Additional Information
Book Details
Abstract
As the surgical community steps up to tackle the global burden of surgical disease in developing countries, Global Reconstructive Surgery is the first reference of its kind to offer focused, pertinent coverage of key areas surgeons need to understand to fully participate in this endeavor. It provides authoritative, real-world guidance on common surgeries performed around the world to help optimize outcomes in difficult environments and for a variety of conditions.
- Offers practical wisdom and experience from surgeons who have lived and worked in challenging global settings. The clear, organized format is based on the way clinicians examine, prepare for, and treat patients in resource-limited circumstances.
- Each chapter matches the clinical pathway and thought processes of care delivery, from the clinical problem and pre-operative assessment to operative intervention, post-operative care, and possible complications and options for management.
- Covers perioperative management, cleft and craniofacial surgery, hand surgery, burns, trauma, and key techniques commonly performed by surgeons across the globe.
- Includes the surgical steps of each procedure, photographs of clinical cases, and surgical pearls for resource-poor settings.
- Discusses alternative approaches related to cultural considerations and unavailability of state-of-the-art equipment.
- Ideal for plastic surgeons, otolaryngologists, craniofacial surgeons. oral and maxillofacial surgeons, general surgeons – both those who volunteer for surgical trips and those training in local communities.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| IFC_Expert Consult PIN page | IFC1 | ||
| Global Reconstructive Surgery | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | vii | ||
| Foreword | viii | ||
| Chirurgia Pro Omnibus | viii | ||
| List of Contributors | x | ||
| Acknowledgments | xiv | ||
| Dedication | xv | ||
| Video Contents | xvi | ||
| 1 Perioperative Management | 1 | ||
| 1.1 Pre-Operative Screening | 1 | ||
| Synopsis | 1 | ||
| Introduction | 1 | ||
| Screening of the Site | 1 | ||
| Ward Needs | 1 | ||
| Nursing Support | 1 | ||
| Ancillary Support | 1 | ||
| Follow-Up Care | 1 | ||
| Patient Selection | 1 | ||
| Patient Screening: History | 2 | ||
| Patient Screening: Physical Examination | 2 | ||
| Patient Screening: Laboratory Evaluation | 3 | ||
| Patient Screening: Specific Concerns | 3 | ||
| Age | 3 | ||
| Weight | 3 | ||
| Malnutrition | 3 | ||
| Syndromes and Developmental Delay | 4 | ||
| Anemia | 4 | ||
| Acute Respiratory Illness | 4 | ||
| Chronic Medical Conditions | 4 | ||
| Patient Screening: Day of Surgery | 4 | ||
| Conclusion | 5 | ||
| Key References | 5 | ||
| 1.2 Operating Room Requirements and Setup | 6 | ||
| Synopsis | 6 | ||
| Introduction | 6 | ||
| Pre-Trip Preparation | 6 | ||
| Establish the Surgical Suite | 6 | ||
| Creating a Functional Operating Room | 7 | ||
| Assess Available OR Furniture and Equipment | 7 | ||
| Equipment | 8 | ||
| Instrument Sets | 9 | ||
| Supplies (Video 1.2.1) | 10 | ||
| Emergency Preparedness | 11 | ||
| Other Considerations | 11 | ||
| Educational Component | 11 | ||
| Conclusion | 12 | ||
| Further Reading | 12 | ||
| 1.3 General Anesthesia | 13 | ||
| Synopsis | 13 | ||
| General Anesthesia in LMICs | 13 | ||
| Anesthesia Delivery Systems (Machines, Vaporizers, and Monitors) | 13 | ||
