دانلود کتاب Plastic Surgery: Volume 4: Trunk and Lower Extremity (Plastic Surgery, 4)

فهرست مطالب :

Any screen. Any time. Anywhere.\nFront Matter\n Fifth Edition\nCopyright\nContents\nVideo Contents\n Volume One\n Volume Two\n Volume Three\n Volume Four\n Volume Five\n Volume Six\nLecture Video Contents\n Volume One\n Volume Two\n Volume Three\n Volume Four\n Volume Five\n Volume Six\nPreface to the Fifth Edition\nList of Editors\nList of Contributors\nAcknowledgments\nDedication\n1\n 1 Comprehensive lower extremity anatomy\n The gluteal region\n Gluteal skeletal structure\n Gluteal fascial anatomy\n Muscles of the buttocks\n Gluteal vasculature\n Gluteal innervation\n The thigh\n Thigh skeletal structure\n Thigh fascial composition\n Thigh musculature\n Thigh vasculature\n Profunda femoris\n Lateral circumflex femoral arterial system\n Clinical correlation – approach to LCFA as recipient vessel for free tissue transfer in the vessel depleted lower extremity\n Clinical correlation – anterolateral thigh flap\n Medial circumflex femoral arterial system\n Profunda femoris perforating branches\n Innervation of the thigh\n Motor innervation\n Cutaneous innervation\n The leg\n Knee skeletal structure\n Leg skeletal structure\n Clinical correlation – fibular flap\n Leg fascial composition\n Lower leg compartments\n Clinical correlation – compartment syndrome and leg compartment release technique\n Leg musculature\n Anterior compartment\n Lateral compartment\n Posterior compartment – superficial layer\n Posterior compartment – deep layer\n Clinical correlation – approach to leg vessels as recipients for free tissue transfer\n Posterior tibial\n Anterior tibial\n Peroneal\n Leg vasculature\n Leg nerve anatomy\n Lower leg motor innervation\n Lower leg cutaneous innervation\n The ankle and foot\n Ankle and foot skeletal structure\n Ankle\n Foot\n Ankle and foot fascial composition\n Extensor retinacula\n Flexor retinaculum\n Peroneal retinaculum\n Plantar fascia\n Fascial compartments of the foot\n Foot musculature\n Foot and ankle vasculature\n Dorsalis pedis artery\n Posterior tibial artery – medial and lateral plantar arteries\n Peroneal arterial branches\n Ankle and foot nerve anatomy\n Foot cutaneous innervation\n Foot motor innervation\n Conclusion\n REFERENCES\n2\n 2 Management of lower extremity trauma\n Introduction\n Basic science\n Inflammatory response to injury\n Diagnosis and patient presentation\n Initial assessment and management\n A: Airway and cervical spine protection\n B: Breathing\n C: Circulation and bleeding control\n D: Disability and level of consciousness\n E: Exposure and environmental control\n Secondary survey\n Extremity examination\n Vascular evaluation\n Compartment syndrome\n Grading system\n Patient selection\n Amputation versus salvage\n Degloving soft-tissue injury\n Treatment and surgical techniques\n Timing of reconstruction and negative-pressure wound therapy (NPWT) in open fracture\n Reconstructive surgery\n Skin grafting\n Local, regional, and propeller flaps\n Free flaps and perforator flaps\n Skeletal reconstruction\n Recipient vessel dissection in trauma\n Arterial anastomosis in extremity vessels\n Flaps and skin from spare parts: fillet flap and tissue harvest\n Flaps in pediatric patients\n Complications\n Amputation and limb pain\n Avascular necrosis (AVN)\n Morel–Lavallée lesion\n Summary\n References\n3-1\n 3.1 Lymphedema: introduction and editors’ perspective\n References\n3-2\n 3.2 Imaging modalities for diagnosis and treatment of lymphedema\n Introduction\n Lymphoscintigraphy\n Technique\n Diagnosis and staging\n Applications in lymphatic surgery\n Limitations\n Near-infrared fluorescent imaging\n Technique\n Diagnosis and staging\n Applications in lymphatic surgery\n Limitations\n Ultrasonography\n Technique\n Diagnosis\n Applications in LVA procedures\n Applications in free lymphatic tissue transplantation\n Limitations\n Magnetic resonance imaging\n Technique\n Diagnosis and lymphedema evaluation\n Applications in lymphatic surgery\n Limitations\n Further imaging modalities\n Computed tomography angiography\n Bioimpedance spectroscopy\n Laser tomography\n Photoacoustic imaging\n Imaging modality selection algorithm\n Diagnosis\n Treatment plan\n Imaging modalities for LVA procedures\n Imaging modalities for free lymphatic tissue transfer\n Conclusion\n REFERENCES\n3-3\n 3.3 Lymphaticovenular bypass\n Introduction\n Background\n Clinical approach\n Diagnostic evaluation\n Diagnosis on clinical grounds is inadequate\n