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Book Details
Abstract
Fully updated to meet the demands of the 21st-century surgeon, Lower Extremity, Trunk and Burns Surgery, Volume 4 of Plastic Surgery, 3rd Edition, provides you with the most current knowledge and techniques across your field, allowing you to offer every patient the best possible outcome. Access all the state-of-the-art know-how you need to overcome any challenge you may face and exceed your patients’ expectations.
- Consult this title on your favorite e-reader , conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices.
- Apply the very latest advances in extremity, trunk, and burn plastic surgery and ensure optimal outcomes with evidence-based advice from a diverse collection of world-leading authorities.
- Purchase this volume individually or own the entire set, with the ability to search across all six volumes online!
- Apply the latest techniques in lower extremity, trunk, and burn reconstruction, including microsurgical lymphatic reconstruction, super microsurgery, sternal fixation, and more.
- Know what to look for and what results you can expect with over 950 photographs and illustrations.
- See how to perform key techniques with 12 surgical videos online.
- Access the complete, fully searchable contents online, download all the tables and figures, and take advantage of additional content and images at www.expertconsult.com!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Plastic Surgery | i | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| Video Contents | xi | ||
| Foreword | xvi | ||
| Preface | xvii | ||
| List of Contributors | xviii | ||
| Acknowledgments | xl | ||
| Dedication | xli | ||
| I Lower Extremity Surgery | 1 | ||
| 1 Comprehensive lower extremity anatomy | 1 | ||
| Embryology | 1 | ||
| The gluteal region | 2 | ||
| Gluteal skeletal structure | 2 | ||
| Gluteal fascial anatomy | 5 | ||
| Muscles of the buttocks | 5 | ||
| Gluteal vasculature | 5 | ||
| Gluteal innervation | 5 | ||
| The thigh | 8 | ||
| Thigh skeletal structure | 8 | ||
| Thigh fascial composition | 8 | ||
| Thigh musculature | 11 | ||
| Thigh vasculature | 19 | ||
| Profunda femoris | 22 | ||
| Lateral circumflex femoral arterial system | 23 | ||
| Medial circumflex femoral arterial system | 23 | ||
| Profunda femoris perforating branches | 25 | ||
| Innervation of the thigh | 26 | ||
| Motor innervation | 26 | ||
| Cutaneous innervation | 26 | ||
| The leg | 30 | ||
| Knee and leg skeletal structure | 30 | ||
| Knee skeletal structure | 30 | ||
| Leg skeletal structure | 30 | ||
| Leg fascial composition | 34 | ||
| Deep fascia of the leg | 34 | ||
| Interosseous membrane | 34 | ||
| Lower leg compartments | 34 | ||
| Compartment syndrome | 37 | ||
| Leg musculature | 37 | ||
| Anterior compartment | 37 | ||
| Lateral compartment | 37 | ||
| Posterior compartment – superficial layer | 43 | ||
| Posterior compartment – deep layer | 45 | ||
| Leg vasculature | 45 | ||
| Leg nerve anatomy | 48 | ||
| Lower leg nerve topography | 48 | ||
| Lower leg motor innervation | 48 | ||
| Lower leg cutaneous innervation | 48 | ||
| The ankle and foot | 50 | ||
| Ankle and foot skeletal structure | 50 | ||
| Ankle | 50 | ||
| Foot | 50 | ||
| Ankle and foot fascial composition | 52 | ||
| Extensor retinacula | 52 | ||
| Flexor retinaculum | 52 | ||
| Peroneal retinaculum | 54 | ||
| Plantar fascia | 54 | ||
| Fascial compartment of foot | 54 | ||
| Foot musculature | 56 | ||
| Foot and ankle vasculature | 59 | ||
