دانلود کتاب Plastic Surgery: Volume 1: Principles (Plastic Surgery, 1)

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Any screen. Any time. Anywhere.\nPlastic\rSurgery\nCopyright\nContents\nVideo Contents\nLecture Video Contents\nPreface to the Fifth Edition\nList of Editors\nList of Contributors\nAcknowledgments\nDedication\nPlastic surgery and innovation in medicine\n 1\r Plastic surgery and innovation in medicine\n Introduction\n Adaptation and change\n Innovation and research\n Major innovations\n Making innovation safe\n Collaboration and teamwork\n Documentation, data-gathering, and regulation\n Conclusion\n References\nHistory of reconstructive and aesthetic surgery\n 2\r History of reconstructive and aesthetic surgery\n Historical definition of plastic surgery\n Origin of plastic surgery\n The distant past – the wound as a problem\n In Ancient Egypt\n In Mesopotamia\n In India\n In Greece\n In Rome\n Plastic surgery after the decline of the Roman Empire\n Byzantine surgery\n The Middle Ages\n Arabian surgery\n The rise of the universities\n The invention of printing\n The Renaissance\n Renaissance surgery\n The decline of plastic surgery\n The rebirth of plastic surgery\n The nineteenth century\n The golden age of plastic surgery\n The twentieth century\n The origin of modern plastic surgery\n The training programs\n The birth of the scientific societies\n The scientific journals\n Postwar plastic surgery\n Aesthetic surgery\n The origin\n The development\n The problem of the beauty doctors\n Postwar aesthetic surgery\n References\n Further reading\nApplying psychology to routine plastic surgery practice\n 3\r Applying psychology to routine plastic surgery practice\n Introduction\n What motivates people to seek appearance-altering surgery?\n The prevalence of appearance dissatisfaction in the general population\n What are the characteristics of people who seek cosmetic interventions?\n Visible differences (disfigurement) and reconstructive surgery\n Does cosmetic surgery meet patients’ needs? The psychological benefits and limitations of cosmetic surgery\n Who is psychologically vulnerable – does vulnerability lead to poorer outcomes?\n Mental health problems\n How can I manage my patients more effectively?\n Communicating effectively\n Screening and assessment\n Understanding motivation and modifying expectations of outcome\n Facilitating the understanding of risk\n Promoting patient involvement in treatment decision-making\n Incorporating psychological care into routine practice in cosmetic surgery\n Managing mental health issues\n Summary\n References\nThe role of ethics in plastic surgery and medico-legal issues in plastic surgery\n 4\r The role of ethics in plastic surgery and medico-legal issues in plastic surgery\n Introduction\n History of ethics and plastic surgery\n Core ethical principles and plastic surgery\n Patient communication, education, informed consent, and disclosure\n Conflict of interest\n Concurrent and overlapping surgery\n Medical errors\n Expert witness testimony\n Social media and advertising\n Conclusions\n References\nBusiness principles for plastic surgeons\n 5\r Business principles for plastic surgeons\n Introduction\n Strategy\n Accounting\n Income statement\n Balance sheet\n Summary of cash flows\n Financial ratios\n Profitability ratios\n Leverage ratios\n Liquidity ratios\n Efficiency ratios\n Finance\n Time value of money\n Opportunity cost\n Net present value (NPV) and discounted cash flows (DCF)\n Return on investment (ROI)\n Economics\n Marketing\n Operations\n Innovation\n Entrepreneurship\n Sustainable enterprise\n Human resource management\n Legal and regulatory considerations\n Sarbanes–Oxley Act, 2002\n American Recovery and Reinvestment Act, 2009\n Patient Protection and Affordable Care Act, 2010\n Dodd–Frank Wall Street Reform and Consumer Protection Act, 2010\n The Coronavirus Aid, Relief, and Economic Security Act, 2020\n Negotiation\n Ethics\n Leadership\n Acknowledgments\n References\n A­dd­it­io­nal Reading\nValue-based healthcare\n 6\r Value-based healthcare\n Introduction\n Why value-based healthcare matters in plastic surgery\n Defining value within plastic surgery\n The numerator: Clinical outcomes and patient-reported outcomes measures\n The denominator: Cost\n Practical implementation of value-based plastic surgery\n Cosmetic/aesthetic surgery – translational lessons for value-based care?\n Tools for value-based care in plastic surgery\n Shared decision-making\n Cost-effectiveness analysis\n Implementation science\n Future directions\n Conclusions\n References\nDigital photography in plastic surgery\n 7\r Digital photography in plastic surgery\n Purpose\n Standards in capturing images\n Digital image characteristics\n Background\n White balance\n Lens aperture and shutter speed\n Focal length and distortion\n Composition and positioning\n Full face\n Eyes\n Glabella\n Nose\n Lips, nasolabial folds, and mentum\n Dental occlusal views\n Ears\n Chest and breast\n Lower trunk, abdomen, and buttocks\n Lower extremity\n Hands and feet\n Specialty views\n In the hospital and operating room\n Archiving and image management\n Cameras\n Storage\n File formats\n Image attributes, metadata, and retrieval\n Digital image processing\n Measurement and analysis\n Planning