Skin Flap Surgery

What you should know

• Skin flap surgery is done to treat large wounds that cannot be closed by skin grafting. It may also be done to repair surgical or traumatic scars to improve skin appearance. Skin flap surgery uses skin flaps, which are skin and tissue near the wound, to cover the wound. Skin flaps have good color matching and contain important skin structures needed to cover the wound. They remain attached to their original site and retain their blood supply. Sometimes, a skin flap may use a portion of skin and tissue that is attached to a specific blood vessel. With skin flap surgery, form and function to areas of the body that have lost skin may be restored.
  
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

There are always risks with surgery. You may bleed more than expected or get an infection. You could have trouble breathing or get blood clots. You could have an allergic reaction to an anesthesia medicine. Your caregivers will watch you closely for these problems. You may have continued pain or swelling after the surgery. The flap site may also not look and feel as you would have expected. Sometimes the surgery may not be successful and need to be done again. If you do not have surgery, the pain and problems you have with your wound may get worse. Call or ask your caregiver if you are worried or have questions about your surgery, medicine or care.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• If you are a female, tell your caregiver if you know or think that you are pregnant.
  
  
• You may need to have blood tests, electrocardiogram (ECG), chest x-ray, and other tests. Ask your caregiver for more information about these tests that you may need. Write down the date, time, and location of each test. Your caregiver may also need to prepare the wound and donor sites before doing the surgery. He may need to clean the wound site by removing dead tissues, and ask you to keep it free from germs. The donor site is chosen to match the color and texture of the wound site.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given medicine to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You will be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the operating room. You may get a local, regional or general anesthesia to keep you asleep and control pain during surgery. You will be placed in a position where you and the caregivers doing the surgery would all be comfortable. A caregiver will use a cleansing liquid to clean and prepare the area of your wound and donor skin. Sheets will be put over you to keep the surgery area clean.
  
  
• During surgery, the wound will be trimmed to produce a wound bed with edges. Incisions (cuts) will be made parallel or along the sides of the wound to be closed. The thickness of the flap will be made equal to the wound and will include a thin layer of fat. The skin flap will be further trimmed to the exact size and shape so it perfectly fits the wound site. It will be moved over to the wound and stitches (threads) will be used to attach it in place. Bandages will be placed to cover the flap site.

After your surgery:

You are taken to a room where you can rest. Caregivers will check on you. When they see that you are ready, you may also be allowed to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A caregiver may remove the bandage soon after your surgery to check the area.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the area where the surgery will be done.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• The problems for which you are having surgery get worse.
  
  
• You have pain, swelling, redness or pus coming out from your wound.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.