Definition & Overview
Reconstructive surgery is a specialized surgical procedure performed mainly to repair and restore function to abnormal body structures. Such abnormality may be caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. The surgery usually involves taking tissue from one part of the body and transferring it to the part that requires reconstruction or repair.
There are two general categories that require reconstructive surgery, congenital and acquired. Congenital conditions refer to those abnormalities that are present at birth such as:
- deformities of the cleft lip and palate
- ear defects like prominent or constricted ears
- craniofacial conditions, and
hypospadias (defect of the urethra in boys)
Acquired conditions are those that result from accidents, injury or disease. Examples are:
Deformities due to cancer treatment – Certain cancer treatments such as mastectomy (for breast cancer) leave the affected body part deformed. Reconstructive surgery is performed to restore appearance.
- Injuries resulting from accidents such as hand and facial trauma
- Infections resulting in dead tissue
Who Should Undergo & Expected Results
Every patient who has undergone reconstructive surgery needs to adhere to follow-up care guidelines drawn up by their surgeons.
The ultimate goal of any reconstructive surgery follow-up is to make sure that the patient is recovering as he should and that there are no problems arising that can hinder his progress. Should problems arise, the patient’s medical team can easily and quickly deal with them. Meticulous observance of the follow-up protocol should lead to a healthier, stronger individual.
How Does the Procedure Work?
The follow-up procedure starts as soon as the reconstructive surgery is completed. Depending on the type of reconstructive surgery that the patient underwent, the follow-up period can extend from months to years. However, it usually progresses in the following stages:
Immediately after surgery – Postoperative care begins at the hospital following surgery. The only thing that the patient has to do is to rest and the care is usually administered by nurses, doctors and family members. Nurses will take care of the dressings, drains, pain and other medications and the patient’s overall well-being while recovering in the hospital. Family members can assist in the patient’s recovery while in the hospital by providing for anything the patient needs and keeping the patient’s movements to a minimum level. The doctor will return to examine and evaluate the patient’s recovery over time. If the patient is ready to be discharged, a postoperative guideline sheet will be given to be followed at home.
Recovery at home – Though this procedure does not require the monitoring of medical personnel, it is up to the patient and his family to make sure that everything in the guideline is followed. Usually, the instructions are related to changing dressings and monitoring for infections. Observance of the scheduling and taking of medications is also important. Care should be taken when doing normal activities, like bathing and eating. There may be some dietary restrictions following an operation. At this point, the patient is expected to rest as much as possible to allow the body to heal on its own.
Outpatient follow-up – Another follow-up appointment is scheduled at least a week after surgery. This usually involves the removal of drains or sutures, a physical examination and checking of laboratory results depending on the type of reconstructive surgery performed. Medications may be re-evaluated depending on the patient’s needs too. The results of this follow-up check-up will dictate the next series of follow-up appointments. If recovery is progressing well, the only thing left to do is monitoring. If there are complications such as fever or bleeding, a new protocol for treatment may be drawn up to ensure that the patient's recovery stays on track.
Long-term follow-up - Some reconstructive surgeries take more than a single procedure to completely repair the problem. There may be more surgeries planned in the future, in which case, there will be a necessary follow-up as well. These follow-ups may be to check on how well the body is healing in order for a new procedure to be performed or if there is a new therapy to undergo. Either way, the success of the procedure will depend on the patient’s dedication in showing up for the necessary check-ups.
Possible Complications and Risks
As with any kind of surgical operation, there are complications and risks that a patient has to watch out for. The purpose of follow-up check-ups is to minimize the risks and if inevitable, to treat them immediately so they don’t get worse.
The most common complications involve infections around the wound site. This may result from improper or negligent cleaning procedures or the body is unable to fight the infection by itself because of its weakened state. This is why it’s important to pay attention to the instructions given by nurses and doctors as well as timing the operation when the patient is healthier. The thing to do is be vigilant especially when the temperature goes higher than 101 degrees, if there is vomiting, excessive bleeding and swelling or pain around the incision area. The faster that the complications are treated, the faster the patient can recover.
- The American Society of Plastic Surgeons
- The American Society of Reconstructive Microsurgery