Pump, place scalp stretch bag

Cavity surgery to place dilatation bags combined with periodic infusion of fluid into the scalp is performed with the aim of shaping defective lesions causing large skin loss. Skin enlargement will be achieved by indirectly inflating the subcutaneous sacs, which are placed in the healthy skin adjacent to the flaw that needs to be covered. From there, there is a foundation to prepare for the second stage of skin grafting surgery.

Injuries that cause defects in the body's soft tissues are very common in daily life. Possible causes of these lesions are wound healing after sequelae of severe burns, surgical excision due to infection, pathological tissue, or accidental trauma. Not only causing functional limitations, the injuries are accompanied by physical defects, which can cause psychological effects on the patient, lose aesthetics and limit community integration. Some serious disfiguring injuries also affect the formation of personality or change in temperament, alienation from society. Therefore, early treatment with regeneration and compensation for the body's defects is very necessary. This not only covers and ensures functional recovery, but also meets aesthetic requirements, helping patients to be confident and secure. At this time, the skill of the plastic surgeon along with the search and selection of suitable materials and shaping techniques is very important.
Along with advances in science and technology, the field of Medicine has also achieved great progress. In particular, in the field of plastic surgery, conventional shaping techniques and microsurgical techniques in shaping body defects have achieved certain effects. However, in the case of large, complex defects, conventional shaping techniques cannot provide a large amount of organization. At this time, another method is applied, which is to pump and place the skin expansion bag.
Pumping, placing dilatation bags in general and pumping and placing stretch bags on the scalp in particular have helped to restore a large area of ​​skin with the same characteristics as the place to be shaped, recovering good feeling after surgery. Stretch skin flaps without secondary stretch, where the flap does not need to be grafted are outstanding advantages obtained when applying this method.
To do this, the patient needs to go through two stages, including:
Scaling scalp surgery: placing fluid-filled bags in place to expand the skin, heal the needed flaw. cover shaping Inject fluid into the dilatation bag on a regular schedule to increase the size of the area that needs dilatation to cover the lesion.

In order to achieve optimal results after implantation and implantation, patient selection criteria need to be carefully applied. Specifically, this intervention should only be applied to subjects with a high prognosis for recovery, able to maintain an almost original quality of life, and at the same time, without damage to other organs or with but not to a great extent.
In contrast, intervention to place and inflate the skin expander bag is contraindicated to apply in patients with severe systemic and mental illness. On the other hand, in order for the lesion to heal well after the intervention, the placement of the expander bag should avoid malignant lesions, severe inflammation, damage to blood vessels or unprepared skin flaps.

3.1 Preparation The patient was prepared for surgery according to the procedure, including body hygiene and fasting from the night before surgery. After that, the patient will be changed into a gown, prepared to lie on his back or side and disinfect the surgical site. The surgery will be performed under endotracheal anesthesia.
3.2 The surgical procedure to place the bag The surgeon will re-evaluate the skin defect lesion immediately before starting the intervention to place and inflate the skin expander, perform cleaning and consider debridement if necessary. The steps of bag placement will be done after selecting an appropriate pocket position, usually located next to the lesion. Depending on the convenience of the placement, easy toleration or poor tolerance as well as the area of ​​​​the skin defect, the doctor will make an appropriate choice for the size of the bag, the location of the drum for periodic pumping. in the future.
When the above steps have been completed, the surgeon begins to dissect the pocket cavity, placing the skin expander into the dissected cavity under the scalp. Then, the doctor will inject a sufficient amount of physiological saline into the bags to evaluate whether the bags are working properly and promptly correct if necessary. Finally, stabilize the position of the expander and close the incision layer by layer with non-absorbable sutures.
At the end of the surgery, the patient will be transferred to the post-anesthesia recovery care area before moving to the rest room. The hospital stay is about 3 to 5 days to take care of the wound, evaluate the possibility of a good healing of the incision site and the patient is discharged from the hospital.
After being discharged from the surgery, the patient can perform all normal activities, including working and driving. At the same time, the patient is also advised about washing and changing the wound dressing as well as periodic examination, assessing the healing process as well as the ability of the bag to function, not to move, obstruct or cause damage. edema, fluid accumulation, irritation.

After the visits to ensure the tolerability of the dilatation bags, the patients were carried out periodically inflating the bags. Unlike bag placement, bag pumping can be done as an outpatient at the clinic.
The time to choose to pump the bag is 7-15 days after surgery with sterile physiological saline equal to 10-15% of the bag volume. At this point, the incision to place the bag has reduced pain, reduced swelling, and the patient can tolerate the increased size of the bag after the pump.
Posterior bag pumps are performed on a regular schedule, usually every 3 days. After the 10th to 12th time, the patient will stop pumping and rest for 1 to 2 days to prepare for the surgery to connect the newly stretched scalp flap.

Similar to other surgeries, the intervention to place and inflate the skin expander can also face complications of anesthesia and anesthesia such as allergies, drug reactions, anaphylaxis ...
Besides, flap The scalp is rich in blood vessels, so bleeding is possible, but hemostasis is easy to do, rare cases of bleeding are difficult to stop or bleeding causes hematoma under the skin. However, complications of swelling, inflammation, and infection of the surgical site if not well taken care of can be encountered like other surgical sites.
For the intervention to place and inflate the skin expander, the doctor needs to carefully evaluate before proceeding, accordingly, it should be avoided in cases where the remaining skin flap is difficult to place the bag, the location is not favorable or order bag size not suitable. This will help to avoid the risk that the implant will cause skin necrosis, expose the expander, in which case, the surgery will fail and the dilator will need to be removed.
During each periodical injection of the bag, the doctor needs to adhere to the correct dose of pumped fluid corresponding to the volume of the bag. Pumping fluids too quickly or too much can be painful and poorly tolerated. Instead, dilatation is recommended as slowly as possible, including using an electric syringe when available and incorporating pain medication if needed. On the other hand, if the technique is rough, it can lead to complications such as opening the incision, exposing the bag or breaking the dilation bag. Although very rare, when this occurs, the only management is to stop the dilator and perform surgical removal of the pouch.
In summary, the intervention of placing and pumping skin expansion bags is a method of restoring and regenerating the defective scalp area, bringing aesthetics and confidence in appearance to the patient. Although the operating principle is simple, the procedure requires a thorough evaluation and the technique needs to be performed with care and professionalism, in order to provide optimal scalp flap restoration results.
Currently Vinmec International General Hospital is a hospital with a system of modern medical equipment that ensures the implementation of difficult and complicated techniques. Thereby helping to bring the best surgical results as well as minimizing pain and shortening the treatment time for the patient.
Along with modern medical facilities and equipment is a team of experienced experts, doctors, and staff who are well-trained in an international environment. Therefore, patients can completely trust when performing minor surgery or major surgery at Vinmec hospital.