Patient Profile

All reconstructive options have to be discussed with the patient, either before debridement in a one-stage reconstruction or after radical debridement in a two-stage procedure. Sometimes the patient has wishes as far as donor site

Figure 17-10 (A and B) Female patient presenting with exposed skull and unstable scars and necrosis after a scalp avulsion injury; (C) defect coverage with a free omental flap; (D) postoperative result; (E) the patient wears a wig.
Figure 17-10 (Continued)

morbidity or perioperative risk is concerned, preclude the use of local flaps even if adequate or vice versa. The functional and nutritional status of the patient, the level of disease burden, as well as the patient's social support system all need to be considered. The specific risk factors for the possible coverage options have to be evaluated on an individual basis. If the patient is older and comorbid, a long operative procedure may not be possible without a substantial risk to the patient. Two operating teams may be necessary to save operating time, one team to debride the defect and the other team to simultaneously harvest the flap. The choice of flap may also be influenced when changing positions during the operation such as from a lateral to a supine position costing too much time. If the patient is an alcoholic or noncompliant patient, one may need to find a compromise and perform a pedicled flap rather than a free flap.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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