| Dorsalis pedis | 59 | ||
| Posterior tibial artery – medial and lateral plantar arteries | 59 | ||
| Peroneal arterial branches | 59 | ||
| Ankle and foot nerve anatomy | 61 | ||
| Foot cutaneous innervation | 61 | ||
| Foot motor innervation | 61 | ||
| Conclusion | 61 | ||
| 2 Management of lower extremity trauma | 63 | ||
| Introduction | 63 | ||
| Basic science and disease process | 63 | ||
| Diagnosis and patient presentation | 64 | ||
| Historical perspective | 63.e1 | ||
| Patient selection | 65 | ||
| Amputation versus salvage | 65 | ||
| Treatment and surgical techniques | 66 | ||
| Timing of treatment | 66 | ||
| Fracture management | 67 | ||
| Vascular injury | 67 | ||
| Reconstructive options | 68 | ||
| Local flaps | 68 | ||
| Perforator flaps | 68 | ||
| Muscle-based flaps | 72 | ||
| Fascial-based flaps | 75 | ||
| Free tissue transfer – muscle | 77 | ||
| Free tissue transfer – fasciocutaneous | 81 | ||
| Skeletal reconstruction | 83 | ||
| Negative-pressure wound therapy in lower extremity defects | 83 | ||
| Amputation | 83 | ||
| Treatment of associated complications | 83 | ||
| Rhabdomyolysis | 83 | ||
| Fat embolization | 84 | ||
| Compartment syndrome | 84 | ||
| Postoperative care | 85 | ||
| Antibiotics | 85 | ||
| Anticoagulation | 85 | ||
| Blood loss | 85 | ||
| Outcomes, prognosis, and complications | 85 | ||
| Outcomes and prognosis | 85 | ||
| Functional outcomes | 85 | ||
| Amputation versus salvage | 86 | ||
| Patient satisfaction | 86 | ||
| Cost-utility | 86 | ||
| Complications | 86 | ||
| Wound complications | 86 | ||
| Osteomyelitis | 86 | ||
| Nonunion | 87 | ||
| Chronic pain | 87 | ||
| Secondary procedures | 87 | ||
| Secondary cosmetic procedures | 87 | ||
| Secondary functional procedures | 91 | ||
| References | 91.e1 | ||
| 3 Lymphatic reconstruction of the extremities | 92 | ||
| Introduction | 92 | ||
| Historical perspective | 92.e1 | ||
| Ablative operations | 92.e1 | ||
| Liposuction | 92.e1 | ||
| Physiological operations | 92.e1 | ||
| Greater omentum flaps | 92.e2 | ||
| Vein grafts | 92.e2 | ||
| Reconstruction methods | 92.e3 | ||
| Lymphovenous bypass | 92.e4 | ||
| Basic science/disease process | 92 | ||
| Classification and etiology of lymphedema | 93 | ||
| Diagnosis/patient presentation | 93 | ||
| Patient selection | 93 | ||
| Nonsurgical therapy | 93 | ||
| Patient selection for reconstruction | 94 | ||
| Treatment/surgical technique | 94 | ||
| Ablative operations | 94 | ||
| Physiological operations | 95 | ||
| Lymphaticolymphatic bypass | 95 | ||
| Lymphatic vessel reconstruction: Baumeister technique | 95 | ||
| Microvascular lymph node transfer | 96 | ||
| Lymphovenous bypass | 96 | ||
| Lymphovenous shunts | 96 | ||
| Postoperative care | 97 | ||
| Outcomes, prognosis, and complications | 98 | ||
| Secondary procedures following the reconstruction | 99 | ||
| Summary | 99 | ||
| References | 100.e1 | ||
| 4 Lower extremity sarcoma reconstruction | 101 | ||
| Introduction | 101 | ||
| Soft-tissue and bone sarcomas | 101 | ||
| Sarcomas in the lower extremity | 102 | ||
| Basic science/disease process | 102 | ||
| Epidemiology soft-tissue sarcomas | 102 | ||
| Bone sarcomas | 103 | ||
| Tumor growth and metastasizing | 103 | ||
| Diagnosis/patient presentation/imaging | 103 | ||
| Historical perspective | 103.e1 | ||
| Patient profile/general considerations/treatment planning | 104 | ||
| Patient profile | 104 | ||
| General considerations | 104 | ||
| Treatment planning | 105 | ||