and simulation\n New frontiers\n Three-dimensional surface imaging\n Video\n Digital image manipulation\n Presentations\n References\nPre- and intra-operative imaging for plastic surgery\n 8\r Pre- and intra-operative imaging for plastic surgery\n Introduction\n Traditional imaging techniques\n External photography\n Standard photography\n Three-dimensional (3D) photography\n Cross-sectional imaging\n Diagnostic ultrasound (US)\n Computed tomography angiography (CTA)\n Magnetic resonance imaging (MRI)\n Image-guided 3D surgical planning\n Virtual surgical planning (VSP)\n 3D printing\n Novel intra-operative imaging techniques\n Perfusion-guided imaging\n Indocyanine green (ICG)\n Laser Doppler\n Dynamic infrared thermography\n Surgical navigation\n Mixed reality\n Eye tracking\n New frontiers in surgical training\n Conclusion\n References\nPatient safety in plastic surgery\n 9\r Patient safety in plastic surgery\n Introduction\n Preoperative\n ASA classification\n Preoperative risk stratification and optimization\n Risk stratification and risk modification for venous thromboembolism\n Perioperative medication cessation\n Intra-operative\n Intra-operative checklist use\n Intra-operative malignant hyperthermia\n Intra-operative VTE risk reduction\n Prevention of hypothermia\n Operating room fire prevention\n Patient safety in teaching hospitals\n Patient safety in ambulatory surgery centers and office-based settings\n Intra-operative procedure-specific concerns\n Procedures that tighten the abdominal wall\n Liposuction and local anesthesia toxicity\n Gluteal fat grafting\n Postoperative\n Postoperative VTE risk reduction\n Anticoagulation in postoperative patients\n Opioid management\n Conclusions\n References\nAnesthesia and pain management in plastic surgery\n 10\r Anesthesia and pain management in plastic surgery\n Introduction\n Clinical consequences of inadequate pain relief\n Acetaminophen, nonsteroidal anti-inflammatory drugs, and cyclooxygenase-2 selective inhibitors\n Acetaminophen\n Nonsteroidal anti-inflammatory drugs\n COX-2 receptor inhibitors\n NMDA-receptor antagonists and gabapentinoids\n Ketamine\n Gabapentinoids\n Opioids\n Local anesthetics\n Minimizing pain with injection of local anesthesia\n Liposomal delivery of local anesthetics\n Local anesthetic infiltration into operative sites (wound infiltration)\n Tumescent analgesia in plastic surgery\n Fluid composition\n Epinephrine in tumescent analgesia\n Complications of tumescent anesthesia\n Peripheral regional and neuraxial analgesia in plastic surgery\n Pectoral 1 and 2 blocks\n Erector spinae block\n Transversus abdominis plane block\n Upper and lower extremity peripheral nerve blocks\n Paravertebral block\n Neuraxial analgesia\n Spinal and epidural anesthesia\n Summary\n References\nEvidence-based medicine and health services research in plastic surgery\n 11\r Evidence-based medicine and health services research in plastic surgery\n The best evidence – where do we find it?\n Evaluating existing literature\n Literature search strategies\n PubMed\n Clinical Queries\n PICO(T)\n Systematic reviews\n Meta-analysis\n Network meta-analysis\n Study design and levels of evidence\n Experimental studies: Randomized controlled trials\n Challenges of RCTs for comparing surgical interventions and possible solutions\n Possible solution: Expertise-based randomized controlled trials\n Possible solution: Multicenter trials\n Limitations of randomized controlled trials: investigating harm\n Observational studies\n Cohort studies\n Case–control studies\n Case series and case reports\n Large-database analysis\n Population-based research\n Effectiveness versus efficacy\n The importance of power and understanding the P-value\n Data sources\n Clinical registries\n Administrative claims data\n Using large databases for research\n Large cohort studies\n Administrative data\n Small-area variation\n Volume–outcome analysis\n Epidemiology\n Examples of large-database analyses in plastic surgery\n Patient-reported outcomes research\n Utilities and preference-based measures\n Key concepts\n Comparative effectiveness research\n Definition\n National research priority\n Types of economic studies\n Complexities\n Whose perspective to take?\n Study design\n Limitations\n Summary\n The preconditions to credible clinical research in plastic surgery\n Future trends\n Knowledge translation (KT)\n A model for understanding KT\n Barriers to uptake\n Learning collaboratives\n Role of electronic health records/integrating data collection into flow of usual care versus research\n Possible solutions: generic\n Possible solutions: plastic surgery and PROMs\n What do we do with the outcomes?\n Performance measures\n Public reporting and pay-for-performance (P4P)\n Decision aids for patients\n Conclusions\n Acknowledgment\n References\nPatient-reported outcomes in plastic surgery\n 12\r Patient-reported outcomes in plastic surgery\n Introduction\n Early PROMs in plastic surgery\n Types of PROMs\n Methodology involved in modern PROM development\n Step 1: Hypothesize conceptual framework\n Step 2: Adjust conceptual framework, draft PROM and cognitive debriefing\n Step 3: Confirm conceptual framework and assess other measurement properties\n Step 4: Finalize the instrument\n Computerized adaptive testing (CAT)\n Characteristics to consider when selecting a PROM\n Validity\n Reliability\n Responsiveness\n Minimal important difference\n Feasibility and burden\n Future directions for PROMs in plastic surgery\n Summary\n References\nHealth services research in plastic surgery\n 13\r Health services research in plastic surgery\n What is health services research?