| Anesthetic Disposable Supplies and Medications in LMICs | 16 | ||
| Preparation for General Anesthesia | 17 | ||
| Preliminary Site Visit/Report | 17 | ||
| Transportation of Anesthesia Supplies and Equipment | 17 | ||
| Preparation of the Operating Room and Patient for General Anesthesia | 17 | ||
| Team Anesthesia Providers | 17 | ||
| Anesthesia Documentation | 19 | ||
| NPO Guidelines | 19 | ||
| Premedication | 19 | ||
| Induction of Anesthesia | 19 | ||
| Airway | 19 | ||
| Unanticipated Difficult Airways | 20 | ||
| Maintenance Anesthesia | 20 | ||
| Emergence From Anesthesia | 20 | ||
| Complications During Emergence and Recovery | 21 | ||
| Conclusions | 21 | ||
| Key References | 22 | ||
| 1.4 Regional Anesthesia | 23 | ||
| Synopsis | 23 | ||
| Clinical Issues | 23 | ||
| Presentation | 23 | ||
| General Risks | 23 | ||
| Associated Conditions | 23 | ||
| Additional Considerations | 23 | ||
| Management | 23 | ||
| Techniques | 23 | ||
| I. Facial Block | 23 | ||
| Infra-Orbital Block | 23 | ||
| 2 Key Techniques | 60 | ||
| 2.1 Skin Grafting | 60 | ||
| Synopsis | 60 | ||
| Clinical Issues | 60 | ||
| Presentation | 60 | ||
| Etiology | 60 | ||
| Associated Conditions | 60 | ||
| Management | 60 | ||
| Key Area of Concern | 60 | ||
| Techniques | 61 | ||
| Split-Thickness Skin Graft Harvest | 61 | ||
| Meshing Skin Grafts | 62 | ||
| Full-Thickness Skin Graft Harvest | 63 | ||
| Skin Graft Immobilization | 64 | ||
| Post-Operative Concerns | 64 | ||
| Management of Complications | 65 | ||
| Identifying Complications | 65 | ||
| Addressing Complications | 65 | ||
| Key References | 65 | ||
| 2.2 Nerve Repair | 66 | ||
| Synopsis | 66 | ||
| Clinical Issues | 66 | ||
| Management | 66 | ||
| Techniques | 66 | ||
| Management of Complications | 69 | ||
| Key References | 69 | ||
| 2.3 Tendon Repair | 70 | ||
| Synopsis | 70 | ||
| Clinical Issues | 70 | ||
| Management | 73 | ||
| Techniques | 73 | ||
| Flexor Tendon Repair | 73 | ||
| Zone 2 Flexor Tendon Injury | 73 | ||
| Palm Laceration | 73 | ||
| Spaghetti Wrist | 73 | ||
| Extensor Tendon Repair | 75 | ||
| Dorsal Hand Laceration | 75 | ||
| Dorsal Forearm Laceration | 75 | ||
| Post-Operative Concerns | 76 | ||
| Management of Complications | 76 | ||
| Key References | 76 | ||
| 2.4 Bone Fixation | 77 | ||
| Synopsis | 77 | ||
| Introduction | 77 | ||
| Preparation | 77 | ||
| Indications/Techniques | 77 | ||
| Implants | 77 | ||
| Ancillary Equipment | 77 | ||
| Operating Schedule | 78 | ||
| Surgical Principles | 78 | ||
| Post-Operative Care | 78 | ||
| Bone Fixation | 79 | ||
| Bone Fixation-Malunion | 79 | ||
| Bone Fixation-Nonunion | 83 | ||
| Key References | 85 | ||
| 2.5 Local Skin Flaps | 86 | ||
| Synopsis | 86 | ||
| Clinical Issues | 86 | ||
| Management | 86 | ||
| Techniques | 88 | ||
| Rotation Flap | 88 | ||
| 3 Cleft and Craniofacial Surgery | 137 | ||
| 3.1 Primary Unilateral Cleft Lip Repair | 137 | ||
| Synopsis | 137 | ||
| Clinical Problem | 137 | ||
| Pre-Operative Management | 137 | ||
| Evaluation and Timing of Surgery | 137 | ||
| Relevant Anatomy | 137 | ||
| Nasoalveolar Molding | 138 | ||
| Pre-Operative Testing | 138 | ||
| Anesthetic Considerations | 138 | ||
| Supplies Needed | 139 | ||
| Surgery | 139 | ||
| Positioning and Surgical Site Preparation | 139 | ||
| Anesthesia | 139 | ||
| Approach | 139 | ||
| Step-by-Step Technique | 139 | ||
| Post-Operative Care | 148 | ||
