Clinical Areas
Reconstructive Surgery for Trauma, Wounds & Burns
Reconstructive surgery rebuilds tissue that has been lost or damaged through injury, burns, tumour removal, or previous surgery — with the aim of restoring function and sound tissue coverage before any cosmetic consideration. It is a wide field, extending from revision of a simple scar to microsurgical free tissue transfer.
Care is led by Dr. Khalid Almutairi, a consultant plastic surgeon who is board certified in all branches of plastic and reconstructive surgery and double-fellowship trained in Canada and the USA.
Complex wounds
Some wounds cannot be managed by simple closure or a skin graft: wounds exposing bone, tendon, or metal fixation hardware; chronic wounds that fail to heal; and tissue defects after trauma, infection, or tumour excision. The reconstructive principle is that exposed vital structures need coverage with healthy, well-vascularised tissue — and the source of that tissue is chosen according to the site and size of the defect and the patient's condition.
The reconstructive ladder: from simplest to most complex
A reconstructive surgeon thinks through a graded series of options known as the reconstructive ladder:
- Direct wound closure when possible.
- Skin grafting to resurface a suitably vascularised bed.
- Local tissue rearrangement and local flaps.
- Regional flaps from a neighbouring area.
- Microsurgical free tissue transfer for complex defects.
The simplest option is not always the right one
The ladder does not mean the simplest solution is always best. A defect exposing tendon or bone may need a well-vascularised flap from the outset, rather than a skin graft that would fail over an unsuitable surface. The choice is built on the nature of the defect, the exposed structures, and the patient's general condition, and the reasoning is explained to the patient before any decision.
Burns: the acute phase versus later reconstruction
Severe acute burns are emergencies managed in emergency departments and burn centres, not through routine clinic booking. The role of reconstructive surgery usually comes after healing: treating hypertrophic scars, releasing scar contractures that restrict joint movement — in the hand, neck, or axilla — and reconstructing unstable healed areas, using scar release, grafting, flaps, or staged tissue rearrangement according to the case.
Scars and contractures
Scars differ in nature: an ordinary visible scar, a hypertrophic scar, a keloid tendency, and a contracture that restricts movement. Each follows a different treatment pathway, extending from observation, topical measures, and injections where appropriate, to surgical revision and rearrangement techniques such as Z-plasty and contracture release. No patient can be promised complete removal of a scar; the realistic goal is to improve it in appearance or function.
Reconstruction after tumour removal
After excision of skin or soft-tissue tumours, a defect may remain that needs rebuilding — from local rearrangement to flaps or free tissue transfer. This pathway is coordinated with the team treating the tumour, and reconstruction is planned so that it does not interfere with oncological treatment and follow-up.
Pressure wounds and the lower limb
This field also includes reconstruction of pressure wounds in selected cases — where surgery is one part of a wider plan covering pressure relief, nutrition, and infection control — and reconstruction of lower-limb defects after trauma, including wounds exposing bone or tendon. Limb-salvage decisions are assessed individually, without assuming that salvage is always the more appropriate option.
What is offered routinely, and what is assessed individually
Consultations for scars, wounds, and reconstructive review are offered routinely at the clinic. Complex reconstruction — such as free flaps and major staged rebuilding — is evaluated case by case, and the appropriate pathway and treating facility are determined according to the individual circumstances and facility requirements.
Medical-information notice
This information is general and does not constitute a diagnosis or individual medical advice. It does not replace consultation, discharge instructions, or patient-specific follow-up advice. Urgent conditions — including severe burns and major open injuries — require emergency services immediately.