\n Plastic surgeons and HSR\n Eliminating inequities – necessary considerations for impactful work\n Considering structural root causes\n Taking action toward equitable research and outcomes\n Health policy research\n Why does health policy matter to surgeons?\n How to engage with policy?\n Causal inference: limits and opportunities with observational data\n Measuring quality\n The future of assessment and technical improvement\n Assessing patient-reported outcomes\n Comparative effectiveness\n Collaborative quality improvement\n Implementation science: how to change practice\n Qualitative research methods – an underused approach\n Collecting and working with qualitative data\n Conclusions\n References\nPrinciples of cancer management\n 14\r Principles of cancer management\n Background\n Cancer presentation and initial evaluation\n Cancer diagnosis and treatment planning\n Critical mass\n Tumor margins\n Classification and staging\n Treatment planning\n Localized treatments\n Surgery\n Radiation\n Photodynamic therapy\n Systemic treatments\n Chemotherapy\n Targeted therapies\n Immunotherapy\n Cancer management: the plastic surgeon perspective\n Conclusions\n References\nWound healing\n 15\r Wound healing\n Introduction\n The wound healing process\n Normal wound healing\n Hemostasis\n Inflammation\n Proliferation\n Maturation, or remodeling\n Abnormal wound healing\n Chronic wounds\n Fibrosis and exuberant scar formation\n Factors affecting wound healing\n Age\n Obesity\n Diabetes\n Medications\n Malnutrition\n Oxygen\n Infection\n Wound types and treatments\n Acute wounds\n Lacerations and avulsion injuries\n Burn injuries\n Superficial burn injury\n Deep burn injuries\n Chronic wounds\n Diabetic foot ulcers\n Ischemic ulcers and pressure sores\n Venous ulcers\n Exuberant wound healing\n Keloids\n Hypertrophic scars\n Wound dressings\n Moist wound healing\n Moist wound dressings\n Alginate dressings\n Film dressings\n Foam dressings\n Hydrocolloid dressings\n Hydrogel dressings\n Negative pressure wound therapy\n Topical oxygen therapy\n Skin tissue engineering\n Approaches to skin regeneration\n Cell therapy\n Growth factor therapy\n Dermal substitutes\n Gene therapy\n Wound imaging and assessment techniques\n Wound healing research\n In vitro research\n Animal research\n Murine and rodent wound models\n Rabbit wound models\n Porcine models\n Clinical research\n Future directions and opportunities\n References\nScar prevention, treatment, and revision\n 16\r Scar prevention, treatment, and revision\n Personal and social significance of scars\n History and physical examination\n Assessing scars\n Scar biology\n Scar prevention: skin regeneration after repair\n Conditions of excessive scarring\n Hypertrophic scar\n Keloid\n Prevention\n Surgical technique\n Patient-specific factors\n Wound infections and foreign-body reactions\n Adjunct therapy\n Treatment\n Treatment of hypertrophic scars\n Treatment of keloid scars\n Preventative management for hypertrophic and keloids scarring\n Scar revision\n Introduction\n Indications\n Timing\n Planning\n Scar release\n Principles of tissue rearrangement\n Scar revision techniques\n Wound dressings and postoperative care\n Mechanical shield\n References\nSkin grafting\n 17\r Skin grafting\n Introduction\n The need for skin\n History of the graft technique\n Anatomy and physiology of skin\n The laminar integument\n The skin\n Epidermis\n Dermal–epidermal junction\n Dermis\n Dermal–hypodermal junction\n Hypodermis\n Structures of the skin\n The cutaneous niche\n Vascular supply of the skin\n Lymphatic drainage\n Neuronal supply of the skin\n Cutaneous appendages and the adnexal niche\n Physiology and functions of the skin\n Cutaneous homeostasis\n The skin as a barrier\n Restoration of barrier function after injury\n Metabolic and regulatory functions of the skin\n UV protection, melanocytes, and pigmentation\n Immunology of the skin and the cutaneous microbiome\n The skin graft\n Clinical application\n Split-thickness skin grafts\n Grafting technique\n Meshed skin grafts\n Full-thickness skin grafts\n Composite grafts\n Skin fixation and dressings\n Recipient site considerations\n Wound bed preparation\n Functional and aesthetic considerations\n Donor site considerations\n Management of complications\n Hematoma/seroma\n Infection\n Instability\n Other factors\n Physiology of skin graft survival\n Skin appendages and other structures\n Beyond the graft\n Adjunctive therapies to autografting\n Graft expansion\n Soft-tissue augmentation\n Long-term graft storage\n Non-autologous alternatives and adjuncts\n Acellular extracellular matrices\n Allogeneic and nonhuman grafting of whole tissues\n Cell-seeded constructs\n References\nTissue engineering\n 18\r Tissue engineering\n Introduction\n Plastic surgery principles in tissue engineering and the first 40 years\n The first evolution of plastic surgery – random pattern and pedicle