Reconstructive Plastic Surgery Principles Course

Lesson 1 • Vascular Anatomy and Perfusion Zones

Defines angiosomes, perforasome theory, and choke vessel dynamics. Directly informs flap design and safe tissue harvest decisions.

Lesson 2 • Anatomy of Skin and Soft Tissue

Covers epidermis, dermis, subcutaneous layers, and fascial planes. Provides the structural baseline for all reconstructive tissue manipulation.

Lesson 3 • Wound Healing Biology

Explains haemostasis, inflammation, proliferation, and remodelling phases. An understanding of these phases guides timing and technique selection in reconstruction.

Lesson 4 • Reconstructive Ladder and Elevator Concepts

Introduces the reconstructive ladder from primary closure to free flaps and the elevator concept for optimal solution selection.

Lesson 1 • Recipient Bed Preparation

Addresses debridement, haemostasis, and bioburden reduction to optimise graft adherence. A well-prepared bed is the primary determinant of graft success.

Lesson 2 • Donor Site Selection and Harvest

Guides donor site choice based on colour match, texture, and morbidity. Proper harvest technique minimises donor site complications.

Lesson 3 • Graft Classification and Biology

Distinguishes graft types by thickness and composition and explains imbibition, inosculation, and revascularisation. Sets the biological rationale for technique choices.

Lesson 4 • Graft Fixation and Bolster Dressings

Teaches suture, staple, and fibrin glue fixation alongside bolster dressing construction. Immobilisation prevents shear and promotes uniform graft take.

Lesson 1 • Advancement Flap Techniques

Covers V-Y, bipedicle, and Burow triangle advancement designs. These flaps recruit adjacent tissue with minimal donor deformity.

Lesson 2 • Rotation and Transposition Flaps

Teaches rotation arc calculation and Z-plasty, rhomboid, and bilobed transposition designs. Correct geometry prevents pin-cushioning and trapdoor deformity.

Lesson 3 • Interpolation and Pedicled Regional Flaps

Addresses two-stage interpolation flaps and named regional pedicled flaps for head, trunk, and extremity defects.

Lesson 4 • Flap Monitoring and Complication Management

Establishes clinical and instrumental monitoring protocols and management of venous congestion, partial necrosis, and dehiscence.

Lesson 1 • Donor Site Closure and Morbidity

Addresses primary closure, mesh reinforcement, and functional outcome preservation at perforator flap donor sites.

Lesson 2 • Perforator Anatomy and Mapping

Details musculocutaneous and septocutaneous perforator anatomy and preoperative mapping with Doppler and CT angiography.

Lesson 3 • Intramuscular Dissection Techniques

Teaches retrograde intramuscular dissection to achieve adequate pedicle length while preserving motor nerve branches.

Lesson 4 • Perforator Flap Troubleshooting

Identifies intraoperative perforator anomalies and outlines conversion strategies to preserve the reconstructive plan.

Lesson 1 • Recipient Vessel Selection

Guides selection of recipient arteries and veins based on calibre match, proximity, and zone-of-injury avoidance.

Lesson 2 • Vessel Preparation and Anastomosis

Teaches adventitia stripping, vessel dilation, and end-to-end and end-to-side anastomosis techniques under magnification.

Lesson 3 • Salvage of Compromised Free Flaps

Covers re-exploration timing, thrombectomy, thrombolysis, and revision anastomosis to maximise flap salvage rates.

Lesson 4 • Free Flap Monitoring Protocols

Establishes hourly clinical checks, implantable Doppler use, and near-infrared spectroscopy monitoring for early thrombosis detection.

Lesson 1 • Nipple-Areola Complex Reconstruction

Addresses local flap nipple reconstruction, areola tattooing, and composite graft techniques for complete breast restoration.

Lesson 2 • Oncologic Context and Timing

Addresses immediate versus delayed reconstruction, radiation effects, and coordination with oncologic treatment planning.

Lesson 3 • Implant-Based Reconstruction

Covers tissue expander placement, exchange to permanent implant, and acellular dermal matrix use for pocket support.

Lesson 4 • Pedicled Flap Breast Reconstruction

Teaches TRAM and latissimus dorsi pedicled flap techniques for patients unsuitable for microsurgery.

Lesson 1 • Pharyngeal and Oesophageal Reconstruction

Addresses tubed radial forearm, jejunal free flap, and gastric pull-up for circumferential pharyngeal and cervical oesophageal defects.

Lesson 2 • Mandibular and Midface Reconstruction

Teaches fibula free flap osteotomy planning, virtual surgical planning, and midface reconstruction with iliac crest and scapula flaps.

Lesson 3 • Facial Subunit and Nasal Reconstruction

Applies aesthetic subunit principles to nasal, eyelid, lip, and ear reconstruction using local and regional flaps.

Lesson 4 • Soft Tissue Flaps for Oral Reconstruction

Covers radial forearm, anterolateral thigh, and submental flaps for tongue, floor-of-mouth, and cheek reconstruction.

Lesson 1 • Lower Extremity Defect Classification

Uses Gustilo-Anderson and Byrd classification systems to stratify open fractures and soft tissue defects for reconstruction planning.

Lesson 2 • Foot and Heel Reconstruction

Teaches instep, reverse sural, and free flap options for plantar, heel, and dorsal foot defects requiring durable coverage.

Lesson 3 • Local and Propeller Flaps for the Leg

Covers gastrocnemius, soleus, and perforator-based propeller flaps for proximal, middle, and distal third leg defects.

Lesson 4 • Free Flap Reconstruction of the Leg

Addresses ALT, latissimus dorsi, and gracilis free flaps for large lower extremity defects with recipient vessel strategies.