| Surgery | 105 | ||
| Radiotherapy | 106 | ||
| Chemotherapy | 106 | ||
| Treatment/surgical resection techniques | 106 | ||
| Biopsy techniques | 106 | ||
| Fine-needle or core needle aspirations | 106 | ||
| Excisional biopsy | 106 | ||
| Incisional biopsy | 107 | ||
| Reoperative biopsies and surgical revisions | 107 | ||
| Surgical technique for definitive resection | 108 | ||
| Soft-tissue sarcomas | 108 | ||
| Vascular involvement | 108 | ||
| Nerve involvement | 109 | ||
| Osseous involvement | 109 | ||
| Primary osseous sarcomas | 109 | ||
| Specimen handling | 109 | ||
| Wound closure | 109 | ||
| Lymph node dissection | 110 | ||
| Indications for amputation | 110 | ||
| Reconstructive options for lower extremity preservation | 110 | ||
| Soft tissue | 110 | ||
| Neuromuscular unit | 111 | ||
| Skeletal reconstruction | 111 | ||
| Vascular surgery | 112 | ||
| Complex approaches | 112 | ||
| Postoperative care | 112 | ||
| Immediate postoperative care | 112 | ||
| Oncologic postoperative care and follow-up | 113 | ||
| Secondary procedures | 113 | ||
| Early secondary procedures – soft tissue | 113 | ||
| Early secondary procedures – skeleton | 113 | ||
| Late secondary procedures | 114 | ||
| Outcomes, prognosis, and complications | 114 | ||
| Outcomes and prognosis | 114 | ||
| Soft-tissue sarcomas | 114 | ||
| Bone sarcomas | 115 | ||
| Complications – management of recurrent disease | 116 | ||
| References | 125.e1 | ||
| 5 Reconstructive surgery: | 127 | ||
| Introduction | 127 | ||
| History | 127.e1 | ||
| Principles | 127 | ||
| The value of autologous tissue | 128 | ||
| The reconstructive elevator | 128 | ||
| Skin grafts and substitutes | 128 | ||
| Approach by location (local flaps) | 130 | ||
| Thigh | 130 | ||
| Lower leg | 130 | ||
| Microvascular free tissue transfer | 131 | ||
| Treatment approach | 131 | ||
| Preoperative evaluation | 131 | ||
| Primary limb amputation | 132 | ||
| Debridement | 133 | ||
| Timing of reconstruction | 133 | ||
| Selection of recipient vessel | 133 | ||
| Special considerations | 133 | ||
| Osteomyelitis | 133 | ||
| Diabetes | 134 | ||
| Coverage after tumor ablation | 136 | ||
| Exposed prosthesis | 137 | ||
| Soft tissue expansion | 137 | ||
| Postoperative care | 137 | ||
| Monitoring | 137 | ||
| Management of flap complications | 138 | ||
| Secondary operations | 138 | ||
| Muscle/musculocutaneous flaps | 138 | ||
| Tensor fascia lata | 138 | ||
| Rectus femoris | 139 | ||
| Biceps femoris | 139 | ||
| Gracilis | 140 | ||
| Soleus | 141 | ||
| Gastrocnemius | 142 | ||
| Fasciocutaneous/perforator flap | 143 | ||
| Groin/SCIP (superficial circumflex iliac perforator) | 143 | ||
| Medial thigh/anteromedial perforator and gracilis perforator | 143 | ||
| Lateral thigh/profunda femoris perforator | 144 | ||
| Anterolateral thigh perforator | 145 | ||
| Sural | 146 | ||
| Tap (thoracodorsal artery perforator) | 147 | ||
| Compound flaps | 148 | ||
| Supermicrosurgery | 149 | ||
| References | 150.e1 | ||
| 6 Diagnosis and treatment of painful neuroma and of nerve compression in the lower extremity | 151 | ||
| Introduction | 151 | ||
| Historical perspective | 152.e1 | ||
| Basic science/disease process | 152 | ||
| The painful neuroma | 152 | ||
| Chronic nerve compression | 153 | ||
| Diagnosis/patient presentation | 156 | ||
| The painful neuroma | 156 | ||
| Chronic nerve compression | 157 | ||
| Patient selection | 157 | ||
| The painful neuroma | 157 | ||
| Chronic nerve compression | 158 | ||
