What does the (abdominal) surgeon needs to know on plastic surgery

Background Graduates and surgeons in the middle of their professional career need to be instructed or minded, which can be considered overlapping fields in surgery.

Aim The aim is based on

• selective references from the scientific medical literature (and)

• own clinical management experiences obtained in daily surgical practice

  to reflect the established interdisciplinary aspects of general/abdominal and plastic surgery.

  Results(corner points): The spectrum of overlapping diagnoses, surgcial fields and surgical interventions comprises:

  • Decubital ulcers- need coverage, e.g., by a rotation flap plasty (fasciocutaneous, gluteal), V-Y flap (myocutaneous) or “tensor-fascia-lata“(TFL) flap,

  • Coverage of soft tissue defects -managed with fasciocutaneous or muscle flaps (TFL, “rectus-femoris“ flap, “vastus-medialis“ flap or “vastus-lateralis“ flap),

  • Bariatric surgery – incl. surgical interventions such as butt lift, tummy tuck,

  • Abdominoperineal rectum extirpation (APE) by Holm’s procedure – tissue defects reconstructed by VRAM flap,

  • Hernia surgery – covered by means of a flap plasty (pediculated “rectus-femoris-muscle“ flap; eventually, free flap plasty),

  • Necrotising fasciitis – tissue defect can be covered by mesh graft of flap plasty (pediculated/free),

  • Soft tissue tumor lesions (as in abdominal surgery but abroad the discipline involving maxillary and fascial surgery, otorhinolaryngology, neurosurgery, orthopedic surgery etc.),

  • Liposuction/-filling – after bariatric surgery or for lipedema and for reconstruction/aesthetic purpose, resp.,

  • Reconstruction of lymphatic vessels (such as lympho-venous anastomoses, lympho-lymphatic anastomoses or free microvascular lymph node transfer),

  • Microsurgery – e.g., surgery of peripheral nerves, such as recurrent laryngeal nerve,

  • Sternumosteomyelitis (exceptional case or additional finding) – plastic surgery coverage.

Conclusion An interdisciplinary approach of abdominal and plastic surgery cannot be further disregarded in the demanding daily clinical practice. Takeover of subsequent subtasks or line-up of interdisciplinary surgical teams will be benefitial in various scenarios. Complex oncosurgical diseases (tumor manifestation within the small pelvis (deep primary rectal cancer or sarcoma after neoadjuvant treatment), post-infection defect coverage, bariatric and lymphedema surgery (among others) will benefit from interdisciplinary cooperation of the two surgical fields abdominal and plastic surgery.

 

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Publication History

Article published online:
19 August 2022