Additional Information
Book Details
Abstract
With coverage of nearly twice the number of flaps as the previous edition, Flaps and Reconstructive Surgery, 2nd Edition provides trainees and practicing surgeons alike with the detailed, expert knowledge required to ensure optimal outcomes. It includes chapters and expert commentaries from more than 100 authors and world-renowned leaders in the field, while brand-new cases and high-quality illustrations focused on flap harvest, markings, and reconstruction keep you abreast of today's latest developments.
- Includes high-quality illustrations of regional anatomy , flap anatomy, and step-by-step flap dissections, as well as clear photographs demonstrating successful reconstructions.
- Detailed case studies illustrate how to optimize every aspect of care for the reconstructive surgery patient, including the postoperative period and long-term follow-up.
- Brand-new section on reconstruction takes an algorithmic approach to the reconstruction of defects around the body.
- Features chapters covering the entire spectrum of reconstructive surgery, including head and neck reconstruction, chest wall reconstruction, abdominal wall, upper and lower extremity, and facial reanimation.
- Content focuses on both local and free flaps.
- New section on reconstructive transplant surgery highlights major topics such as face and hand transplantations, abdominal wall transplantation, uterus transplantation, and nerve allotransplantation.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Flaps and Reconstructive Surgery | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Video Table of Contents | ix | ||
| List of Chapter Contributors | xv | ||
| List of Expert Commentary Contributors | xxiv | ||
| Video Contributor List | xxx | ||
| Preface | xxxix | ||
| Dedication | xli | ||
| Acknowledgments | xlii | ||
| 1 Principles | 1 | ||
| 1 Problem Analysis in Reconstructive Surgery | 1 | ||
| History of Reconstructive Surgery | 1 | ||
| The Reconstructive Ladder | 1 | ||
| The Reconstructive Elevator | 2 | ||
| Surgical Judgment | 2 | ||
| The Present State of Reconstructive Surgery | 2 | ||
| A Modified Reconstructive Ladder/Elevator | 3 | ||
| Reconstructive Microsurgery | 3 | ||
| The Future of Microsurgery | 4 | ||
| References | 5 | ||
| 2 Classification of Flaps | e1 | ||
| Introduction | e1 | ||
| A Brief History of Flaps | e1 | ||
| Skin Flaps and Their Classification | e2 | ||
| Cormack and Lamberty Classification | e2 | ||
| Mathes and Nahai Classification | e2 | ||
| Nakajima Classification | e2 | ||
| Taylor’s “Angiosome” Concept-Based Classification | e3 | ||
| Muscle Flaps | e4 | ||
| Mathes and Nahai Muscle Flap Classification | e4 | ||
| Taylor Classification | e4 | ||
| Other Flaps | e4 | ||
| Serafin Classification | e4 | ||
| Combined Flaps | e4 | ||
| Conjoined Flaps | e5 | ||
| Chimeric Flaps | e6 | ||
| Secondary Characteristics | e7 | ||
| Perforator Flaps | e7 | ||
| Vascularized Composite Allotransplantation Classification | e7 | ||
| Conclusion | e8 | ||
| References | e9 | ||
| 3 Considerations in Flap Selection | 6 | ||
| Introduction | 6 | ||
| The Recipient Site | 6 | ||
| The Donor Site | 11 | ||
| Role of Combined Flaps | 12 | ||
| Future Considerations | 13 | ||
| References | 14 | ||
| 4 Emerging Technology in Reconstructive Surgery | e11 | ||
| Introduction | e11 | ||
