the 2 nd day the patient may feel moisture under the dresssings . Dressings are usually removed 24 to 48 hrs.

20. The patient may be permitted to fash thewith lukewarm water or advised to shower several times daily to help remove remaining facial crusting. Dermabrasion Dermabrasion is a form of skin abrasion used to correct acne scarring, aging & sun damaged skin. A special instrunment ( i.e motor driven wire brush,diamond impregnated dik or scarred wheel) is used in the procedure.

21. PROCEDURE Deramabrasion may be performed in physician office or operating room. It is performed under local or general anasthesia . During the procedure are used to turn the skin into numb to provide a bloodless surrounding field. During & after planning, the area is irrigated with copious amounts of saline solution to remove debris.

22. FACIAL RECONSTRUCTIVE SURGERY They are performed to repair deformities or restore normal function. They may from closure small defects to complicated procedures involving implantation of prosthetic devices to conceal a large defect or reconstruct a lost part of the face.

23. NURSING MANAGEMENT The main aim of nursing management is to provide the support to the patient and prevent the patient from psychological stress. It includes: Nursing assessment Nursing diagnosis

24. NURSING ASSESSMENT Firstly the nurse assess the condition of the patient it includes: The nurse has to check the facial expressions of the patient that whatever the procedure is succeeded or not. The nurse asses the patient emotional responses and identifies the strength as well as coping mechanisms to determine how the patient will handle the surgical procedure. The nurse should clarify the misconception after assessment.

25. NURSING DIAGNOSIS Ineffective airway clearance r/t tracheobronchial secretions. Assess the condition of the patient. If the secretions are p resent then provide suctioning to the patient. Provide oxygenation to the patient. Check the vital signs of the patient. Provide proper position to the patient to facilitate the patency of airway.

26. Acute pain r/t facial edema & effects of the procedure. Assess the level of pain. Elevate the head of patient to the facial swelling. Analgesics are prescribed to relieve pain.

27. Imbalanced nutrition less than body requirement r/t altered physiology of oral cavity, drooling, chewing, swallowing. Assess the nutrition of patient. Assess the likes &dislikes of patient. Fluids may be offered to the patient. Provide vitamins in the form of I/V fluids. Measure the weight of patient. Assess serum protein & electrolyte levels periodically.

28. Disturbed body image r/t disfigurement. Assess for any kind of deformities due to surgical procedure. Provide psychological support to the patient. Remove the mirror from the patient’s room. Ventilate the feelings of the patient. Provide the education to the family members that the disturbed image is temporary & can be improved.