Skin plastic surgery according to Douglas

Douglas plasty is a surgical operation in which a soft tissue defect is sutured after surgery on the young growing body of children and adolescents, for example after a burn. The operation allows you to maintain the length and shape of the excised flap.

Description Douglas made an incision in the circumference of the wound perpendicular to the damaged edge. Using tweezers, he pulls 1-2 rows of superficial muscles from the underlying tissues and performs skin plasty over them. The Douglas plasty technique makes it possible to more fully take into account the thickness of the connective tissue membrane. Plastic surgery using the Yudin-Rubtsov method is named after the names of the authors. It is otherwise called superficial arcuate plastic surgery according to Palomo-Palma. The side walls of the wound are opened to a depth of half the thickness of the case or its middle part. Tongue-shaped continuous incisions are made along the edge of the incision and interrupted sutures are placed on the separated edges of the skin. Then the edges are brought together and the plate tightly adheres to the underlying tissues. After such an operation, scar tissue does not appear under the suture; the graft is firmly held in the capsule, especially if it contains more than half the thickness of subcutaneous fatty tissue. Periosteal grafting technique The incision is made straight or curved depending on the location of the underlying bone. The periosteum is filed, as indicated above, from the interosseous section, starting from the periphery and ending in the middle of the length of the bone (“crow’s foot”). Clamps are applied to its edges and passed through the edema. To lengthen the ends, a rubber tube is put on the periosteal pedicle and between the layers of its wall the ends are moved to the whole periosteal layer without damaging the bone marrow. The periosteal layer is cut along the entire line with one incision.