| Virtual Surgical Planning and Rapid Prototype Modeling | e11 | ||
| Mandibular and Maxillary Reconstruction | e11 | ||
| Orbital Reconstruction | e14 | ||
| Intraoperative Stereotactic Navigation | e14 | ||
| Assessment of Tissue Perfusion with Indocyanine Green Angiography | e15 | ||
| Free Flap Perfusion | e16 | ||
| Free Flap Design | e17 | ||
| Mastectomy Skin Flap Necrosis | e18 | ||
| Lymphatic Surgery | e18 | ||
| Preoperative Planning with Computed Tomography Angiography | e19 | ||
| Breast Reconstruction | e19 | ||
| Use in Designing Other Free Flaps | e20 | ||
| Three-Dimensional Imaging Systems | e21 | ||
| Conclusions | e22 | ||
| References | e23 | ||
| 5 Prefabrication and Prelamination | 16 | ||
| Introduction | 16 | ||
| Flap Prefabrication | 18 | ||
| Concept | 18 | ||
| Technique | 18 | ||
| Flap Maturation | 19 | ||
| Flap Transfer | 19 | ||
| Clinical Examples | 19 | ||
| Flap Prelamination | 20 | ||
| Concept | 20 | ||
| Technique | 20 | ||
| Flap Maturation | 23 | ||
| Flap Transfer | 23 | ||
| Clinical Examples | 23 | ||
| Conclusion | 23 | ||
| References | 27 | ||
| 6 Tissue Engineering | e25 | ||
| Introduction | e25 | ||
| Mechanisms of Action | e26 | ||
| Current Strategies in Tissue Engineering | e26 | ||
| Complex Scaffolds and Matrices | e26 | ||
| Fundamental Role of Vascularization | e26 | ||
| Proangiogenic Strategies | e26 | ||
| Decellularization of Tissues to Obtain the Ideal Scaffold | e27 | ||
| Cells and Stem Cells: the Substrate | e27 | ||
| Pluripotent Stem Cells for Use in Autologous Conditions | e27 | ||
| Induced Pluripotent Stem Cells | e27 | ||
| Multipotent Stem Cells for Use in Autologous Conditions | e27 | ||
| Unipotent Progenitor Cells | e27 | ||
| Blood Outgrowth Endothelial Cells | e27 | ||
| Tissue Engineering-Based Clinical Applications | e27 | ||
| Skin | e28 | ||
| Epidermal Substitutes | e28 | ||
| Dermal Substitutes | e28 | ||
| Compound Substitutes with Epidermal and Dermal Elements | e28 | ||
| De-Novo Assembly of Matrices | e29 | ||
| Urethra and Bladder | e30 | ||
| Bone | e30 | ||
| Trachea | e30 | ||
| The Cardiovascular System | e32 | ||
| Vascular Grafts | e32 | ||
| Cell Therapy for Myocardium | e32 | ||
| Heart Valves | e32 | ||
| Conclusion | e32 | ||
| References | e33 | ||
| 7 Percutaneous Aponeurotomy and Lipofilling (PALF): | 28 | ||
| Introduction | 28 | ||
| 2-D Application of PALF | 29 | ||
| 3-D Application of PALF | 31 | ||
| Cicatrix to Matrix | 31 | ||
| Keys to Fat Grafting | 32 | ||
| Surface Area-to-Volume Ratio. | 32 | ||
| Interstitial Fluid Pressure. | 32 | ||
| Recipient Site Vascularity. | 33 | ||
| Ability to Differentiate Necrotic Cysts from Cancer. | 33 | ||
| General Fat Grafting Techniques | 33 | ||
| Fat Harvest | 33 | ||
| Fat Processing | 33 | ||
| Fat Delivery | 34 | ||
| Postoperative Support | 35 | ||
| Reverse Abdominoplasty and Fat Transfer | 35 | ||
| References | 35 | ||
| 8 Lymphedema: | 40 | ||
| Introduction | 40 | ||
| Lymphatic Anatomy and Physiology | 40 | ||
| Pathophysiology | 42 | ||
| Indications for Lymphatic Surgery | 42 | ||
| Contraindications to Physiologic Procedures | 45 | ||
| The Initial Patient Visit | 45 | ||
| Anatomic Imaging | 46 | ||
| Functional Imaging | 47 | ||
| Lymphoscintigraphy | 47 | ||
| Indocyanine Green Lymphangiography | 47 | ||