| Surgical technique | 159 | ||
| The painful neuroma (Box 6.1) | 159 | ||
| Chronic nerve compression (Box 6.3) | 164 | ||
| Postoperative care/rehabilitation | 170 | ||
| The painful neuroma | 170 | ||
| Chronic nerve compression | 170 | ||
| Outcomes, prognosis, and recurrence | 172 | ||
| The painful neuroma | 172 | ||
| Chronic nerve compression | 172 | ||
| References | 173.e1 | ||
| 7 Skeletal reconstruction | 174 | ||
| Introduction | 174 | ||
| Basic science | 174 | ||
| Diagnosis/patient presentation | 175 | ||
| Historical perspective | 174.e1 | ||
| Treatment and surgical technique | 176 | ||
| Methods of skeletal reconstruction | 176 | ||
| Bone grafting | 176 | ||
| Vascularized bone transfer | 177 | ||
| Periosteal and other bone flaps | 178 | ||
| Distraction osteogenesis and the Ilizarov technique | 179 | ||
| Allograft reconstruction | 180 | ||
| Reconstruction by anatomic area | 181 | ||
| Upper extremity | 181 | ||
| Humerus | 181 | ||
| Forearm | 181 | ||
| Femur | 183 | ||
| Tibia | 183 | ||
| Pelvis and spine | 184 | ||
| Clavicle | 185 | ||
| Vascularized epiphyseal reconstruction | 185 | ||
| Postoperative care | 186 | ||
| Postoperative monitoring | 186 | ||
| Adjuncts to skeletal reconstruction | 186 | ||
| Postoperative aesthetic considerations | 187 | ||
| Conclusion | 188 | ||
| References | 188.e1 | ||
| 8 Foot reconstruction | 189 | ||
| Introduction | 189 | ||
| Historical perspective | 189.e1 | ||
| Basic science | 189 | ||
| Angiosomes of the foot | 189 | ||
| Compartment pressure measurement | 190 | ||
| Gait analysis | 190 | ||
| Patient presentation | 191 | ||
| Clinical evaluation | 191 | ||
| Connective tissue disorders | 192 | ||
| Venous ulcer | 192 | ||
| Ischemia | 193 | ||
| Diabetic foot ulcer | 194 | ||
| Neuropathic changes | 195 | ||
| Hemorheologic abnormalities | 195 | ||
| Chronic wound evaluation | 196 | ||
| Bone assessment | 196 | ||
| Infection identification and directed antibiotic therapy | 196 | ||
| Patient selection | 197 | ||
| Identify function of the limb | 197 | ||
| Management | 198 | ||
| Trauma and crush injuries | 198 | ||
| Debridement of the chronic wound | 198 | ||
| Wound management | 199 | ||
| External fixation | 199 | ||
| Treatment/surgical technique | 201 | ||
| Soft tissue reconstruction | 201 | ||
| Angiosomes and clinical implications | 201 | ||
| Closure techniques | 201 | ||
| Reconstruction by anatomic location | 205 | ||
| Ankle and foot dorsum | 205 | ||
| Extensor digitorum brevis muscle flap | 205 | ||
| Lateral supramalleolar flap | 206 | ||
| Plantar forefoot | 207 | ||
| Toe fillet flap | 207 | ||
| Neurovascular island flap | 207 | ||
| V-Y plantar flap | 207 | ||
| Forefoot amputations and associated flaps | 207 | ||
| Plantar midfoot | 208 | ||
| Neurovascular island flaps | 208 | ||
| Suprafascial flaps | 208 | ||
| Midfoot amputations | 208 | ||
| Plantar hindfoot | 208 | ||
| Intrinsic muscle flaps | 209 | ||
| Medial plantar artery flap | 209 | ||
| Heel pad flaps | 209 | ||
| Sural artery flap | 209 | ||
| Microvascular composite tissue transplantation (free flaps) | 211 | ||
| Hindfoot amputations | 216 | ||
| Postoperative care | 217 | ||
| Outcomes | 217 | ||
| Summary | 218 | ||
| References | 218.e1 | ||
| II Trunk Surgery | 220 | ||
| 9 Comprehensive trunk anatomy | 220 | ||
| Basic science and disease process: embryology of the trunk | 220 | ||
| History | 220.e1 | ||
| Back | 220 | ||
| Muscles | 221 | ||
| Vascular anatomy | 223 | ||
| Chest | 223 | ||