flaps and the culture of better solutions\n The second evolution of plastic surgery – microsurgery and the precedent for better solutions\n The third evolution of plastic surgery: tissue engineering, the answer beyond surgery\n The fall of tissue engineering Mark-I\n Issues that led to the collapse of the early tissue engineering sector\n Tissue engineering Mark-II – focusing on the old domains and new paradigms\n Modern tissue engineering – the TERM for progress\n Cell biology and cell signaling – a complex interplay of individual fields of expertise\n Biomaterials biology\n Case studies of tissue engineering in plastic surgery\n Skin tissue engineering\n Engineering therapeutic delivery in skin\n Antifibrotic therapies\n Engineering lymphatics in skin\n Scaffold-based approaches to lymphatic engineering\n Macrovascular lymphatic scaffolds\n Microvascular lymphatic scaffolds\n Interstitial flow-based lymphatic engineering models\n Secondary lymphoid scaffolds\n Non-scaffold approaches\n Conclusion and future perspectives\n References\nRepair, grafting, and engineering of cartilage\n 19\r Repair, grafting, and engineering of cartilage\n Introduction\n Autologous cartilage grafts and applications6\n Auricular cartilage graft\n Nasal cartilage graft\n Rib cartilage graft\n Autologous perichondrial graft\n Cartilage engineering\n Introduction and basic principle\n Engineering of auricular cartilage\n Engineered cartilage for rhinoplasty and facial contouring\n Engineered cartilage for joint cartilage repair and reconstruction\n Clinical translation of engineered human ear cartilage\n Future directions\n Stem cell-based cartilage engineering\n In vitro engineering of cartilage with enhanced mechanical strength\n Design and precise control of engineered cartilage 3D structure\n References\nRepair and grafting of bone\n 20\r Repair and grafting of bone\n Microanatomy and histochemistry\n Cortical versus cancellous bone\n The chemical composition of bone\n Inorganic phase\n Organic phase\n The cellular composition of bone\n Osteoblasts\n Histology and function\n Regulation of osteoblast differentiation\n Major signaling pathways\n Transcriptional regulation\n Osteocytes\n Histology\n Osteocyte function\n Osteoclasts\n Histology and function\n Osteoclast differentiation\n Extracellular matrix\n Principles of bone homeostasis and turnover\n Wolff\'s law and mechanotransduction\n Bone regeneration: the role of the stem cell\n Molecular mechanisms of bone regeneration\n Bone morphogenetic protein\n Bone morphogenetic protein function\n Transforming growth factor-β\n Fibroblast growth factor\n Platelet-derived growth factor\n Healing of fractures\n Primary bone repair\n Secondary (callus) bone repair\n Variables influencing bone repair\n Blood supply\n Fracture fixation\n Age\n Bone remodeling\n Osteoinduction\n Osteoconduction\n Osseointegration\n Distraction osteogenesis\n Histology\n Variables affecting osteogenesis\n Patient factors\n Age\n Blood supply\n Radiation/chemotherapy\n Clinical application of bone transfers\n Indication for bone transfers\n Bone graft healing and graft survival\n Cancellous versus cortical grafts\n Clinical considerations\n Techniques of harvest: autologous bone grafts\n Ilium\n Tibia and fibula\n Greater trochanter and olecranon\n Rib\n Calvarium\n Vascularized bone flaps\n Vascularized iliac transfer\n Vascularized fibula\n Vascularized scapula\n Vascularized rib\n Vascularized calvarium\n Principles of bone transfer\n Allogeneic bone grafts\n Processing and preservation\n Risk of disease transmission\n Immunogenicity\n Incorporation of allograft bone\n Formulations of allogeneic bone grafts\n Xenogeneic bone grafts\n Bone substitutes\n Cement pastes\n Calcium phosphates\n BoneSource\n Norian SRS/CRS\n Osteoactive materials\n Prefabricated polymers\n Methylmethacrylate\n Medpor\n Experimental scaffolds\n References\nRepair and grafting of peripheral nerve\n 21\r Repair and grafting of peripheral nerve\n Introduction\n Pathophysiology of nerve injury\n Classification of nerve injury\n Mechanism of nerve injury\n Penetrating injuries\n Crush injuries\n Stretch and avulsion injuries\n Evaluation of nerve injuries\n History and physical examination\n Electrodiagnostic evaluation\n Imaging\n Patient selection\n Treatment\n Nerve repair\n Timing of repair\n Tension\n Type of repair\n Intraoperative nerve stimulation\n Bridging the nerve gap\n Autologous nerve grafting\n Nerve allografts\n Nerve conduits\n Nerve transfers\n Bioengineering and adjunctive therapies to improve nerve regeneration\n Postoperative care\n Prognosis and outcomes\n Secondary procedures\n Summary\n Acknowledgment\n References\nRepair and grafting fat and adipose tissue\n 22\r Repair and grafting fat and adipose tissue\n Introduction\n Historical perspective\n Basic science\n Adipose tissue: structure and physiology\n Biology of ASCs\n Fat harvesting, preparation, and grafting techniques\n Safety concerns\n Diagnosis/patient presentation\n Patient selection\n Treatment/surgical technique\n Harvesting\n Refinement\n Placement\n Postoperative care\n Outcomes, prognosis, and complications\n Secondary procedures\n References\nVascular territories\n 23\r Vascular territories\n Introduction\n Historical perspective\n Vascular anatomical research\n