Wound reconstruction

wound reconstruction

Complex wounds can require intricate surgical treatment to heal properly. They often involve muscles, bones, nerves, tendons, ligaments and other tissues. Our Plastic surgeons use a variety of techniques to close severe wounds, improve healing and minimize visible scarring. The HAPSI is staffed by some of the most experienced and skilled plastic and reconstructive surgeons. Our doctors have the training and expertise to perform a variety of the most complex and innovative procedures available. We utilize the latest surgical techniques in wound healing, and often combine treatment with hyperbaric oxygen therapy to further promote healing.

We Always try to use the simplest reconstructive surgery technique (according to the reconstructive ladder) but in many cases complicated surgical techniques are needed in order to adequately treat and cover the wound. There are many reconstructive surgical techniques to close open wounds that are acute or chronic. Here the most common approaches are discussed. Every patient’s wound must be individually approached and only very experienced plastic surgeons must manage such wounds.

The modern reconstructive ladder offers many options with today’s surgical techniques, medical products and technologies.

Primary closure

This refers to wound closure immediately following a surgery or an injury and prior to the formation of granulation tissue inside the gap (the defect). In general, closure by primary intent will lead to faster healing and the best cosmetic result.

Closure by secondary intention

This refers to the strategy of allowing wounds to heal on their own without surgical closure. Of course the wound should be cleaned and dressed as with any wound. Certain wounds such as small partial thickness avulsions and fingertip amputations are best left to close by secondary intent.

Negative Pressure Wound Therapy

Negative pressure wound therapy involves using a special vacuum dressing to promote wound healing. Our surgeons apply a special foam and drain with a tube before closing the wound. The tube is connected to a vacuum source. The vacuum draws excess fluid from the wound to reduce the risk of infection and increase blood flow to the area.

Skin Grafts

involves the transfer of skin from a healthy part of the body (the donor site) to cover the injured area. The graft is said to “take”when new blood vessels and scar tissue form in the injured area. While most grafts from a person’s own skin are successful, sometimes the graft doesn’t take. In addition, all grafts leave some scarring at the donor and recipient sites.

Skin Substitutes / skin matrices

Skin substitutes, either temporary or permanent, can be used to close wounds and promote healing. Temporary substitutes can be used to protect the wound from infection, such as before skin grafting, and are usually removed after a few weeks. Permanent skin substitutes are used to replace the full thickness of the skin and improve the quality of the skin at the wound site. Substitutes can be made from live human or animal cells, or made from synthetic materials, such as silicone.

Flap Reconstruction / Flap surgery

Flap surgery involves the transfer of a living piece of tissue from one part of the body to another, along with the blood vessels that keep it alive. It may be used for a variety of reasons, including breast reconstruction, open fractures or large wounds. In most cases, the skin remains partially attached to the body, creating a “flap”. The flap is then repositioned and stitched over the damaged area. Depending on the location and size of the flap, the operation can be carried out under general or local anaesthetic. As flap surgery allows the blood supply to the repaired area to be maintained, there’s a lower risk of the repair failing compared with a skin graft.

Tissue expansion

Tissue expansion is a relatively straightforward procedure that enables the body to “grow” extra skin for use in reconstructing almost any part of the body. A silicone balloon expander is inserted under the skin near the area to be repaired and then gradually filled with salt water over time, causing the skin to stretch and grow. It is most commonly used for breast reconstruction following breast removal-but it’s also used to repair skin damaged by birth defects, accidents or surgery, and in certain cosmetic procedures. If your doctor is recommending tissue expansion, this will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances.

Microsurgery/ Free flap surgery

For more complex reconstruction, a technique called a free flap is used. This is where a piece of skin, and the blood vessels supplying it, are entirely disconnected from the original blood supply and then reconnected at a new site. A technique called microsurgery (surgery using a microscope) is used to connect the tiny blood vessels at the new site. A free flap is often used when large areas of specific tissue types are needed for reconstruction. Microsurgery involves the use of a high-magnification operating microscope to perform intricate reconstructive procedures. Our specialized microsurgeons can repair damaged blood vessels, nerves and other tiny structures, as well as transplant large sections of tissue, muscle or bone from one area of the body to another.

Hellenic / American Plastic Surgery Institute

/ 117 Vasilissis Sofias Avenue · Athens · 11521
T +30 210 6854799

/ 5 Erythrou Stavrou street · Marousi · 15123
T +30 210 6854399

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