| Management of Complications | 148 | ||
| Key References | 150 | ||
| 3.2 Primary Bilateral Cleft Lip Repair | 151 | ||
| Synopsis | 151 | ||
| Clinical Problem | 151 | ||
| Presentation | 151 | ||
| Etiology | 151 | ||
| Associated Conditions | 152 | ||
| Pre-Operative Management | 152 | ||
| Physical Examination and Key Anatomy | 152 | ||
| Pre-Operative Testing | 153 | ||
| Optimal Timing of Surgery | 153 | ||
| Supplies Needed | 153 | ||
| Anesthesia | 154 | ||
| Surgery | 154 | ||
| Post-Operative Care (Figs 3.2.12–3.2.16) | 156 | ||
| Complications | 156 | ||
| Key References | 159 | ||
| 3.3 Secondary Cleft Lip Reconstruction | 160 | ||
| Synopsis | 160 | ||
| Clinical Problem and Principles of Treatment | 160 | ||
| General Scarring | 160 | ||
| Short and Long Lip (Unilateral Cleft) | 160 | ||
| Tight and Wide Lip (Bilateral Clefts) | 161 | ||
| Vermilio-Cutaneous Mismatch (Unilateral Clefts) | 161 | ||
| Vermilio-Mucosal Mismatch and Deficiencies (Unilateral and Bilateral Clefts) | 161 | ||
| Mucosal and Buccal Sulcus Deformity | 162 | ||
| Muscle Deformities | 163 | ||
| Nasal Repair | 163 | ||
| Pre-Operative Management | 163 | ||
| Timing | 163 | ||
| Post-Operative Care and Management of Complications | 164 | ||
| Case Illustration | 164 | ||
| Key References | 165 | ||
| 3.4 Primary Cleft Palate Repair | 166 | ||
| Synopsis | 166 | ||
| Clinical Problem | 166 | ||
| Pre-Operative Evaluation and Management | 167 | ||
| Operative Technique | 168 | ||
| Soft Palate | 168 | ||
| Hard Palate | 171 | ||
| Post-Operative Care | 171 | ||
| Management of Complications | 173 | ||
| Key References | 175 | ||
| 3.5 Alveolar Bone Grafting | 176 | ||
| Synopsis | 176 | ||
| Clinical Problem | 176 | ||
| Pre-Operative Management | 176 | ||
| Surgery | 177 | ||
| Post-Operative Care | 179 | ||
| Management of Complications | 180 | ||
| Key References | 180 | ||
| 3.6 Scalp Reconstruction | 182 | ||
| Synopsis | 182 | ||
| Clinical Problem | 182 | ||
| Presentation and Etiologies | 182 | ||
| Associated Conditions | 182 | ||
| Pre-Operative Management | 182 | ||
| Physical Examination | 182 | ||
| Key Anatomy | 182 | ||
| Operative Planning | 185 | ||
| Surgery | 185 | ||
| General Principles and Pearls | 185 | ||
| Secondary Intention | 185 | ||
| Primary Closure | 185 | ||
| Skin Grafting | 185 | ||
| Local Flaps | 185 | ||
| Tissue Expansion | 186 | ||
| Regional Flaps | 187 | ||
| Free Tissue Transfer | 187 | ||
| Post-Operative Care | 188 | ||
| Management of Complications | 189 | ||
| Key References | 189 | ||
| 3.7 Ptosis Repair | 190 | ||
| Synopsis | 190 | ||
| Clinical Problem | 190 | ||
| Pre-Operative Management | 192 | ||
| Physical Examination | 192 | ||
| Surgery | 193 | ||
| Setup and Positioning | 193 | ||
| Post-Operative Care | 196 | ||
| Management of Complications | 196 | ||
| Key References | 197 | ||
| 3.8 Nasal Reconstruction | 198 | ||
| Synopsis | 198 | ||
| Clinical Problem | 198 | ||
| Pre-Operative Management | 198 | ||
| Key Anatomy | 198 | ||
| Physical Examination | 198 | ||
| Operative Planning | 199 | ||
| Surgery | 199 | ||
| Operative Principles and Pearls | 199 | ||
| Soft Tissue Reconstruction | 199 | ||
| Bony and Cartilaginous Framework Reconstruction | 203 | ||
| Lining Reconstruction | 208 | ||
| Post-Operative Care | 208 | ||
| Management of Complications | 208 | ||
| Key References | 210 | ||
| 3.9 Microtia | 211 | ||
| Synopsis | 211 | ||