Angiosome\n Arterial territories\n Venous drainage\n Neurovascular territories\n Neurovascular anatomy of muscles of the body\n Comparative anatomy\n The angiosome concept\n The anatomical and clinical territory of a cutaneous perforator\n Vascular territories of the body\n Vascular territories of the forearm\n Forearm skin\n Muscles\n Forearm bones\n Clinical implications\n Donor site morbidity\n Free-flap donor sites\n Vascular territories of the lower leg\n Lower leg skin\n Lower leg muscles\n Anterior leg muscles\n Lateral leg muscles\n Posterior leg muscles\n Leg skin vascular supply\n Connective tissue framework\n Compartment syndromes\n Flap donor sites\n Vascular anastomoses around the knee\n Vascular territories of the head and neck\n Head and neck skin and superficial musculoaponeurotic system\n Head and neck muscles\n Muscles of facial expression\n Ocular muscles\n Muscles of mastication\n Posterior neck muscles\n Lateral neck muscles\n Anterior neck muscles\n Aerodigestive system\n Internal nose\n Tongue and floor of mouth\n Palate, pharynx, larynx, esophagus, and trachea\n Glands\n Anatomic concepts related to flap design\n Vessels follow the connective tissue framework of the body\n Arteries radiate from fixed to mobile areas and veins converge from mobile to fixed areas\n Vessels “hitchhike” with nerves\n Vessel growth and orientation are products of tissue growth and differentiation\n Vessels interconnect to form a continuous three-dimensional network of vascular arcades\n Arteries\n Veins\n Vessels obey the law of equilibrium\n Vessels have a relatively constant destination but may have a variable origin\n Venous networks consist of linked valvular and avalvular channels that allow equilibrium of flow and pressure\n Directional veins\n Oscillating avalvular veins\n Muscles are prime movers of venous return\n Superficial veins follow nerves and deep veins follow arteries\n Applications of the angiosome concept\n Preoperative assessment of the cutaneous vascular supply\n Flap design\n Dopplers\n Color duplex Doppler\n CT angiography\n Axes of skin flaps\n Distally based skin flaps\n Skin flap dimensions\n Fasciocutaneous flaps\n Musculocutaneous flaps\n Perforator flaps\n The delay phenomenon\n Composite flaps\n Angiosome concept and flap design\n References\nFlap physiology, classification, and applications\n 24\r Flap physiology, classification, and applications\n History\n Classification of flaps\n Flaps based on the constituents\n Muscle and musculocutaneous flaps\n Fascia and fasciocutaneous flaps\n Perforator flap (skin with fat and with or without fascia)\n Visceral flaps\n Bone flap (vascularized bone, osseous–periosteal flap)\n Nerve flap\n Lymph node flap\n Flaps based on construction (flow)\n Retrograde-flow flaps\n Turbocharged and supercharged flap\n Venous flaps (arterialized venous flap)\n Flaps based on conditioning\n Delay\n Tissue expansion\n Prelaminated and prefabricated flaps\n Sensory flap\n Functional muscle flaps\n Flaps based on conformation\n Flap applications\n The reconstructive elevator\n The guide for reconstruction using flaps\n Preoperative planning\n Intraoperative techniques\n Postoperative management\n Flap physiology\n The no-reflow phenomenon\n Selection of specific flaps\n Muscle and musculocutaneous flaps\n Fascia, fasciocutaneous, and perforator flaps\n Perforator flap (free-style)\n Regional application of flaps\n Head and neck reconstruction\n Breast reconstruction\n Mediastinum\n Chest wall and pulmonary cavity\n Abdominal wall\n Groin and perineum\n Lower extremity\n Foot\n Posterior trunk\n Pressure wounds\n Microsurgical application of flaps\n Free perforator flaps\n Anterolateral thigh (ALT)\n Deep inferior epigastic artery perforator (DIEAP) flap\n Thoracodorsal artery perforator (TDAP) flap\n Complications\n R­ef­er­en­ces\nPrinciples and techniques of microvascular surgery\n 25\r Principles and techniques of microvascular surgery\n Introduction\n Historical perspective\n Tools\n Surgical microscopes\n Loupes\n Types\n Choosing loupes\n Microsurgical instruments\n Types\n Scissors\n Needle holders\n Forceps\n Vascular clamps\n Bipolar coagulator\n Irrigation and suction\n Microsutures\n Anastomotic devices\n Other non-suture methods\n General principles of microvascular surgery\n The working environment\n Training\n Planning and positioning\n Securing the flap or flap inset\n Selection and dissection of recipient vessels\n Preparation of vessels\n Anastomoses sequence\n Microvascular anastomosis techniques\n Suturing techniques\n End-to-end anastomosis\n End-to-side\n Use of the coupler\n Difficult, less commonly encountered microvascular anastomosis\n Anastomosis between size-discrepant vessels\n Vertically oriented anastomosis\n Atherosclerosis and loose intima\n Microvascular grafts\n Testing patency\n General aspects of free flap surgery\n Advantages and disadvantages\n Preoperative evaluation\n Patient factors\n Recipients and donor site evaluation\n Choice of flap\n Timing\n Microvascular anesthesia\n Special techniques and flap modifications\n Endoscopic harvest\n Robot-assisted free flap surgery\n Perforator flaps, free-style flaps, and supramicrosurgery\n Combined flaps\n Thinned flaps\n Prefabricated/prelaminated flaps\n Postoperative