History and physical examination\n Confirmatory studies\n Staging\n Patient selection\n Surgical technique (Video 3.3.1)\n Incision placement\n Dissection\n Anastomosis\n Postoperative care\n Lymphaticovenular bypass for subclinical lymphedema\n Conclusion\n References\n3-4\n 3.4 Vascularized lymph node transplant\n History of VLNT\n Mechanism of VLNT\n Indications for VLNT\n Types of VLNT\n Inguinal/­Groin\n Surgical anatomy and technique\n Supraclavicular\n Surgical anatomy and technique (Video 3.4.1 )\n Lateral thoracic\n Surgical anatomy and technique\n Submental\n Surgical anatomy and technique (Fig. 3.4.7)\n Intra-­abdominal donor sites\n Surgical anatomy and technique\n Outcomes\n Complications\n Summary\n References\n3-5\n 3.5 Debulking strategies and procedures: liposuction of leg lymphedema\n Introduction\n Excess subcutaneous adiposity and chronic lymphedema\n Other research regarding adipose tissue deposition\n How to assess the efficacy of liposuction\n Preoperative planning\n Operative technique\n Postoperative care\n Controlled compression therapy\n Volume measurements\n How CCT and liposuction works in clinical practice –­ an example\n Controlled compression therapy (CCT)\n Liposuction and postoperative success\n Complications\n The lymphedema team\n How liposuction helps\n Lymph transport system and liposuction\n When to use liposuction to treat lymphedema –­ patient selection\n When liposuction should never be used\n Can the outcome be reproduced?\n References\n3-6\n 3.6 Debulking strategies and procedures: excision\n Chen-­modified Charles procedure\n Anatomy\n Patient selection (Algorithms 3.6.1–­3.6.3)\n Preparation before surgery (Fig. 3.6.1)\n Surgical techniques for modified Charles procedure (Fig. 3.6.1)\n Transfer of lymph node flap with Chen-­modified Charles procedure (Video 3.6.1 )\n Postoperative care\n Outcomes of modified Charles procedure\n Radical reduction with preservation of perforators (RPP procedure)18,19\n Patient selection\n Surgical techniques for RPP procedure\n Outcomes of RPP procedure\n Excisional therapy for genital lymphedema20–­23\n Follow-­up\n Surgical limitations\n Other options if debulking procedure fails\n Summary\n References\n4\n 4 Lower extremity sarcoma reconstruction\n Introduction\n Soft-­tissue and bone sarcomas\n Sarcomas in the lower extremity\n Basic science/­disease process\n Epidemiology soft-­tissue sarcomas\n Bone sarcomas\n Tumor growth and metastasizing\n Historical perspectives\n Diagnosis/­patient presentation/­imaging\n Patient profile/­general considerations/­treatment planning\n Patient profile\n General considerations\n Treatment planning (Algorithm 4.1)\n Surgery\n Radiotherapy\n Chemotherapy\n Treatment/­surgical resection techniques\n Biopsy techniques\n Fine-­needle or core-­needle aspirations\n Excisional biopsy\n Incisional biopsy\n Re-­operative biopsies and surgical revisions\n Surgical technique for definitive resection\n Soft tissue sarcomas (STS)\n Vascular involvement\n Nerve involvement\n Osseous involvement\n Primary osseous sarcomas\n Specimen handling\n Wound closure\n Lymph node dissection\n Indications for amputation\n Reconstructive options for lower extremity preservation\n Soft tissue\n Neuromuscular unit\n Skeletal reconstruction\n Vascular surgery\n Complex approaches\n Postoperative care\n Immediate postoperative care\n Oncologic postoperative care and follow-­up\n Secondary procedures\n Early secondary procedures –­ soft tissue\n Early secondary procedures –­ skeleton\n Late secondary procedures\n Outcomes, prognosis, and complications\n Outcomes and prognosis\n Soft tissue sarcomas\n Bone sarcomas\n Complications –­ management of recurrent disease\n References\n5\n 5 Reconstructive surgery: lower extremity coverage\n Introduction\n History\n Principles\n The value of autologous tissue\n The reconstructive elevator\n Skin grafts and substitutes\n Approach by location (local flaps)\n Thigh\n Lower leg\n Microvascular free tissue transfer\n Treatment approach\n Preoperative evaluation\n Primary limb amputation\n Debridement\n Timing of reconstruction\n Selection of recipient vessel and microanastomosis\n Special considerations\n Osteomyelitis\n Diabetes\n Coverage after tumor ablation\n Exposed prosthesis\n Soft-­tissue expansion\n Postoperative care\n Monitoring\n Management of flap complications\n Secondary operations\n Muscle/­musculocutaneous flaps\n Tensor fascia lata\n Rectus femoris\n Biceps femoris\n Gracilis\n Soleus\n Gastrocnemius\n Fasciocutaneous/­perforator