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Tissue transfers (from one part of the patient’s body to another, also known as “flaps”) and tissue transplants (from a deceased donor) provide a means for reconstructive surgeons to repair parts of the body, restoring appearance and in many cases function and feeling. The most common reasons for patients to undergo tissue transfer or transplant is after treatment for cancer or after trauma, burn or injury.
In tissue transfer, the plastic surgeon removes tissue, including skin, fat, muscle, nerves and bone, from one part of the body and moves it to the part of the body where it is needed. The arteries and veins are re-attached and, in some cases, the nerves are as well. One of the most well-known types of tissue transfer is used in breast reconstruction for women who have had a mastectomy as part of their treatment for breast cancer. Another common type of tissue transfer is done for patients who have been severely burned or have significant tissue damage from devastating injuries or accidents.
#TomorrowsDiscoveries: Toward Less Risky Hand Transplants – Dr. W.P. Andrew Lee
#TomorrowsDiscoveries: While prosthetic limbs have limitations, transplantation can allow patients to resume normal activities. Dr. Lee and his team use a single medication that prevents immune rejection from transplanted tissues to reduce the health risks that come with transplantation.
There are four kinds of tissue transfer:
- Local flaps are an exact match to tissue and the shape of the space it’s being used for, such as the face.
- Regional flaps are comprised of tissues taken from a nearby area and are often used to re-build large areas of vital structures including bone and nerves.
- A free flap, or free tissue transfer, involves the removal of tissue from an entirely different part of the body. This procedure requires optimal blood supply and advanced microvascular surgery.
- Compostite tissue transplantation, or composite tissue allograft, is reconstructive tranplant in an external feature or limb from one individual is transferred to another. Reconstructive transplants have been perfromed on hands, faces, abdominal walls, and other parts of the body. Learn more about reconstructive transplant.
Tissue transplants can be done for a range of conditions and injuries, including corneal transplants to restore sight and heart valves to repair damage done by heart disease. In reconstructive surgery, tissue transplants are used to:
- Repair bones and soft musculoskeletal tissue, such as ligaments
- Replace skin destroyed by burns
In a span of just five years, the department has protocols approved and in place for hand, face and penile transplants—an indication of just how quickly its transplant portfolio has grown, and how the entire field has evolved.
Why choose Johns Hopkins?
At Johns Hopkins, our plastic surgeons have done thousands of tissue transfers. They have learned about and, in many cases, taught the latest and most effective surgical techniques. In addition, because they work at Johns Hopkins, they can call on any other kind of medical expertise needed right at the facility, from orthopedists and oncologists to pediatricians and dermatologists.
Our reconstructive surgeons are devoted to their profession and that includes consultation with the patients, their families, and others as needed. From the first consultation to the final check-up, they make themselves available and accessible to patients.
The Reconstructive Transplant Research Lab is leading research aimed at warding against rejection and reducing the number of medications patients have to take for the rest of their lives. They’re testing a protocol that involves treating the patient with antibodies on the day of transplant, followed by a donor bone marrow infusion several days later. This protocol would allow patients to be treated with low doses of a single maintenance drug after being transplanted.
At Johns Hopkins, we treat hand and arm injuries and defects with the newest and most innovative technologies and procedures. The Center for Upper Extremity Restoration (CUER) offers comprehensive care with a multidiscplinary medical team including in plastic and reconstructive surgeons, trauma and critical care surgeons, orthepedic surgeons, physical medicine and rehabilitation specialists, as well as engineers and dedicated researchers.