management, complications, and outcomes\n Monitoring\n Telemonitoring\n Buried flaps\n Flap outcomes\n Causes of a failing flap\n Anastomotic failure\n Vasospasm\n Thrombogenesis\n Ischemic tolerance, ischaemia–reperfusion injury, and no-reflow phenomenon\n Donor site complications – dependent again on flap choice\n Management of failed flaps\n The future of microsurgery\n References\nTissue expansion and implants\n 26\r Tissue expansion and implants\n Introduction\n Historical perspective\n Tissue expanders\n Breast implants\n Basic science of tissue expansion\n Cellular and molecular basis for tissue expansion/mechanotransduction\n Vascularity of expanded tissue\n Patient and tissue expander/implant selection\n Tissue expanders and implant types\n Tissue expanders\n Tissue expander types with different port systems\n Breast implants\n Surface of breast implants\n Filler material of breast implants\n Shape of breast implants\n Size of breast implants\n Profile types of breast implants\n Diagnosis/preoperative planning/implant selection\n Tissue expansion\n Breast implants\n Treatment and surgical technique\n Tissue expanders in head and neck surgery\n Breast expanders\n Breast implants\n Postoperative care\n Tissue expansion\n Breast implants\n Complications\n Hematoma and seroma\n Infection\n Capsular fibrosis\n Expander/implant malposition\n Expander/implant rupture, deflation, and failure\n Exposure of expander/implant\n Flap ischemia and skin necrosis\n Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)\n Breast implant illness (BII)\n References\nPrinciples of radiation therapy\n 27\r Principles of radiation therapy\n Historical perspective\n Introduction\n Radiation technology\n Cobalt radiation therapy\n Linear accelerators (linacs)\n Particle therapy\n Electrons\n Proton beam therapy\n Neutron therapy\n Carbon ion therapy\n FLASH therapy\n Brachytherapy\n Physics\n Radiation therapy delivery techniques\n Three-dimensional conformal radiation therapy\n Intensity-modulated radiation therapy (IMRT)\n Stereotactic body radiation therapy (SBRT)\n Intraoperative radiation therapy (IORT)\n Radiobiology\n Applications\n Radiation treatment-planning and process\n Clinical applications\n Units of radiation\n Treatment intention, fractionation, and dosing\n Patient selection\n Breast cancer\n Breast conservation therapy\n Indications for postmastectomy radiation (PMRT)\n Radiation of the nodal draining areas\n RT indications, dose, and techniques\n Breast: Spotlight on upfront multidisciplinary evaluation topics\n Head and neck cancer\n Head and neck: Spotlight on upfront multidisciplinary evaluation topics\n Sarcoma\n RT indications, dose, and techniques\n Sarcoma: Spotlight on upfront multidisciplinary evaluation topics\n Skin cancers\n RT indications, dose, and techniques\n Skin cancers: Spotlight on upfront multidisciplinary evaluation topics\n Pediatrics\n RT indications, dose, and techniques\n Pediatrics: Spotlight on upfront multidisciplinary evaluation topics\n Benign disorders\n Specific toxicities and complications\n Bony injury\n Bone growth in children\n Cardiovascular disease\n Lymphedema\n Brachial plexopathy\n Radiation-induced malignancies\n Exposure to radiation\n Conclusion and future trends\n References\nLymphedema pathophysiology and basic science\n 28\r Lymphedema: pathophysiology and basic science\n Introduction\n Anatomy and physiology\n Lymphatic circulation\n Lymph nodes\n Etiology of lymphedema\n Primary lymphedema\n Secondary lymphedema\n Pathophysiology of lymphedema\n Lymphatic vascular defects in secondary lymphedema\n Regulation of fibrosis\n Regulation of adipose deposition\n Epidermal changes\n Risk factors of lymphedema\n Obesity\n Radiation\n Infection\n Genetics\n Clinical presentation, evaluation, and diagnosis\n Signs and symptoms of lymphedema\n Differential diagnosis\n Diagnostic measurements\n Other diagnostic tools\n Radiologic diagnosis of lymphedema\n Near-infrared (NIR) lymphography with ICG dye\n Patient-reported outcomes\n Lymphedema classification\n Summary\n References\nBenign and malignant nonmelanocytic tumors of the skin and soft tissue\n 29\r Benign and malignant nonmelanocytic tumors of the skin and soft tissue\n Introduction\n Diagnosis\n Inspection and palpation\n Dermoscopy\n Ultrasound and Doppler imaging\n X-ray, CT, MRI, angiography, scintigraphy, and positron emission tomography (PET)\n Pathologic diagnosis\n The TNM clinical classification system and the pTNM pathologic classification system\n Clinical staging\n Treatment\n Wide excision\n Lymph node dissection\n Axillary lymph node dissection\n Inguinal lymph node dissection\n Reconstructive surgery\n Radiation therapy\n Chemotherapy\n Laser therapy\n Others (including immunotherapy, cryotherapy, electrocoagulation therapy, and sclerotherapy)\n Benign cutaneous and soft-tissue tumors\n Benign epithelial-origin tumors\n Epidermal nevus (e.g., verrucous epidermal nevus and linear epidermal nevus)\n Seborrheic keratosis (also known as senile wart)\n Keratoacanthoma\n Epidermoid cyst (also known as epidermal cyst and atheroma)\n Milia\n Dermoid cyst\n Others\n Benign appendage-origin tumors\n Nevus sebaceous\n Pilomatricoma (also known as calcifying epithelioma and pilomatrixoma)\n Trichilemmal cyst\n Syringoma\n Apocrine cystadenoma (also known as apocrine cysthidroma)\n Chondroid syringoma (also known as cutaneous mixed tumor)\n Others\n Benign neural crest-origin tumors\n Pigment cell nevus (also known as pigmented nevus and nevus cell nevus)\n Lentigo simplex\n Acquired pigment cell nevus\n Congenital pigment cell nevus\n Dysplastic nevus (also known as Clark’s nevus and atypical mole)\n Juvenile melanoma (also known as Spitz nevus)\n Nevus spilus (also known as café-au-lait spot)\n Becker’s melanosis (also known as Becker’s pigmented hairy nevus)\n Nevus of Ota (also known as nevus fuscoceruleus ophthalmomaxillaris and oculodermal melanocytosis)\n Nevus of Ito\n Mongolian spot (also known as congenital dermal melanocytosis)\n Blue nevus\n Neuroma\n Schwannoma (also known as neurilemmoma)\n Neurofibroma\n Others\n Benign mesenchymal-origin tumors\n Dermatofibroma (also known as fibrous histiocytoma)\n Xanthoma\n Juvenile xanthogranuloma\n Soft fibroma\n Keloid and hypertrophic scars\n Lipoma\n Leiomyoma\n Rhabdomyoma\n Osteochondrogenic tumors\n Accessory auricle (also known as nevus cartilagines)\n Granuloma\n Glomus tumor\n Capillary malformation\n Hemangioma simplex\n Strawberry hemangioma\n Venous malformation\n Arteriovenous fistula and arteriovenous malformation (AVM)\n Lymphatic malformation\n Others\n Malignant cutaneous and soft-tissue tumors\n Malignant epithelial-origin tumors\n Actinic keratosis\n Bowen’s disease\n Squamous cell carcinoma\n Basal cell carcinoma\n Malignant appendage-origin tumors\n Sebaceous carcinoma\n Trichilemmal carcinoma\n Sweat gland carcinoma\n Extramammary Paget’s disease\n Merkel cell carcinoma\n Malignant mesenchymal-origin tumors\n Dermatofibrosarcoma protuberans (DFSP)\n Pleomorphic undifferentiated sarcoma (PUS)\n Liposarcoma\n Leiomyosarcoma\n Rhabdomyosarcoma\n Osteosarcoma\n Chondrosarcoma\n Angiosarcoma\n Kaposi’s sarcoma\n Others\n References\nMelanoma\n 30\r Melanoma\n Introduction\n Clinical evaluation – dermoscopy and confocal\n Benign melanocytic lesions\n Melanocytic nevi\n Congenital nevi\n Acquired naevi\n Predisposing conditions\n Melanoma\n In situ melanoma\n Superficial spreading melanoma\n Nodular melanoma\n Lentigo maligna melanoma\n Desmoplastic melanoma\n Acral/subungual\n Staging\n Tumor category\n Regional nodal category\n Distant metastasis category\n Stage\n Other histopathological features\n Clark’s level\n Neurotropism\n Lymphovascular invasion\n Tumor infiltrating lymphocytes (TILs)\n Follow-up and imaging\n Surgical considerations and management\n Biopsy of a clinically suspicious melanocytic lesion\n Wide local excision of primary melanoma\n Wide excision of melanoma in situ\n Sentinel lymph node biopsy\n Management of sentinel node metastases\n Management of clinically detected nodal metastases\n Lymph node dissection (lymphadenectomy)\n Neck dissection\n Axillary dissection\n Iliofemoral dissection\n Distant metastases\n Systemic therapy for melanoma\n Immune checkpoint inhibitors\n Targeted therapy\n Adjuvant treatment\n Adverse effects of systemic therapy\n ICI\n Targeted therapy\n Radiotherapy\n References\nImplants and biomaterials\n 31\r Implants and biomaterials\n Historical perspective\n Metals\n Stainless steel\n Cobalt–chromium\n Titanium\n Gold\n Platinum\n Polymers\n Silicone\n Silicone shell texturing\n Polytetrafluoroethylene\n Polyester\n Polyprolene\n Polyethylene\n Biodegradable polymers\n Polymer coatings\n Ceramics\n Adhesives and glues\n Fibrin tissue adhesives\n Platelet gels\n Cyanoacrylate\n Integra\n Skin substitutes\n Epicel (cultured epidermal autografts)\n Dermagraft\n Apligraf\n Bioprosthetic mesh\n Small intestinal submucosa\n Human acellular dermal matrix\n Porcine acellular dermal matrix\n Other bioprosthetic mesh products\n Amniotic/placental-based materials\n Addressing the foreign body response\n Future materials\n References\nTransplantation in plastic surgery\n 32\r Transplantation in plastic surgery\n Introduction\n History of transplantation in plastic surgery\n Transplant immunology\n VCA program requirements\n Selection of patients and donors\n Patient selection\n Donor selection\n Surgical approach\n Surgical preparations and graft procurement\n Facial transplantation\n Upper extremity transplantation\n Postoperative care\n Immunosuppression regimen\n Clinical monitoring\n Complications\n Allograft rejection\n Immunosuppression-related complications\n Surgical complications/revision\n Outcomes\n Future of VCA\n References\nTechnology innovation in plastic surgery a practical guide for the surgeon innovator\n 33\r Technology innovation in plastic surgery: a practical guide for the surgeon innovator\n Introduction\n The idea\n Determining the value\n Funding\n Intellectual property\n Institutional technology transfer\n FDA regulatory approval process\n AI/ML device regulatory approval process\n Starting clinical trials in plastic surgery\n Innovating for global health and low- and middle-income countries\n Conflict of interest\n Innovations in plastic surgery\n Negative pressure wound therapy\n Acellular dermal matrix\n Noninvasive body contouring\n References\nRobotics in plastic surgery\n 34\r Robotics in plastic surgery\n Introduction\n Robotics in plastic surgery\n Transoral robotic reconstructive surgery (TORRS)\n Robotic microsurgery\n