| Clinical Problem | 211 | ||
| Presentations and Etiologies | 211 | ||
| Associated Conditions | 211 | ||
| Pre-operative Management | 211 | ||
| Surgery | 213 | ||
| Post-Operative Care | 216 | ||
| Management of Complications | 216 | ||
| Key References | 217 | ||
| 3.10 Jaw Surgery | 218 | ||
| Synopsis | 218 | ||
| Lower Facial Fractures | 218 | ||
| Clinical Problem | 218 | ||
| Pre-Operative Management | 218 | ||
| Physical Examination | 218 | ||
| Pre-Operative Testing | 218 | ||
| Optimal Timing of Surgery | 218 | ||
| Supplies Needed | 218 | ||
| Anesthesia Concerns | 219 | ||
| Surgery | 219 | ||
| Post-Operative Care | 219 | ||
| Management of Complications | 219 | ||
| Malocclusion and Malunion | 219 | ||
| Infection and Nonunion | 220 | ||
| Hardware Failure | 220 | ||
| Mandibular Distraction for Severe Retrognathia | 221 | ||
| Clinical Problem | 221 | ||
| Pre-Operative Management | 221 | ||
| Physical Examination | 221 | ||
| Pre-Operative Testing | 222 | ||
| Optimal Timing of Surgery | 222 | ||
| Supplies Needed | 222 | ||
| Anesthesia Concerns | 222 | ||
| Surgery | 222 | ||
| Post-Operative Care | 222 | ||
| Management of Complications | 223 | ||
| Infection | 223 | ||
| Skeletal Relapse | 223 | ||
| Tooth and Nerve Injury | 223 | ||
| Distractor Failure | 223 | ||
| Jaw Tumors | 223 | ||
| Clinical Problem | 223 | ||
| Clinical and Radiographic Presentation | 223 | ||
| Diagnosis and Treatment | 224 | ||
| Pre-Operative Management | 224 | ||
| Mandibular Resection: Supplies Needed | 224 | ||
| Anesthetic Concerns | 225 | ||
| Mandible Resection: Transoral Approach | 225 | ||
| Mandible Resection: Submandibular Approach | 225 | ||
| Post-Operative Care | 226 | ||
| Management of Complications | 226 | ||
| Key References | 227 | ||
| 4 Burns | 228 | ||
| 4.1 Acute Burn Management | 228 | ||
| Synopsis | 228 | ||
| Clinical Problem | 228 | ||
| Presentation | 228 | ||
| Etiology | 228 | ||
| Associated Conditions | 228 | ||
| Pre-Operative Management | 228 | ||
| Physical Examination | 228 | ||
| Pre-Operative Testing Needed | 229 | ||
| Optimal Timing of Surgery | 229 | ||
| Supplies Needed | 229 | ||
| Anesthesia Concerns | 229 | ||
| Surgery | 230 | ||
| Skin Grafting | 230 | ||
| Escharotomies | 230 | ||
| Post-Operative Care | 231 | ||
| Management of Complications | 231 | ||
| Key References | 232 | ||
| 4.2 Burn Wound Management | 233 | ||
| Synopsis | 233 | ||
| Clinical Problem | 233 | ||
| Burn Wound Assessment | 233 | ||
| Etiology | 233 | ||
| Electrical Burn Injuries | 233 | ||
| Inhalation Injury | 233 | ||
| Injury Depth | 234 | ||
| Superficial Partial-Thickness Wounds | 234 | ||
| Deep Partial-Thickness Wounds | 234 | ||
| Full-Thickness Injuries | 234 | ||
| Size of Injury | 234 | ||
| Patient Age | 234 | ||
| Past Medical History and Risk Factors | 235 | ||
| Part of the Body Burned | 235 | ||
| Pre-Operative Management | 235 | ||
| Wound Care | 235 | ||
| Cleansing | 235 | ||
| Debridement | 236 | ||
| Shaving | 236 | ||
| Application of Topical Agents | 237 | ||
| Wound Infection Assessment | 237 | ||
| Positioning and Contracture Prevention | 237 | ||
| Therapeutic Positioning | 237 | ||
| Exercise Program | 237 | ||
| Splinting | 237 | ||
| Pain Management | 237 | ||
| Post-Operative Care | 238 | ||
| Skin Grafting | 238 | ||
| Donor Site Care | 238 | ||
| Management of Complications | 238 | ||
| Key References | 240 | ||
