Flap, trauma and post-cancer reconstruction using living tissue with its own blood supply.
Reconstructive surgery rebuilds tissue lost to injury, cancer surgery or disease. It uses flaps, which are pieces of living tissue moved with their own blood supply. The aim is to restore function first, with appearance following, and it is the work hospitals across Gujarat refer here.
A skin graft is a thin sheet of skin that survives by absorbing nutrients from the wound bed. It works well on flat, well supplied wounds. It fails where bone, tendon or metal is exposed, because those surfaces cannot nourish it.
A flap is different. It carries its own artery and vein, so it survives independently of what lies beneath. Local flaps rotate tissue from beside the wound. Free flaps take tissue from a distant site, such as the thigh or forearm, and reconnect the vessels under a microscope. Free flaps make it possible to close defects that would otherwise mean amputation.
Three situations account for most cases. Trauma, particularly road traffic and industrial injuries where bone is exposed. Reconstruction after cancer surgery, especially of the head and neck, where removing the tumour leaves a defect that must be filled. And chronic wounds that will not close, including diabetic and pressure ulcers.
Timing matters differently in each. Trauma often needs early cover, within days, because exposed bone and tendon deteriorate. Cancer reconstruction is usually done immediately at the time of tumour removal, which gives better function and avoids a second major operation.
Free flap surgery is long, commonly six to ten hours, and needs several days of close monitoring afterwards. The flap is checked hourly at first for colour, warmth and refill, because a problem with the blood supply detected early can often be corrected in theatre.
Hospital stay is usually one to two weeks. Recovery continues for months, particularly where the donor site was a limb. Physiotherapy is central rather than optional, and the functional result depends on it as much as on the surgery.
| Factor | What it covers |
|---|---|
| Type of reconstruction | Graft, local flap and free flap differ greatly in theatre time |
| Duration of surgery | Free flap procedures commonly run six to ten hours |
| Hospital and ICU stay | Monitoring after free tissue transfer requires close observation |
| Staged procedures | Some reconstructions need refinement in a second operation |
| Rehabilitation | Physiotherapy over the following months |
These pages answer the questions that most often come up alongside this one.
It varies enormously, because the term covers everything from a small local flap to a ten hour free tissue transfer with intensive care monitoring. An estimate is given once the operative plan is decided, covering surgery, anaesthesia, hospital stay and expected follow up.
A graft is thin tissue that survives by absorbing nutrients from the wound bed, so it needs a healthy base. A flap carries its own artery and vein, so it survives on exposed bone, tendon or metal where a graft would fail.
Usually one to two weeks for free flap reconstruction, including several days of close monitoring. Local flaps and grafts often need only a few days.
Free flap procedures commonly run six to ten hours because vessels roughly a millimetre across must be joined under a microscope. Local flaps are considerably shorter.
Free flap survival is high in experienced hands, though no honest figure can be given without seeing the individual case. Smoking, poorly controlled diabetes and previous radiotherapy all reduce it, and those factors are discussed openly before surgery.
Yes. Tissue taken from the thigh, forearm or abdomen leaves a scar there, and sometimes a skin graft is needed to close it. This is part of the trade and is explained clearly before consent.
Flap failure, partial flap loss, infection, bleeding, wound problems at the donor site, and the general risks of long anaesthesia including clots. Early flap problems can often be corrected if detected quickly, which is why monitoring is so intensive.
Reconstruction after trauma, cancer or disease is frequently covered, and the hospital team assists with pre-authorisation and documentation. Cover is confirmed with the insurer, and emergency treatment is never delayed while that happens.
Published with written patient consent and shown for education rather than promotion. Every case is different and these images are not a promise of results.
Consultations at Kiran Hospital, Katargam, Surat. Outstation and NRI patients can request a video consultation before travelling.