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Trauma Reconstructive Surgery

Reconstructive surgery can physically and functionally enhance abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. Generally, reconstructive surgery is performed to improve functions, but may also be performed to achieve a normal appearance. Trauma reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures and the levels of coverage may vary depending on the healthcare provider.

Facial trauma can result from a penetrating or blunt injury, such as those from gunshots, physical altercations, and motor vehicle accidents. Trauma can result in severe damage to the skin, underlying skeleton, the nasal and oral lining, and dental structures. Depending upon the extent of injuries, patients with facial trauma may be cared for by a team of specialists that includes a plastic surgeon, neurosurgeon, oral surgeon, orthodontist, ophthalmologist, otolaryngologist, psychologist and nurse.

The goals of trauma reconstructive surgery differ from those of cosmetic surgery. Trauma reconstructive surgery is performed on abnormal structures of the body caused by trauma or injury. Burn wounds, lacerations, growths, and aging problems are considered acquired deformities, in which trauma reconstructive surgery may be necessary. Some patients may find that a procedure commonly thought to be aesthetic in nature may be performed to achieve a reconstructive goal. For example, an adult whose face has an asymmetrical look because of paralysis might have a balancing facelift. Although appearance is enhanced, the main goal of the trauma reconstructive surgery is to restore function.

Skin grafts can be used to fix a wound that is wide and difficult or impossible to close directly. A skin graft is a patch of healthy skin that is taken from one area of the body, called the "donor site," and used to cover another area where skin is missing or damaged. There are three basic types of skin grafts used in trauma reconstructive surgery.

A split-thickness skin graft uses only the layers of skin closest to the surface. This type of trauma reconstructive surgery is commonly used to treat burn wounds. Your plastic surgeon will choose an inconspicuous donor site to graft the skin from. Location will be determined in part by the size and color of the skin patch needed. The skin will grow back at the donor site, although it may be a bit lighter in color.

A full-thickness skin graft might be used to treat a burn wound that is deep and large, or to cover jointed areas where maximum skin elasticity and movement are needed. A full-thickness section of skin means all layers of skin from the donor site. A thin line scar usually results from a direct wound closure at the donor site.

A composite graft is used for extremely severe trauma reconstructive surgery, when the wound needs more underlying support, as with skin cancer on the nose. All the layers skin, fat, and sometimes the underlying cartilage are required for a composite graft. A straight-line scar will remain at the site where the graft was taken.

When trauma reconstructive surgery is performed by an experienced, board-certified plastic surgeon, complications are infrequent and usually minor. The outcome of trauma plastic surgery is never completely predictable, and each individual case will vary greatly depending on the patient's anatomy and healing ability. As with any surgery, trauma reconstructive surgery complications can occur. Infection, excessive bleeding, blood clots, significant bruising and wound-healing difficulties, and problems related to anesthesia and surgery are all possible complications from trauma reconstructive surgery. Consult with your doctor to decide if trauma reconstructive surgery can benefit you.