The nose is a layered unit: thin bony vault, cartilaginous middle/tip, and skin-soft tissue cloak. Key angles guide aesthetics (nasofrontal 115-130°, nasolabial 90-105°, Goode ratio). Septum, valve, & turbinates ensure airflow; rich carotid vessels and trigeminal nerves supply it.
Flap vascular compromise, arterial ischaemia or venous congestion, usually emerges within 72 h post‑op. Watch colour, cap‑refill, Doppler/NIRS. Early re‑exploration or adjunct venous‑drainage within 6 h can salvage >60 % of flaps; delays sharply cut survival.
Fasciocutaneous flaps use skin, fat, and fascia (without muscle) for thin, pliable, well-vascularized coverage. Supplied by perforator-fed plexuses, they’re classified by vascular entry or pedicle type. Ideal for trauma and oncologic reconstruction, with low donor morbidity and muscle preservation.
Fat grafting transfers autologous adipose tissue for volume restoration, contour correction, and tissue repair. The process involves harvesting, processing, and reinjection. Key complications include fat resorption, necrosis, and embolism.
Rotation flaps are curvilinear pivotal flaps ideal for triangular defect repair, commonly used for facial, cheek, chin, and scalp reconstruction. Success depends on defect triangulation, flap circumference, and pivot point positioning. Post-op focuses on hematoma prevention and sun avoidance.
Keloids are fibrotic scars extending beyond the original wound, driven by genetic predisposition, inflammation, and abnormal fibroblast activity. Treatment involves non-surgical options like lasers and silicone sheeting, pharmaceuticals like corticosteroids, or surgery with adjuvant therapy.
Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain disorder. It involves dysregulation of the nervous system with sensory, motor, and autonomic disturbances. Diagnosis is clinical, and treatment is multidisciplinary, including physical therapy, medications, and surgical options.
Wound dressings vary from non-occlusive to occlusive, with antimicrobial options like silver dressings. Dressing choice depends on wound factors, and adjuncts like NPWT can enhance healing.
Thatte and Thatte classify venous flaps into three types based on vein number and function. Venous flaps are infrequently used due to low survival rates and venous congestion, despite their reliable anatomy and minimal donor site morbidity.
The Mathes and Nahai Classification, introduced in 1981, describes the vascular supply to muscle and musculocutaneous flaps based on major and minor pedicles. This system is essential for planning reconstructive surgeries to ensure optimal flap survival and function.
Tissue expansion increases the availability of soft tissue by optimising the skin's viscoelastic properties. This article details the mechanism of creep, tissue expander types and indications.
Local Anaesthesia has two main types, amides and esters. This article discusses dosing, side effects, calculations with examples.
Nerve injury is a common plastic surgery condition. The degree of nerve injury helps guide its classification, management and outcomes.
Cartilage grafts can be used as supportive adjuncts in reconstruction surgery. They are autografts, prone to warping and are slow to heal due to a lack of blood supply.
Bone grafts are biological scaffolds and support structures. They can be autografts (patient's own bone), allografts (from a donor) or alloplastic. This article details their indications, properties and types of grafts.
Bone healing can be classified as primary or secondary. It undergoes haematoma formation, inflammation, proliferation, callus and remodelling.
Full-thickness and split-thickness skin grafts have a donor and recipient wound. Their healing process occurs in 4 phases. This procedure is seldom unsuccessful.
The delay phenomenon increases flap survival by increasing axial blood, increasing ischaemia tolerance, and reducing sympathetic fibres.
Angiosomes are a vascular territory. An underlying named artery supplies 3D composite blocks which are connected by choke vessels and can be used for tissue transfer.
Wound Healing is most commonly by primary and secondary intention. It involves hemostasis, inflammation, proliferation and remodelling.
Z-Plasty is a double transposition flap used to surgically treat scars. This article details indications, design, variations and complications of Z-plasty.
A flap can be classified or described by its tissue composition, vascularity, type of movement, and location in relation to the defect. This article details these classifications with illustrations and examples.
The bilobed flap is a common reconstructive option for nasal tip defects. This article describes the indications, design, geometry, and modifications of this double transposition flap.
Transversus Abdominis Plane (TAP) block uses the space between internal oblique & transversus abdominis muscle. Technique can be direct or ultrasound-guided.
The rhomboid flap is a type of transposition local flap commonly. This article on rhomboid flaps explains the classification, design repair and modifications with location-based examples and pictures.
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