| Lymphaticovenular Anastomosis Versus Vascularized Lymph Node Transfer | 48 | ||
| Lymphaticovenular Anastomosis | 48 | ||
| Operative Technique | 48 | ||
| Postoperative Management | 49 | ||
| Treatment of Upper Extremity Lymphedema with Lymph Node Transfer | 49 | ||
| Flap Options | 49 | ||
| Recipient Site | 50 | ||
| Preparation of the Axillary Recipient Site | 50 | ||
| Vascularized Groin Lymph Node Transfer with Reverse Lymphatic Mapping | 50 | ||
| Anatomy and Flap Design | 50 | ||
| Treatment of Lower Extremity Lymphedema with Vascularized Lymph Node Transfer | 53 | ||
| Vascularized Axillary Lymph Node Transfer with Reverse Lymphatic Mapping | 53 | ||
| Donor Site | 53 | ||
| Recipient Site Preparation | 54 | ||
| Medial Sural Vessels | 54 | ||
| Vascularized Supraclavicular Lymph Node Transfer with Reverse Lymphatic Mapping | 55 | ||
| Flap Markings and Elevation | 56 | ||
| Postoperative Management | 56 | ||
| Outcomes | 56 | ||
| Conclusion | 57 | ||
| References | 59 | ||
| 9 Robotic Applications in Plastic and Reconstructive Surgery | e36 | ||
| Introduction | e36 | ||
| Operating Interface | e36 | ||
| Robotic Operating Team | e37 | ||
| Transoral Robotic Surgery (TORS) | e37 | ||
| Indications | e37 | ||
| Robotic Muscle Harvest | e37 | ||
| Indications | e38 | ||
| Robotic Microvascular Anastomosis | e39 | ||
| Indications | e39 | ||
| Future Directions | e39 | ||
| Summary | e39 | ||
| References | e41 | ||
| 2 Clinical Anatomy and Recipient Vessel Anatomy, Selection, and Exposure | 61 | ||
| 10 Clinical Anatomy of the Head and Neck, and Recipient Vessel Selection | 61 | ||
| Introduction | 61 | ||
| Anatomy of the Head and Neck | 61 | ||
| Anatomy of the Facial Skeleton | 61 | ||
| The Fascia of the Head and Neck | 62 | ||
| Anatomy of the Facial Musculature | 63 | ||
| Arterial Anatomy of the Head and Neck | 64 | ||
| Facial Artery | 64 | ||
| Advantages and Disadvantages | 68 | ||
| Exposure of the Facial Artery | 68 | ||
| Submental Artery | 69 | ||
| 3 Reconstruction | 138 | ||
| 14 Head and Neck Reconstruction | 138 | ||
| Introduction | 138 | ||
| Preoperative Considerations | 138 | ||
| Critical Concepts of Craniofacial Microvascular Reconstruction | 138 | ||
| Aesthetic Subunit Appearance | 138 | ||
| Defect Boundaries | 139 | ||
| Tissue Requirements | 140 | ||
| Bone and Soft Tissue Support | 140 | ||
| Soft Tissue Volume | 140 | ||
| Timing | 141 | ||
| Secondary Revisions | 141 | ||
| Indications | 142 | ||
| Regions of the Head and Neck | 142 | ||
| Scalp and Forehead | 142 | ||
| Periorbit | 142 | ||
| Midface | 143 | ||
| Nose | 143 | ||
| Mandible | 143 | ||
| Tongue | 144 | ||
| Esophagus | 144 | ||
| Voice | 145 | ||
| Free Flap Choices for Craniofacial Reconstruction | 145 | ||
| Ulnar Forearm Flap | 145 | ||
| Anatomy | 147 | ||
| Surgical Technique | 147 | ||
| Application, Advantages, and Disadvantages | 147 | ||
| Anterolateral Thigh (ALT) Flap | 148 | ||
| Application, Advantages, and Disadvantages | 148 | ||
| Groin Flap | 149 | ||
| Application, Advantages, and Disadvantages | 150 | ||
| Deep Circumflex Iliac Artery Flap | 151 | ||
| 4 Conventional Workhorse Flaps | 367 | ||
| A Local and Free Flaps in the Head and Neck | 367 | ||
| 31 Local Flaps in the Head and Neck | 367 | ||
| 5 Perforator-Based Workhorse Flaps | 648 | ||
| 56 Perforator Flaps in the Lateral Thoracic Region | 648 | ||
| Introduction | 648 | ||
