A presentation I made on the basics of pediatric plastic surgery.

1. Plastic and Reconstructive Surgery
in Paediatric Age Group
Presented By :
Dr. JANNATUL NAYEEMA TONNY
Resident, Phase A, Year 2
Department of Paediatric Surgery

2. Contents
• Introduction to Plastic Surgery
• Types of Plastic Surgery
• Anatomy of Skin
• Principles of Plastic Surgery
• Reconstructive Ladder
• Grafts
• Flaps
• Scopes of Plastic & Reconstructive Surgery in
Paediatric Surgery

3. Introduction
• The term “plastic” in plastic surgery comes from the
ancient Greek word “plassein” meaning to mould or
shape.
• Can be traced back to ancient Egypt then to 600BC
in India
• It may be defined as the surgery that involves
various techniques to restore form and function of
the body when tissues have been damaged by any
means.

4. Types of Plastic Surgery
• Cosmetic surgery
• Reconstructive Surgery

5. The Skin
Skin with its separate layers and appendages

6. Principles of Plastic surgery
• Optimization of wound by adequate debridement or resection
• Ensuring good blood supply to heal wound or flap
• Careful placement of scars - 'lines of election'
• Replacement of defect with similar tissue - like with like
• Observation of meticulous surgical technique
• Donor site 'cost‟ should be kept in mind

7. The Reconstructive Ladder

8. Grafts
Grafts are tissues that are transferred without their
blood supplies, which therefore have to revascularise
once they are in a new site.
They include the following:
• Split thickness skin grafts (Thiersch grafts).
• Full thickness skin grafts (Wolfe grafts).
• Composite skin grafts
• Nerve grafts
• Tendon grafts

9. Skin grafting process

10. The stages of Graft healing

11. Factors affecting graft healing

12. Flap
A Flap is a unit or block of tissue that is
used for reconstruction or wound closure that
retains all or part of its original blood supply
after the tissue has been moved to the
recipient location.

13. Classification of Flaps
Flaps can be classified by the four „C‟s
 Circulation – According to the blood supply
 Composition - According to the tissue contained
 Contiguity - According to the proximity to the defect
 Contour - According to the method of transfer

14. According to mode of blood supply

15. According to proximity of the defect
Regional flapLocal flap Distant flap

16. Rotation flap Transposition flap
According to mode of transfer
Advancement flap

17. Z plasty Rhomboid flap

18. Classification according to
Tissue composition
• Skin flap
• Fasciocutaneous flap
• Musculocutaneous flap
• Muscle flap
• Osteo-musculo-cutaneous
• Osseous

19. Tissue Expanders

20. Scope of Plastic surgery
in Paediatric Surgery
• Craniofacial Surgery
• Genital Reconstruction
• Congenital Limb Abnormalities
• Vascular Anomalies
• Burn Contracture

21. Apert Syndrome

22. Cleft Lip (R)

23. Cleft Palate (complete)

27. SymbrachdactylyThumb Duplication
Polydactyly

28. Cystic HygromaHemangioma

29. Post Burn Contracture

30. Y to V Flap

31. Timing of Surgery on Burn

32. Take Home Message
Plastic Surgery not only helps to regain the
form or function of an organ of a child but it
also is of extreme importance for the
psychological wellbeing of the child &
parents.

33. Thank You