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MICROSURGERY / RECONSTRUCTIVE SURGERY

Reconstructive / Microsurgery

Frank is an internationally renowned reconstructive and micro-surgeon that has developed a number of techniques in this field. During his time at Stellenbosch University his unit advanced, under his guidance and leadership, to a leading center in microsurgery and free tissue transfer. This was complemented by the inception of a microsurgery lab in 2008 offering continuous microsurgery training and has culminated in his integral role as microsurgeon in the worlds first successful penile transplant that was performed at Tygerberg Hospital in December 2014.

Frank performs reconstructive micro-surgery mostly in breast reconstruction surgery, but also in other clinical situations where a defect needs reconstruction by free microsurgical tissue transfer. This can entail defects after cancer resection in other areas of the body, patients that have occurred severe traumatic injuries or special conditions like penis reconstruction. Micro-surgical reconstruction is done if better results and outcomes can be achieved or if there are no other conventional options of reconstruction. Some of the more commonly performed procedures are described below:

BREAST RECONSTRUCTION:

Microsurgical breast reconstruction procedures like the DIEP flap have become the workhorse in autologous breast reconstruction in my practice. I offer a variety of free vascularized tissue transfer procedures to patients that are in need of own tissue breast reconstruction.

HEAD AND NECK RECONSTRUCTION:

This is done simultaneously with large cancer resections in the head and neck area. This can be floor of mouth cancers, tongue cancers and cancers involving the jawbones. The tissue that is transferred micro-surgically can include skin and soft tissue and often a combination of free vascularized bone flaps with skin islands.

ORTHOPEDIC AND UPPER AND LOWER LIMB SURGERY:

Free flap cover is sometimes the only or last modality left to salvage a severely injured limb in order to improve healing and to prevent amputation.

FACIAL NERVE INJURY:

Free vascularized muscle with re-adaptation of nerve supply can help to innervate part of the face and make it possible to smile again in some patients. Frank uses free gracilis muscle flaps for this purpose.

PENIS RECONSTRUCTION:

Thin fasciocutaneous free flaps, mostly taken from the forearm are utilized to reconstruct penis shaft and urethra in one go. Special prosthetic devices need to be implanted at a later stage to increase the size and firmness of the reconstructed penis and to mimic erection.

Many other less common indications for free microvascular flap transfer exist.

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