CANCER TREATMENT MODALITIES

Reconstructive Surgery

Overview

Reconstructive surgery is the process of restoring the human body to “whole”

following tumor extirpation, infection, trauma, or congenital or acquired deformity –
restoring both form and function. Because the result of tumor, infection, trauma, or
deformity has such a major effect on a patient’s life, health, and well-being,
reconstructive surgery can have the powerful effect of truly rebuilding a patient’s life.
The professional and personal gratification this brings to the reconstructive surgeon is
profound

Perioperative Nursing Considerations

Assessment

Plastic surgery often results in a change of body image and self esteem

Perioperative nurses must possess:

• Respect for the patient

• A nonjudgmental attitude

• Effective communication skills

Positioning

• Position patient so that all operative sites appropriately exposed and airway easily
observed & accessed

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• OR bed may be turned for ease of access

• Provide comfort measures, such as pillow under knees, as some procedures are
long in duration

• Always check patient after position changes

Types

Brow lift

• Minimizes forehead creases, drooping eyebrows, hooding over eyes, furrowed

forehead and frown lines by removing excess tissue, altering muscles &
tightening forehead skin

• Length: 1-3 hours

• Risks: facial nerve injury, muscle weakness, asymmetrical look, infection,

scarring

Rhytidectomy (Face Lift)

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• Improves sagging facial skin, jowls & loose neck skin by removing excess fat,
tightening muscles, & redraping skin.

• Length: several hours

• Risks: Facial nerve injury, infection, bleeding, poor healing, scarring, asymmetry
or change in hairline

Chin Implant

• Incision is made inside mouth or under the chin

• A pocket is created in front of the jawbone

• Implant is inserted & wound closed

Rhinoplasty

• Reshape nose by reducing or increasing size, removing hump, changing shape of

tip, narrowing span of nostrils, changing angle between nose and upper lip

• Length: 1-2 hours

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• Risks: infection, temporary swelling & bruising around eyes & nose, headaches,
bleeding, stiffness

Otoplasty

• Sets prominent ears back closer to the head, or reduce the size of large ears

• Length: 2-3 hours

• Risks: infection, scarring, blood clot formation on the ear, recurrence of

protrusion

Cleft Lip Repair

• Correction of a congenital split in the upper lip. Incidence 1 in 800 babies

• Length: 30 min-1 hour

• Risks: Pain, Restlessness, difficulty with feeding

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Cleft Palate Repair

• Correction of a congenital deformity that results in a cleft in the hard palate, soft
palate or both

• Length: 1-1.5 hours

• Risk: Pain, decrease in appetite requiring an IV for 1-2 days

Augmentation Mammoplasty

• Use of implants to enhance breast size, correct breast asymmetry, or recreate the
breast after mastectomy

• Length: 1-2 hours

• Risks: deflation, scar tissue around implant (capsular contracture), infection,

change in nipple sensation, difficult mammograms

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Mastopexy (Breast Lift)

• Raise and reshape sagging breasts by removing excess skin & repositioning
remaining tissue and nipples

• Length: 1-3 hours

• Risks: infection, skin loss, scarring, unevenly positioned nipples, loss of

sensation in nipples or breast

Nursing Diagnosis

• Disturbed Body Image

• Anxiety

• Deficient Knowledge

• Risk for Positioning Injury

• Risk for Ineffective Tissue Perfusion

• Risk for Infection

Nursing Management

 Administer care to invasive device sites

 Classifies surgical wound Reclassify if becomes contaminated
 Evaluates factors associated with increased risk for postop infection at the
completion of the procedure
 Reconstructive nurses use their training to identify the type of reconstructive care
a patient requires and develops a recovery plan to help the patient throughout their
reconstructive and recovery process.

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 These nurses are responsible for monitoring the recovery process of their patients,
administering medications, wound management, performing skin assessments and
educating patients about their surgical procedure and providing advice on how to
properly recover from their procedure as well as other medical tasks related to
reconstructive surgery.
 Those who work as part of an administrative team may perform tasks such as
scheduling appointments, overseeing and managing other nurses, healthcare
providers and various surgical/clinical departments, maintaining medical records
and ordering diagnostic treatment and test results among other administrative
duties.

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