| Flap Anatomy (Figs 56.1, 56.2 and 11.1, 11.2, 11.3, 11.5, 11.8, and 11.9) | 649 | ||
| Arterial Supply of the Flap (see Figs 56.1, 56.2 and 11.1, 11.2, 11.3, 11.5) | 649 | ||
| Latissimus Dorsi Perforator Flap | 649 | ||
| 6 Reconstructive Transplant Surgery | e204 | ||
| 63 Starting a Reconstructive Transplantation Program | e204 | ||
| Introduction | e204 | ||
| Should an Institution Develop a Reconstructive Transplant Program? | e205 | ||
| Forming the Team | e205 | ||
| Research or Clinical Practice | e207 | ||
| Committee Approvals | e207 | ||
| Funding the Program | e207 | ||
| The Organ Procurement Organization | e207 | ||
| Going Live | e208 | ||
| Maintaining an Active Program | e208 | ||
| Conclusions | e208 | ||
| References | e209 | ||
| 64 Face Transplantation | 739 | ||
| Introduction | 739 | ||
| Immune Suppression | 740 | ||
| Acute Rejection | 740 | ||
| Chronic Rejection | 740 | ||
| GVHD | 740 | ||
| Immune Tolerance | 741 | ||
| Side Effects of Immune Suppression | 741 | ||
| Indications | 741 | ||
| Trauma and Burns | 741 | ||
| The Military | 742 | ||
| Congenital Defects | 742 | ||
| Infectious Disease | 742 | ||
| Malignant Disease | 742 | ||
| Future Indications | 742 | ||
| Preoperative Considerations | 743 | ||
| Patient Selection | 743 | ||
| Donor Considerations | 744 | ||
| Surgical Planning | 744 | ||
| Surgical Technique | 744 | ||
| Postoperative Considerations | 745 | ||
| Complications | 746 | ||
| Outcomes | 746 | ||
| Medical Outcomes | 746 | ||
| Functional Outcomes | 747 | ||
| Aesthetic Outcomes | 747 | ||
| Social Outcomes | 748 | ||
| Discussion | 748 | ||
| Future Directions | 748 | ||
| References | 752 | ||
| 65 Hand and Upper Extremity Transplantation | 754 | ||
| Introduction | 754 | ||
| Immunotherapy | 754 | ||
| Indications | 755 | ||
| Preoperative Considerations | 755 | ||
| Patient Screening | 755 | ||
| Preoperative Planning | 755 | ||
| Cadaver Rehearsal | 756 | ||
| Team Assignments | 756 | ||
| Rotating Surgeons | 757 | ||
| Use or Replace Existing Motors | 757 | ||
| Ischemia Time | 757 | ||
| Surgical Technique | 757 | ||
| Donor Operation | 757 | ||
| Anesthesia Considerations | 759 | ||
| Operating Room Set-Up | 759 | ||
| Dissections | 759 | ||
| Osteosynthesis | 760 | ||
| Muscle/Tendon Reconstruction | 760 | ||
| Nerve Reconstruction | 760 | ||
| Revascularization | 761 | ||
| Skin Closure | 761 | ||
| Dressings | 762 | ||
| Transplant Level, Specific Techniques | 762 | ||
| Distal Forearm (see Case 65.1, left hand) | 762 | ||
| Middle Forearm | 762 | ||
| Proximal Forearm (see Case 65.2, left forearm) | 762 | ||
| Transhumeral (see Cases 65.1 and 65.2, right upper limbs) | 762 | ||
| Postoperative Considerations | 764 | ||
| Complications | 764 | ||
| Outcomes | 765 | ||
| Future Directions | 766 | ||
| References | 768 | ||
| 66 Laryngeal, Abdominal Wall, and Uterus Transplantation | 770 | ||
| Introduction | 770 | ||
| Laryngeal Allotransplantation | 770 | ||
| Arterial Anatomy (Fig. 66.1 and Figs 10.4 and 10.5) | 770 | ||
| Venous Anatomy | 771 | ||
| Neural Anatomy | 771 | ||
| Indications | 771 | ||
| Laryngeal Composite Tissue Component (Fig. 66.1) | 771 | ||
| Flap Design | 771 | ||
| Donor Procedure | 771 | ||
| Recipient Procedure | 771 | ||
| Flap Modifications | 772 | ||
| Postoperative Care | 772 | ||
| Immunosuppressive Protocol | 772 | ||
