Another dimension for the choice in the Reconstructive Ladder, the More Beneficial for the patient, or the Simplest? | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Articles in Press, Accepted Manuscript, Available Online from 09 January 2023 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2023.182418.1239 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Tarek Gamal Shoukr  1; Nader G Elmelegy2; Sameh Elghamry3
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| 1Plastic and reconstructive surgery dep Tanta University | ||||
| 2Tanta Faculty of Medicine | ||||
| 3Department of Plastic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt. | ||||
| Abstract | ||||
| Abstract: Background: The reconstructive ladder is an old concept that is familiar to all plastic surgeons. It is an arrangement of methods to reconstruct tissue defects from the easy to most complex one. With the advent of surgery, a lot of flimsy spots and difficulties showed up and yet showing up with the utilization of this old reconstructive stepping stool. The reconstructive ladder thus was subjected to several modifications. These modifications included adding rungs as negative pressure wound therapy, dermal Matrices, and perforator flap techniques2. Some authors recommended that the rungs should be considered as shifts in the surgeon’s surgical skills empathizing that the difficulty of reconstruction method is related to the degree surgeon's skills3. Objective: In this work, the authors will present another view of the reconstructive ladder that they incited that is more valuable to the patient than the bygone one. Patients and Methods: The authors discussed six clinical cases. In each case, a travel study comparing the use of all the steps of the ladder to reach the best. Results: The discussion of the clinical cases that included other reconstructive options demonstrated and affirmed the requirement for modifications in the reconstructive ladder. Conclusion: The addition of the pedicled freestyle perforator flap would be a valuable update to the reconstructive ladder. The reconstructive Ladder is better viewed and organized as an order of beneficial priority to the patients rather than a classification of reconstructive options from simplicity to sophistication. | ||||
| Keywords | ||||
| Reconstructive ladder; Pedicled freestyle perforator flaps; Perforator flaps | ||||
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