| Muscles | 224 | ||
| Vascular anatomy | 225 | ||
| Abdomen | 227 | ||
| Muscles | 228 | ||
| Vascular anatomy | 229 | ||
| Nerves | 230 | ||
| Pelvis | 230 | ||
| Female perineum | 230 | ||
| Vascular anatomy | 232 | ||
| Male perineum | 235 | ||
| Vascular anatomy | 235 | ||
| References | 238.e1 | ||
| 10 Reconstruction of the chest | 239 | ||
| Introduction | 239 | ||
| Common flaps for reconstruction | 241 | ||
| Pectoralis major | 241 | ||
| Latissimus dorsi | 241 | ||
| Serratus anterior | 244 | ||
| Rectus abdominus | 244 | ||
| Omentum | 245 | ||
| Patient selection/approach to patient | 247 | ||
| History | 245.e1 | ||
| Chest wall tumors | 247 | ||
| Basic science/disease process | 247 | ||
| Diagnosis/presentation/patient selection | 247 | ||
| III Burns Surgery | 393 | ||
| 18 Acute management of burn/electrical injuries | 393 | ||
| Aims of burn care | 393 | ||
| Acute management of burn injuries | 393 | ||
| History | 393.e1 | ||
| Epidemiology | 393 | ||
| Risk factors | 394 | ||
| Mechanisms of thermal injury | 394 | ||
| Types of burns | 394 | ||
| Thermal burns | 394 | ||
| Flash and flame burns | 394 | ||
| Scalds | 394 | ||
| Contact burns | 394 | ||
| Tar | 395 | ||
| Chemical burns | 396 | ||
| Electrical burns | 396 | ||
| Nonaccidental burns | 397 | ||
| Pathophysiology | 397 | ||
| Local response | 398 | ||
| Systemic response | 398 | ||
| Hypovolemia and fluid extravasation | 399 | ||
| Mediators of burn injury | 399 | ||
| Initial evaluation and treatment | 399 | ||
| Burn assessment | 402 | ||
| Diagnosis/patient presentation | 402 | ||
| Epidermal burns | 404 | ||
| Superficial partial thickness burns | 404 | ||
| Deep partial thickness | 405 | ||
| Full thickness injuries | 406 | ||
| Inhalation injury | 407 | ||
| Management of moderate to severe burns | 408 | ||
| Resuscitation formulae | 409 | ||
| Monitoring | 410 | ||
| Management of the burn wound | 410 | ||
| Topical ointments | 410 | ||
| Wound dressings | 410 | ||
| Biological wound dressings | 410 | ||
| Physiological wound dressings | 415 | ||
| Conservative versus surgical therapy | 416 | ||
| Surgery | 416 | ||
| Summary of burn wound treatment (Box 18.10) | 420 | ||
| Metabolism/nutrition | 421 | ||
| Nutrition | 423 | ||
| Nutrition formulae | 423 | ||
| Endocrine and glucose monitoring | 423 | ||
| Hepatic protein monitoring | 423 | ||
| Anabolic steroids | 423 | ||
| β-blockade | 425 | ||
| Amino acids | 425 | ||
| Rehabilitation | 425 | ||
| Pain control | 426 | ||
| Complications (Box 18.16) | 427 | ||
| Skin graft loss | 427 | ||
| Infected burn | 427 | ||
| Adrenal insufficiency | 428 | ||
| Compartment syndrome | 428 | ||
| Deep venous thrombosis | 431 | ||
| Gastrointestinal complications | 431 | ||
| Heterotopic ossification | 431 | ||
| Heparin-induced thrombocytopenia | 432 | ||
| Inflammation | 432 | ||
| Neutropenia | 432 | ||
| Infection | 432 | ||
| Hypertrophic scar | 434 | ||
| Hypothermia | 434 | ||
| Secondary sclerosing cholangitis | 434 | ||
| References | 434.e1 | ||
| 19 Extremity burn reconstruction | 435 | ||
| Introduction | 435 | ||
| History | 435.e1 | ||
| Basic science/disease process | 435 | ||
| Electrical burns | 435 | ||
| Diagnosis/patient presentation | 436 | ||
| Fluid infusion and edema | 436 | ||
| Compartment syndrome | 437 | ||
| Related trauma | 439 | ||
| Patient selection | 440 | ||
| Treatment/surgical technique | 440 | ||
| Acute-phase surgery: skin grafting | 441 | ||
| Skin substitutes | 441 | ||
