Cancer Reconstruction

Cancer Reconstruction

Bone Reconstruction of Jaw – Upper Jaw and Lower Jaw

Tumors of the jaw bone most often require surgical removal. This will leave a gross deformity and also affects the basic function of chewing and speech. Hence reconstruction of such defects is mandatory. As the principle of Plastic Surgery states “Like with like tissue”, the defect in the jaw is to be replaced with bone. This bone is generally harvested from leg. The bone is contoured as per the defect dimension and fixed with plates and screws. The bone is harvested with its blood vessels and these vessels are connected to the neck vessels, to re-establish the blood supply. The new jaw bone joins with the existing jaw bone like fracture healing. Once the bone heals completely, teeth can be placed on this bone by a process called Osseo integration.

Reconstruction of Tongue, Lips, Buccal Mucosa

Oral cancer affects the tongue, the inner lining of the cheek and the lips. The treatment for oral cancer is usually to remove the cancerous tissue. In most cases, reconstructive surgery is required to maintain normal function of the mouth. The reconstructive procedure is usually a part of the cancer surgery. This reconstruction generally involves free tissue transfer involving microsurgery which gives a better functional and aesthetic outcome compared to conventional flaps. We may take tissue from the abdomen, back, or muscles of the arm to replace tissue in the mouth or throat. Tongue reconstruction generally involves creating a mound which assists in speaking and swallowing.

Reconstruction of Breast & Nipple Areola Complex

Breast cancer is typically treated with a mastectomy or a lumpectomy procedure, in which the breast is surgically removed to prevent further spread of the cancer. The patient usually opts for breast reconstruction to re-gain the shape and aesthetic appearance of the breast. The reconstruction is usually performed soon after the mastectomy or lumpectomy, but it can also be performed later. The breast reconstruction can be done using an artificial implant made of silicone or an autologous transplant made of the patient’s own tissue, harvested from the abdomen, buttocks or thighs. Autologous transplants are said to feel more natural than artificial transplants. The surgeon will educate the patient on their options and answer any questions the patient may have regarding the long-term outlook. Nipple reconstruction is performed after the breast reconstruction, to achieve a more aesthetic appearance. Skin grafts from the back or stomach are used to construct the nipple. It is then tattooed to match the patient’s nipple colour.

Management of Radiation Ulcer

Radiation ulcers are wounds formed as a complication of long-term radiation treatment. The ulcer could affect the skin, underlying soft tissues and even the bone. The ulcers could turn chronic because of the repeated radiation therapy to treat the underlying cancer or because of the patient’s lowered healing capacity. Radiation ulcers are treated with topical creams, non-steroidal anti-inflammatory drugs, special wound dressings or hyperbaric oxygen therapy. Correct nutrition and wound care protocol can also help the patient recover faster. In some cases, especially when vital structures and bone are exposed, it will require a flap cover to heal the wound.

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