| 4.3 Eyelid Burn Reconstruction | 241 | ||
| Synopsis | 241 | ||
| Clinical Problem | 241 | ||
| Presentation | 241 | ||
| Etiology | 241 | ||
| Associated Conditions | 241 | ||
| Pre-Operative Management | 241 | ||
| Physical Examination and Key Anatomy | 241 | ||
| Pre-Operative Testing | 241 | ||
| Optimal Timing of Surgery | 242 | ||
| Supplies Needed | 242 | ||
| Anesthesia Concerns | 242 | ||
| Surgery | 242 | ||
| Post-Operative Care | 245 | ||
| Dressings | 245 | ||
| Splinting | 245 | ||
| Therapy | 245 | ||
| Management of Complications | 245 | ||
| Key References | 247 | ||
| 4.4 Face Burn Reconstruction (Cheek, Nose, and Lip) | 248 | ||
| Synopsis | 248 | ||
| Clinical Problem | 248 | ||
| Pre-Operative Management | 248 | ||
| Surgery | 249 | ||
| The Cheek | 249 | ||
| The Nose | 250 | ||
| The Lips | 251 | ||
| Step-by-Step Guide: The Y-V Commissuroplasty for Microstomia | 253 | ||
| Post-Operative Care | 253 | ||
| Management of Complications | 253 | ||
| Key References | 254 | ||
| 4.5 Neck Burn Reconstruction | 255 | ||
| Synopsis | 255 | ||
| Clinical Problem | 255 | ||
| Presentation | 255 | ||
| Etiology | 255 | ||
| Associated Conditions | 255 | ||
| Pre-Operative Management | 255 | ||
| Physical Examination and Key Anatomy | 255 | ||
| Pre-Operative Testing Needed | 257 | ||
| Optimal Timing of Surgery | 257 | ||
| Supplies Needed | 257 | ||
| Anesthesia Concerns | 257 | ||
| Surgery | 258 | ||
| Post-Operative Care | 259 | ||
| Management of Complications | 260 | ||
| Key References | 262 | ||
| 4.6 Shoulder and Axilla Burn Reconstruction | 263 | ||
| Synopsis | 263 | ||
| Clinical Problem | 263 | ||
| Pre-Operative Management | 263 | ||
| Surgery | 264 | ||
| Post-Operative Care | 266 | ||
| Management of Complications | 267 | ||
| Key References | 269 | ||
| 4.7 Elbow and Wrist Burn Reconstruction | 270 | ||
| Synopsis | 270 | ||
| Clinical Problem | 270 | ||
| Pre-Operative Management | 270 | ||
| Surgery | 271 | ||
| Post-Operative Care | 274 | ||
| Management of Complications | 274 | ||
| Key References | 275 | ||
| 4.8 Hand Burn Reconstruction | 276 | ||
| Synopsis | 276 | ||
| Clinical Problem | 276 | ||
| Pre-Operative Management | 276 | ||
| Surgery | 277 | ||
| Release of Contractures | 277 | ||
| Skin Grafts | 277 | ||
| Z-Plasties | 277 | ||
| Four-Flap Z-Plasty | 277 | ||
| Five-Flap Z-Plasty | 277 | ||
| Release and Coverage of the First Web Space | 277 | ||
| Burn Claw Hand Release | 278 | ||
| Palmar Burn | 278 | ||
| Groin Flap and Abdominal Wall Flap | 278 | ||
| Forearm Flaps | 278 | ||
| Other Reconstructive Options | 278 | ||
| Post-Operative Care | 279 | ||
| Pain Control | 279 | ||
| Wound Care | 279 | ||
| Splinting and Therapy | 279 | ||
| Management of Complications | 280 | ||
| Bleeding | 280 | ||
| Nerve Function | 280 | ||
| Ischemia | 280 | ||
| Poor Skin Graft Take | 280 | ||
| Recurrent Contracture | 280 | ||
| Future Directions | 280 | ||
| Key References | 280 | ||
| 4.9 Leg Burn Reconstruction | 281 | ||
| Synopsis | 281 | ||
| Clinical Problem | 281 | ||
| Pre-Operative Management | 281 | ||
| Surgery | 282 | ||
| Case Example | 282 | ||
| Surgery Steps | 283 | ||
| Post-Operative Care | 283 | ||
| Management of Complications | 283 | ||
| Key References | 284 | ||
| 4.10 Foot Burn Reconstruction | 285 | ||
| Synopsis | 285 | ||
| Clinical Problem | 285 | ||
| Presentation and Etiology | 285 | ||
| Associated Conditions | 285 | ||