Robotic flap harvest\n Robotic harvest of the latissimus dorsi muscle flap\n Robotic harvest of the rectus abdominis dorsi muscle flap\n Robotic harvest of the deep inferior epigastric perforator flap (RoboDIEP)\n Limitations of robotic surgery\n Cost\n Robotic training in plastic surgery\n New frontiers in robotic plastic surgery\n Conclusion\n References\nDigital technology in plastic surgery\n 35\r Digital technology in plastic surgery\n Introduction\n Digital technology before the first consultation\n Information on procedures\n Choosing a surgeon\n After selection\n Digital technology during the office visit\n Medical records and practice management\n Choosing an EHR\n Certification\n Server on-site or off-site or subscription model (SaaS – Software as a Service)\n Stability in the market\n Features and functionality\n Support and implementation\n Contracting considerations\n Using the EHR\n Intake and entry of information via patient portals and onsite\n Data entry at the time of the patient consultation\n Alerts\n Document and forms management\n Integrated systems\n Upfront investment of time – know your EHR\n Photo system\n Practice management\n Billing\n Reports\n Theft prevention\n Customer relation management\n Security and safety\n Onsite patient education\n Digital educational materials\n Digital simulation\n On-site clinical information and decision-making\n Perioperative digital technology\n Preoperative workup\n Assessing photographs in preoperative planning\n Digital simulation in preoperative and intraoperative planning\n Preoperative quotes and informed consent\n Preoperative labs and studies\n Automated preoperative workflows\n Preoperative risk assessments and tools\n Preoperative modeling\n Day of operation\n Preoperative holding digital technology\n Intraoperative monitoring\n Intraoperative communication and collaboration\n Intraoperative tools for surgical decision-making\n Postoperative digital technologies\n Digital technology between patient visits (including long-term follow-up)\n Direct patient communication\n Patient monitoring with wearables and accessories\n Patient community engagement online\n Digital technology in plastic surgery education and training\n Digital technology for the advancement of plastic surgery (research and clinical outcomes and advocacy)\n References\nAesthetic improvement through noninvasive technologies\n 36\r Aesthetic improvement through noninvasive technologies\n Introduction\n Cryolipolysis\n Mechanism of action\n Efficacy\n Safety\n Magnetic resonance contouring\n Mechanism of action\n Efficacy\n Safety\n Radiofrequency energy devices (RFED)\n Mechanism of action\n Efficacy\n Safety\n Ultrasound\n Mechanism of action\n Efficacy\n Safety\n Low-level laser therapy (LLLT)\n Mechanism of action\n Efficacy\n Safety\n Discussion\n References\nEducation and teaching in plastic surgery\n 37\r Education and teaching in plastic surgery\n Introduction\n Medical education theory\n Adult learning theory\n Bloom’s taxonomy and Miller’s pyramid\n Dreyfus model\n The evolution of plastic surgery education\n The birth of a new specialty: plastic and reconstructive surgery\n Present-day training model for plastic and re-constructive surgery residents in the US\n Standardizing graduate medical education outcomes\n Milestones\n Entrustable professional activities\n Competency-based graduate medical education\n The future of plastic surgery education\n Simulation in plastic surgery\n Conclusion\n References\nGlobal plastic surgery\n 38\r Global plastic surgery\n Introduction\n The global plastic surgery landscape\n The role of the plastic surgeon in global surgery\n Burns\n Clefts and other congenital anomalies\n Trauma\n Oncologic reconstruction\n Teaching\n Advocacy\n Research\n Mentorship\n Suggested guidelines for participation in global plastic surgery\n Phase 1 – Engagement: why, where, and with whom?\n Phase 2 – Logistics: what and how?\n Phase 3 – Assessment and outcomes\n Ethical considerations\n Conclusion\n References\nGender-affirming surgery\n 39\r Gender-affirming surgery\n Introduction\n General preoperative evaluation\n Hormones\n Hair removal\n Chest and breast gender-affirming surgery\n Mastectomy\n Preoperative evaluation and decision-making\n Techniques\n Double incision mastectomy and free nipple graft (DIFNG) (Fischer grade 2a-4)\n Circumareolar/periareolar (Fischer grade 1 and 2A)\n Postoperative management and outcomes\n Breast augmentation\n Preoperative and technical considerations\n Postoperative management and outcomes\n Genital gender-affirming surgery\n Phalloplasty and metoidioplasty\n Preoperative evaluation\n Metoidioplasty\n Phalloplasty\n Flap design\n Donor sites\n Modular variations of phalloplasty types\n Single-stage vs. staged phalloplasty\n Single-stage phalloplasty\n Big Ben method\n Metoidioplasty-first\n Implants\n Complications\n Donor site management and complications\n Vaginoplasty\n Preoperative evaluation and decision-making\n Techniques\n Penile inversion vaginoplasty\n Intestinal vaginoplasty\n Postoperative management and outcomes\n Facial gender affirmation surgery\n Upper third\n Middle third\n Lower third and larynx\n Complications and outcomes\n Conclusions\n References\nConfidence is ClinicalKey\n Confidence is ClinicalKey