| Joint reconstruction with dermis in acute phase (Figs 19.7 and 19.8) | 441 | ||
| Postoperative care | 442 | ||
| Positioning the patient | 443 | ||
| Upper extremity | 443 | ||
| Shoulder | 443 | ||
| Elbow | 443 | ||
| Wrist | 443 | ||
| Lower extremity | 443 | ||
| Hip | 443 | ||
| Knee | 444 | ||
| Ankle | 444 | ||
| Passive mobilization | 444 | ||
| Active mobilization | 444 | ||
| Outcomes, prognosis, complications | 444 | ||
| Unstable healing: Marjolin’s ulcer | 444 | ||
| Scar retraction | 444 | ||
| Axillary contractures (Fig. 19.11) | 445 | ||
| Elbow contractures | 445 | ||
| Heterotopic ossification | 446 | ||
| Skeletal-muscle complications: bone exposure | 446 | ||
| Secondary procedures | 446 | ||
| Z-plasty | 447 | ||
| Skin grafts | 447 | ||
| Dermal substitutes (INTEGRA®) in the surgical treatment of sequelae | 448 | ||
| Flaps | 448 | ||
| Fasciocutaneous and myocutaneous flaps | 449 | ||
| Skin expansion | 450 | ||
| Free flap | 450 | ||
| Nerve repair | 450 | ||
| Surgery of tendon retraction | 451 | ||
| Amputation | 451 | ||
| Lipofilling | 453 | ||
| Laser | 454 | ||
| References | 455.e1 | ||
| 20 Cold and chemical injury to the upper extremity | 456 | ||
| Cold injury | 456 | ||
| History | 456.e1 | ||
| Basic science/disease process | 456 | ||
| Pathophysiology | 456 | ||
| Freezing phase | 457 | ||
| Rewarming phase | 457 | ||
| Diagnosis/patient presentation | 457 | ||
| Physical exam | 457 | ||
| Staging | 457 | ||
| Radiographic studies | 457 | ||
| Patient selection | 458 | ||
| Treatment/surgical technique | 458 | ||
| Nonoperative management | 458 | ||
| Field management | 458 | ||
| Rapid rewarming | 458 | ||
| Adjunctive therapy | 458 | ||
| Splinting | 458 | ||
| Operative management | 458 | ||
| Amputation | 458 | ||
| Length salvage | 459 | ||
| Postoperative care | 459 | ||
| Outcomes/prognosis/complications | 459 | ||
| Secondary procedures | 460 | ||
| Sympathectomy | 460 | ||
| Hyperbaric oxygen | 460 | ||
| Thrombolytics | 460 | ||
| Chemical injury | 460 | ||
| History | 460.e1 | ||
| Basic science/disease process | 460 | ||
| Pathophysiology | 460 | ||
| Classification | 460 | ||
| Oxidizing agents | 460 | ||
| Chromic acid | 460 | ||
| Sodium hypochlorite | 461 | ||
| Reducing agents | 461 | ||
| Hydrochloric acid | 461 | ||
| Corrosive agents | 461 | ||
| Phenol | 461 | ||
| White phosphorus | 461 | ||
| Desiccants | 461 | ||
| Sulfuric acid | 461 | ||
| Vesicants | 461 | ||
| Mustard gas | 461 | ||
| Protoplasmic poisons | 461 | ||
| Formic acid | 461 | ||
| Hydrofluoric acid | 461 | ||
| Diagnosis/patient presentation | 461 | ||
| Oxidizing agents | 461 | ||
| Chromic acid | 461 | ||
| Sodium hypochlorite | 462 | ||
| Reducing agents | 462 | ||
| Hydrochloric acid | 462 | ||
| Corrosive agents | 462 | ||
| Phenol | 462 | ||
| White phosphorus | 462 | ||
| Desiccants | 462 | ||
| Sulfuric acid | 462 | ||
| Vesicants | 462 | ||
| Mustard gas | 462 | ||
| Protoplasmic poisons | 462 | ||
| Formic acid | 462 | ||
| Hydrofluoric acid (HF) | 462 | ||
| Patient selection | 462 | ||
| Treatment/surgical technique | 462 | ||
| Primary treatment | 462 | ||
| Secondary treatment | 463 | ||
| Oxidizing agents | 463 | ||
| Chromic acid | 463 | ||
| Sodium hypochlorite | 463 | ||
| Reducing agents | 463 | ||
| Hydrochloric acid | 463 | ||
| Corrosive agents | 463 | ||
| Phenol | 463 | ||
| White phosphorus | 463 | ||
| Desiccants | 463 | ||
| Sulfuric acid | 463 | ||
| Vesicants | 463 | ||
| Mustard gas | 463 | ||
| Protoplasmic poisons | 463 | ||