| Future Landmarks | 772 | ||
| Abdominal Wall Allotransplantation | 772 | ||
| Arterial Anatomy (see Fig. 66.2 and Figs 11.3 and 11.6) | 772 | ||
| Venous Anatomy (see Fig. 11.8) | 772 | ||
| Neural Anatomy (see Figs 11.9 and 11.10) | 772 | ||
| Indications | 772 | ||
| Abdominal Wall Composite Tissue Component (Fig. 66.2) | 772 | ||
| Flap Design | 772 | ||
| Donor Procedure | 772 | ||
| Recipient Procedure | 773 | ||
| Flap Modifications | 773 | ||
| Postoperative Care | 773 | ||
| Immunosuppressive Protocol | 773 | ||
| Future Landmarks | 773 | ||
| Uterus Transplantation | 773 | ||
| Arterial Anatomy | 774 | ||
| Venous Anatomy | 774 | ||
| Neural Anatomy | 774 | ||
| Indications | 774 | ||
| Uterine Transplanted Tissue Component (Fig. 66.3A) | 774 | ||
| Flap Design | 774 | ||
| Donor Procedure | 774 | ||
| Surgical Procedure in the Donor | 774 | ||
| Recipient Procedure | 775 | ||
| Surgical Procedure in Recipient | 775 | ||
| Flap Modifications | 776 | ||
| Postoperative Care | 776 | ||
| Immunosuppressive Protocol | 776 | ||
| Future Landmarks | 776 | ||
| Case Report | 776 | ||
| The Donor | 777 | ||
| Surgical Procedure | 777 | ||
| Immunosuppressive Protocol | 777 | ||
| Prophylaxis | 777 | ||
| Results | 777 | ||
| Other CTAs in Case Reports | 778 | ||
| References | 778 | ||
| 67 Immunology and Research in Reconstructive Transplantation | e210 | ||
| Introduction | e210 | ||
| Basics of Transplantation Immunology | e210 | ||
| The Role of the MHC/HLA Antigens | e210 | ||
| Non-HLA Antigens | e211 | ||
| ABO Blood Group Antigens | e211 | ||
| Minor Histocompatibility Antigens | e211 | ||
| Allorecognition Pathways | e211 | ||
| T-Cell Activation | e211 | ||
| B-Cell Activation | e212 | ||
| Rejection | e212 | ||
| Hyperacute Rejection | e213 | ||
| Accelerated Rejection | e213 | ||
| Acute Rejection | e213 | ||
| Chronic Allograft Vasculopathy (Chronic Rejection) | e213 | ||
| Immunologic Factors of Chronic Rejection | e213 | ||
| Non-Immunologic Factors of Chronic Rejection | e213 | ||
| Tolerance | e214 | ||
| Chimerism and Donor Bone Marrow Transplantation | e215 | ||
| Cell-Based Therapies in VCA | e216 | ||
| T-Regulatory Cells | e216 | ||
| Dendritic Cells | e216 | ||
| Mesenchymal Stem Cells | e217 | ||
| References | e218 | ||
| 68 Peripheral Nerve Allotransplantation | 779 | ||
| Introduction | 779 | ||
| Peripheral Nerve Regeneration | 779 | ||
| Nerve Allotransplantation | 781 | ||
| Schwann Cells and Immunology of Nerve Allotransplantation | 781 | ||
| Current Strategies for Nerve Allotransplantation | 782 | ||
| Clinical Experience with Nerve Allotransplantation | 783 | ||
| Nerve Regeneration in Vascularized Composite Allotransplantation | 785 | ||
| Summary | 788 | ||
| Nerve Autograft Substitutes | 788 | ||
| Conduits and Processed Nerve Allografts | 788 | ||
| Nerve Conduits | 788 | ||
| Processed Nerve Allografts | 792 | ||
| Conclusion | 794 | ||
| References | 795 | ||
| Index | 799 | ||
| A | 799 | ||
| B | 801 | ||
| C | 802 | ||
| D | 803 | ||
| E | 804 | ||
| F | 805 | ||
| G | 809 | ||
| H | 810 | ||
| I | 811 | ||
| J | 812 | ||
| K | 812 | ||
| L | 812 | ||
| M | 814 | ||
| N | 816 | ||
| O | 816 | ||
| P | 817 | ||
| R | 820 | ||
| S | 822 | ||
| T | 825 | ||
| U | 827 | ||
| V | 827 | ||
| W | 828 | ||
| Y | 828 | ||
| Z | 828 | ||
| Inside Back Cover | ibc1 |