Conventional plastic surgery in head Conventional plastic surgery in head and neck reconstructionand neck reconstructionand neck reconstructionand neck reconstruction

Is it out of date ?Is it out of date ?

J BAUDETJacques BAUDET

Department of Plastic SurgeryHôpital Pellegrin-Tondu

Bordeaux

IPRAS – Sydney 2003

Conventional plastic surgery in head and neckConventional plastic surgery in head and neck

• Excision – Suture• Skin graftsSkin grafts

– Partial skin graftFull thickness skin graft– Full thickness skin graft

• Local, regional or conventional distal flapsSki i• Skin expansion

• Skin culture + dermal grafts

Post traumatic defectsPost traumatic defects

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

Hemangioma and vascular malformationsHemangioma and vascular malformations

NeurofibromatosisNeurofibromatosis

Giant naevusGiant naevus

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Skin carcinomasSkin carcinomas

Sequellae of burnSequellae of burn

Rare cranioRare cranio--facial malformation : the sinus pericraniifacial malformation : the sinus pericranii

Rare cranioRare cranio--facial malformation : the sinus pericraniifacial malformation : the sinus pericranii

Rare cranioRare cranio--facial malformation : the sinus pericraniifacial malformation : the sinus pericranii

Rare cranioRare cranio--facial malformation : the sinus pericraniifacial malformation : the sinus pericranii

Rare cranioRare cranio--facial malformation : the sinus pericraniifacial malformation : the sinus pericranii

ConclusionConclusionConclusionConclusion

Advantages of conventional plastic surgeryAdvantages of conventional plastic surgery

• Simple• Reliable• Good color match• Satisfactory cosmetic shape

Disadvantages Disadvantages –– Pitfalls Pitfalls -- Limits Limits

• Limited coverage potential• Sequellae at the donor site• Unability toy

– Solve composite defects– Achieve restoration of functionc e e esto at o o u ct o

Other alternativesOther alternatives

Free transfers– Skin– Skin– Muscle-tendon

Bone– Bone– Intestinal tract

Others– Others …..Isolated or in association

… Whenever mandatory