| Formic acid | 463 | ||
| Hydrofluoric acid | 464 | ||
| Postoperative care | 464 | ||
| Outcomes/prognosis/complications | 464 | ||
| Secondary procedures | 464 | ||
| Extravasation injury | 464 | ||
| History | 464.e1 | ||
| Basic science/disease process | 464 | ||
| Osmotically active agents | 464 | ||
| Vasoconstrictive agents | 464 | ||
| Cytotoxic agents | 464 | ||
| Diagnosis/patient presentation | 465 | ||
| Patient selection | 465 | ||
| Treatment/surgical technique | 465 | ||
| Osmotically active agents | 466 | ||
| Vasoconstrictive agents | 466 | ||
| Cytotoxic agents | 466 | ||
| Postoperative care | 466 | ||
| Outcomes/prognosis/complications | 466 | ||
| Secondary procedures | 467 | ||
| References | 467.e1 | ||
| 21 Management of facial burns | 468 | ||
| Introduction | 468 | ||
| History | 468.e1 | ||
| Basic science | 468 | ||
| Diagnosis: determination of depth of burn | 470 | ||
| Treatment of acute facial burns | 470 | ||
| Eyes/eyelid | 470 | ||
| Ears | 473 | ||
| Nose | 473 | ||
| Mouth | 473 | ||
| Wound nonoperative management of facial burn scars | 473 | ||
| Surgical management of the late effects of face, head and neck burns | 473 | ||
| Introduction | 473 | ||
| General principles | 474 | ||
| Importance of allowing total wound healing and scar maturation | 474 | ||
| Reconstruction must be preceded by analysis of the problem and diagnosis of the factors causing it | 474 | ||
| An overall plan for reconstruction should be developed | 474 | ||
| Restoration of function usually precedes aesthetic reconstruction | 474 | ||
| Local flaps should be used whenever possible | 474 | ||
| Skin grafts are used because of their thinness when a thicker flap would hide underlying anatomic contours or interfere with function | 474 | ||
| Skin replacement should generally be performed in “aesthetic units” when subtotal or total unit defects are present | 474 | ||
| Skin replacement should be performed with as well-matched skin as possible to the recipient site | 475 | ||
| As many goals as possible should be accomplished during each operative procedure | 475 | ||
| Ancillary techniques should be employed to maximum advantage | 475 | ||
| Follow-up must be diligent | 475 | ||
| An algorithmic approach to facial burn in reconstruction | 475 | ||
| Specific techniques | 478 | ||
| Scar replacement with local skin | 478 | ||
| Serial excision | 478 | ||
| W-plasty | 478 | ||
| Skin grafts | 479 | ||
| Introduction | 479 | ||
| Split-thickness skin grafts in facial burn reconstruction | 479 | ||
| The application of full-thickness skin grafts in facial burn reconstruction | 479 | ||
| Composite and nonskin grafts | 480 | ||
| Flaps | 480 | ||
| Introduction | 480 | ||
| Z-plasty | 481 | ||
| Trapeze-plasty | 481 | ||
| Reconstructive options when normal skin for donor site is inadequate | 482 | ||
| Tissue expansion | 482 | ||
| Technical points in tissue expansion | 482 | ||
| Dermal substitutes | 482 | ||
| Nonoperative facial reconstructive adjunct techniques | 484 | ||
| Laser therapy | 484 | ||
| Steroid injections | 485 | ||
| Corrective cosmetics | 485 | ||
| Hair transplantation | 485 | ||
| Fat transplantation | 485 | ||
| Prosthetics | 485 | ||
| Reconstruction of specific anatomic areas | 485 | ||
| Forehead | 485 | ||
| Eyebrows | 485 | ||
| Eyelids | 485 | ||
| Upper eyelids | 486 | ||
| Lower eyelids | 486 | ||
| Medial canthus scars | 488 | ||
| Nose | 488 | ||
| Upper lip | 489 | ||
| Lower lip and chin | 489 | ||
| Oral commissure | 489 | ||