| Pre-Operative Management | 285 | ||
| Physical Examination, Key Anatomy, and Pre-Operative Studies Needed | 285 | ||
| Optimal Timing of Surgery | 285 | ||
| Supplies Needed | 286 | ||
| Anesthesia Concerns | 286 | ||
| Surgery | 286 | ||
| General Principles | 286 | ||
| Local Tissue Rearrangement | 286 | ||
| Skin Grafting | 292 | ||
| Local Flaps | 292 | ||
| Regional Flaps | 293 | ||
| Free Flaps | 294 | ||
| Post-Burn Foot and Ankle Deformities | 294 | ||
| Toe Contractures | 294 | ||
| Rocker-Bottom Deformity | 294 | ||
| Ankle Contractures | 294 | ||
| Post-Operative Care | 295 | ||
| Dressings | 295 | ||
| Splinting | 295 | ||
| Therapy | 295 | ||
| Management of Complications | 295 | ||
| Graft/Flap Loss | 295 | ||
| Recurrent Contracture | 297 | ||
| Key References | 297 | ||
| 4.11 Post-Operative Burn Therapy | 298 | ||
| Synopsis | 298 | ||
| Clinical Issues | 298 | ||
| Presentation | 298 | ||
| Post-Burn Therapy Evaluation | 298 | ||
| Objective Evaluations | 299 | ||
| Burn Management and Treatment Techniques | 299 | ||
| Wound Management | 299 | ||
| Anti-Contracture Positioning | 300 | ||
| Splinting | 300 | ||
| Edema Management | 303 | ||
| Therapeutic Exercises | 304 | ||
| Purposeful Activities and Activities of Daily Living | 304 | ||
| Scar Management | 304 | ||
| Strengthening and Conditioning Exercises | 305 | ||
| Patient/Family Education and Home Program | 306 | ||
| Conclusions | 306 | ||
| Key References | 306 | ||
| 5 Hand Surgery | 307 | ||
| 5.1 Syndactyly Reconstruction | 307 | ||
| Synopsis | 307 | ||
| Clinical Problem | 307 | ||
| Pre-Operative Management | 307 | ||
| Surgery | 308 | ||
| Post-Operative Care | 310 | ||
| Management of Complications | 310 | ||
| Key References | 311 | ||
| 5.2 Polydactyly Reconstruction | 312 | ||
| Synopsis | 312 | ||
| Introduction | 312 | ||
| Radial Polydactyly | 312 | ||
| Clinical Presentation | 312 | ||
| Pre-Operative Management | 313 | ||
| Surgical Technique | 315 | ||
| Type I (Distal Phalanx) and Type II (Distal Interphalangeal Joint) | 315 | ||
| Type III (Proximal Phalanx) and Type IV (Metacarpophalangeal Joint) | 315 | ||
| Type V (Metacarpal) and Type VI (Carpometacarpal Joint) | 315 | ||
| Type VII (Accompanied by Triphalangism) | 315 | ||
| 6 Trauma | 390 | ||
| 6.1 Compartment Syndrome Treatment | 390 | ||
| Synopsis | 390 | ||
| Clinical Problem | 390 | ||
| Pre-Operative Management | 390 | ||
| Physical Examination and Key Anatomy | 390 | ||
| Pre-Operative Testing Needed | 392 | ||
| Optimal Timing of Surgery | 393 | ||
| Anesthesia and Supplies | 393 | ||
| Surgery (Video 6.1.1) | 394 | ||
| Patient Case | 394 | ||
| Post-Operative Care | 394 | ||
| Management of Complications | 395 | ||
| Key References | 395 | ||
| 6.2 Lower-Extremity Trauma Reconstruction | 396 | ||
| Synopsis | 396 | ||
| Clinical Problem | 396 | ||
| Pre-Operative Management | 396 | ||
| Surgery | 397 | ||
| Gastrocnemius Flap—Most Useful Flap for Proximal 1/3 Lower Leg Defects | 397 | ||
| Index | 404 | ||
| A | 404 | ||
| B | 404 | ||
| C | 405 | ||
| D | 406 | ||
| E | 406 | ||
| F | 407 | ||
| G | 407 | ||
| H | 408 | ||
| I | 408 | ||
| J | 409 | ||
| K | 409 | ||
| L | 409 | ||
| M | 409 | ||
| N | 410 | ||
| O | 410 | ||
| P | 410 | ||
| Q | 411 | ||
| R | 411 | ||
| S | 412 | ||
| T | 413 | ||
| U | 414 | ||
| V | 414 | ||
| W | 414 | ||
| Y | 414 | ||
| Z | 414 | ||
| IBC_Clinical Key advert | IBC1 |