End of the Reconstructive Ladder, Local Flaps & Tissue Expansion & more.

The ladder was great for its time, guiding us through complexity in a neat, orderly fashion. But let's face it, surgery isn’t cookie-cutter, and neither are our patients. Sticking rigidly to this method can sometimes feel like wearing blinders, missing out on innovative techniques that could offer better results, faster.

Why Change

The introduction of technologies like negative-pressure wound therapy and the use of dermal matrices are game changers. These aren’t just minor tweaks; they represent a significant shift in how we can manage wounds more effectively and with better outcomes.

It’s comfortable, sure. Climbing the traditional ladder step by step is safe because it’s familiar. But what if I told you that jumping straight to what works—skipping unnecessary steps—could save time, reduce patient discomfort, and lead to better overall results?

A Different Way to Think

Think of the reconstructive elevator as your express pass to the right solution. This isn't a new idea, it's been around for a couple of decades (at least) in the literature. No more unnecessary steps—just straight to the level of complexity needed for each unique case. It’s about working smarter, not harder, and definitely not slower.

And the Reconstructive Triangle? That's an idea in the literature too. This isn’t just a shift; it’s a whole new game. Flaps, microsurgery, tissue expansion—all the tools in our kit considered simultaneously to tailor the best possible outcome from the get-go. It’s a creative, multidimensional way of thinking about reconstruction that really puts the patient’s needs front and centre.

It’s time to let go of the ladder.
P'Fella ❤️

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Read below for an overview of our article on Tissue Expansion.

Tissue Expansion

Definition
Tissue expansion optimises the viscoelastic properties of skin and increases tissue availability.

Mechanisms
Tissue expansion involves 3 processes: mechanical creep, biological creep, and stress relaxation.

Changes in Tissue Expansion
During the tissue expansion, histological changes occur. The epidermis is the only anatomical layer that increases in thickness.

Capsule Formation
After insertion, a capsule forms around the tissue expander. This has been shown to develop in 4 layers of different cellular structures.

Types of Tissue Expanders
Tissue expanders are designed in different shapes, sizes, textures, and expansion directions to fit their specific indication.

Clinical Indications
Tissue expansion can be used for a diverse group of reasons. It is commonly used in delayed breast reconstruction. It should not be used in wounds with a high risk of wound breakdown.

Read the Article