| Cheeks | 490 | ||
| Ears | 491 | ||
| Scalp | 492 | ||
| Neck | 493 | ||
| Severe cervical burn scars and contractures | 494 | ||
| Postoperative care | 497 | ||
| Complications | 497 | ||
| Outcomes and prognosis | 497 | ||
| Secondary procedures | 498 | ||
| Besides these general techniques, there are specific examples of common secondary procedures in facial reconstruction | 498 | ||
| References | 499.e1 | ||
| 22 Reconstructive burn surgery | 500 | ||
| Introduction | 500 | ||
| Timing of reconstructive procedures | 500 | ||
| Hypertrophic scars and contractures | 501 | ||
| History | 500.e1 | ||
| Overview of techniques for reconstructive surgery | 501 | ||
| Scar release | 501 | ||
| Wound closure | 502 | ||
| Skin grafts | 502 | ||
| Skin substitutes | 502 | ||
| Local flaps | 502 | ||
| Other flaps | 503 | ||
| Tissue expansion | 503 | ||
| Specific reconstructive problems and procedures | 503 | ||
| Head and neck | 504 | ||
| Scalp | 504 | ||
| Facial defects | 504 | ||
| Eyelids and eyebrows | 504 | ||
| Nose and lips | 505 | ||
| Ears | 505 | ||
| Other facial areas | 506 | ||
| Neck | 506 | ||
| Breast reconstruction | 506 | ||
| Perineum | 506 | ||
| Upper extremity | 507 | ||
| Axilla | 507 | ||
| Elbow | 507 | ||
| Wrist and hand | 507 | ||
| Wrist | 508 | ||
| Digit contractures | 508 | ||
| Web space contractures | 508 | ||
| Nail deformities | 509 | ||
| Lower extremity | 509 | ||
| Postoperative management: splints, pressure garments and rehabilitation | 509 | ||
| Outcomes | 509 | ||
| Conclusion | 509 | ||
| References | 510 | ||
| 23 Management of patients with exfoliative disorders, epidermolysis bullosa, and TEN | 511 | ||
| Toxic epidermal necrolysis | 511 | ||
| Basic science/disease process | 511 | ||
| Patient presentation/diagnosis | 512 | ||
| Historical perspective | 511.e1 | ||
| Patient selection | 514 | ||
| General | 514 | ||
| Treatment/surgical technique | 515 | ||
| ABCs | 515 | ||
| Wound care | 515 | ||
| Drug withdrawal and the issue of corticosteroids | 515 | ||
| Postoperative care | 516 | ||
| General care issues | 516 | ||
| Ocular care | 516 | ||
| Novel pharmacologic therapy | 517 | ||
| Outcomes, prognosis, and complications | 517 | ||
| Secondary procedures | 517 | ||
| Epidermolysis bullosa | 517 | ||
| Basic science/disease process | 517 | ||
| Patient presentation/diagnosis | 518 | ||
| Subtypes and clinical characteristics | 519 | ||
| Investigations | 520 | ||
| Patient selection | 521 | ||
| Treatment/surgical technique | 521 | ||
| Surgical care | 521 | ||
| Use of skin equivalents | 522 | ||
| Postoperative care | 522 | ||
| Outcomes, prognosis, and complications | 522 | ||
| References | 525.e1 | ||
| Index | i1 | ||
| A | i1 | ||
| B | i11 | ||
| C | i30 | ||
| D | i51 | ||
| E | i53 | ||
| F | i59 | ||
| G | i79 | ||
| H | i82 | ||
| I | i95 | ||
| J | i99 | ||
| K | i99 | ||
| L | i100 | ||
| M | i108 | ||
| N | i120 | ||
| O | i131 | ||
| P | i136 | ||
| Q | i149 | ||
| R | i149 | ||
| S | i158 | ||
| T | i172 | ||
| U | i187 | ||
| V | i195 | ||
| W | i199 | ||
| X | i202 | ||
| Y | i203 | ||
| Z | i203 | ||
| Online \rIndex | e1 | ||
| A | e1 | ||
| B | e2 | ||
| C | e5 | ||
| D | e6 | ||
| E | e6 | ||
| F | e7 | ||
| G | e10 | ||
| H | e11 | ||
| I | e11 | ||
| J | e12 | ||
| K | e12 | ||
| L | e12 | ||
| M | e15 | ||
| N | e16 | ||
| O | e16 | ||
| P | e16 | ||
| Q | e18 | ||
| R | e18 | ||
| S | e19 | ||
| T | e22 | ||
| U | e24 | ||
| V | e25 | ||
| W | e25 | ||
| X | e26 | ||
| Z | e26 |