9 topics with a brief review: definitions, key facts, and classroom questions.
Plastic and reconstructive surgery in the general surgery course is not about aesthetics, but about saving lives, closing extensive defects, and restoring lost functions. In this chapter, we consistently examine all levels of reconstruction: from basic free and non-free skin grafting to highly complex operations using microanastomoses, as well as bone grafting, myoplasty, and nerve and vascular repair.
The second critical section of the chapter is dedicated to transplantology. You will study the fundamental principles of tissue and organ transplantation: from skin allotransplantation to whole-organ transplantation. Special attention is paid to immunology—the main barrier to successful engraftment—and methods for combating rejection.
During practical classes and exams, instructors most frequently ask about the classification of skin flaps (including the Filatov pedicle), indications for various types of surgery, and the basic principles of immunosuppression in organ transplantation. Without understanding these mechanisms, passing the final assessment is impossible.
What does the term "replantation" mean and when is it used?
Replantation is a type of free grafting in which affected or traumatically severed tissues (for example, a torn-off limb or scalp) are reattached to their original anatomical site.
Why is the Reverdin-Yatsenko method practically unused in modern surgery?
This method uses grafts consisting solely of the epidermis. They proved ineffective due to the extremely rapid destruction of the thin epidermal layer on the wound.
What is the difference between the Indian and Italian methods?
The Indian method is local plastic surgery (the flap is taken from the forehead and rotated to the nose). The Italian method is direct transplantation from a distant site (a flap from the arm, requiring rigid fixation of the hand to the head).
Why is an allograft transplanted for only 2–3 weeks?
This is foreign tissue that is inevitably rejected by the recipient's immune system. Its main goal is to give the patient a temporary respite, reduce intoxication, and prepare the wound for autologous skin transplantation.
What is the difference between pedicled muscle transplantation and free muscle grafting?
A pedicled flap retains its artery and innervation, allowing it to engraft and close large defects (cavities in osteomyelitis, hernias). Free grafting involves complete detachment of the muscle fragment and is used primarily to stop bleeding from parenchymal organs.
What is the main difference between free and non-free bone grafting?
In non-free grafting, the graft maintains its connection with soft tissues and blood supply. In free transplantation, the vascular pedicle is not preserved.
Master the entire topic in the "General Surgery" course
This is a summary. The course covers everything tested in classes and exams.
3,335 pages of study guides on all topics
Assignments and quizzes after every topic — just like in a colloquium