flap\n Propeller flaps\n Groin/­SCIP (superficial circumflex iliac perforator)\n Medial thigh/­anteromedial perforator and gracilis perforator\n Lateral thigh/­profunda femoris perforator flap\n Anterolateral thigh perforator\n Sural\n TAP (thoracodorsal artery perforator)\n Compound flaps\n Supermicrosurgery\n References\n6-1\n 6.1 Diagnosis, treatment, and prevention of lower extremity pain\n Introduction\n Etiology of lower extremity pain\n Overview\n Symptomatic neuroma\n Symptomatic stump neuroma\n Phantom limb pain\n Complex regional pain syndrome\n Diagnosis and patient selection\n Clinical history\n Physical exam\n Diagnostics\n Surgical candidates and preoperative counseling\n Treatment options for lower extremity pain\n Overview\n Neuroma excision\n Targeted muscle reinnervation\n Regenerative peripheral nerve interface\n General principles for amputations\n Postoperative management\n Prevention of lower extremity pain\n Overview\n Primary physiologic nerve stabilization at time of amputation\n Alternative treatment measures\n Physical therapy\n Nerve stimulators\n Peripheral nerve ablation\n Amputation\n Conclusion\n References\n6-2\n 6.2 Targeted muscle reinnervation in the lower extremity\n Introduction\n Physiology of targeted muscle reinnervation\n Indications for targeted muscle reinnervation in the lower extremity\n General concepts and principles\n Expendable motor target\n Anatomic feasibility of transfer\n Axonal capture\n Nerve transposition with proximal transfer\n Maintain proximal nerve function\n Evaluate proximal compression points\n Targeted muscle reinnervation in primary amputations\n Overview\n Perioperative evaluation and multidisciplinary care\n Operative technique in below-knee amputations\n Operative technique in knee disarticulations\n Operative technique in above-knee amputations\n Outcomes\n Targeted muscle reinnervation in secondary amputations\n Overview\n Operative technique for superficial peroneal nerve\n Operative technique for tibial nerve\n Operative technique for saphenous nerve\n Operative technique for sural nerve\n Operative technique for deep peroneal nerve\n Operative technique for sciatic nerve\n Operative technique for posterior femoral cutaneous nerve\n Outcomes\n Targeted muscle reinnervation in very proximal lower extremity amputations\n Targeted muscle reinnervation in minor amputations of the foot\n Targeted muscle reinnervation for symptomatic neuromas in non-amputees\n Overview\n Operative technique for superficial peroneal nerve\n Operative technique for deep peroneal nerve\n Operative technique for saphenous nerve\n Operative technique for sural nerve\n Operative technique for tibial nerve\n Operative technique for femoral cutaneous nerves\n Outcomes\n Future directions\n Conclusions\n References\n6-3\n 6.3 Lower extremity pain: regenerative peripheral nerve interfaces\n Introduction\n Pathophysiology of neuropathic lower extremity pain from symptomatic neuromas\n Wallerian degeneration and symptomatic neuroma formation\n Central sensitization\n Presentation and diagnosis of neuropathic lower extremity pain from symptomatic neuromas\n Treatment of lower extremity pain from symptomatic neuromas\n Regenerative peripheral nerve interface\n In vivo testing of RPNIs\n Clinical outcomes using RPNIs\n Technique to perform RPNI surgery\n Preoperative considerations\n Surgical technique and operative pearls\n Postoperative care\n Future directions\n Conclusion\n Disclosure statement\n References\n7\n 7 Skeletal reconstruction\n Introduction\n Biology of bone healing and grafting\n Historical perspective\n Methods of skeletal reconstruction\n Bone graft\n Healing process\n Surgical indication\n Masquelet technique\n Donor sites\n Bone pedicled and free flaps\n Fibular flap\n Iliac crest flap\n Medial femoral condyle flap\n Other bone flaps\n Vascularized epiphyseal reconstruction\n Allograft\n Capanna technique\n Distraction osteogenesis\n Patient evaluation\n Reconstruction by anatomic areas\n Pelvis\n Femur\n Double-barrel fibular flap\n Fibular flap plus allograft\n Tibia\n Fibular flap\n Fibular flap plus allograft\n Foot\n Iliac crest flap\n Medial femoral condyle flap\n Postoperative care\n Postoperative monitoring\n Postoperative aesthetic considerations\n Conclusion\n References\n8\n 8 Foot reconstruction\n Introduction\n Angiosomes of the foot\n Clinical relevance of the angiosome model\n Patient evaluation and diagnosis\n Clinical history\n Limb function\n Wound assessment\n Vascular work-up\n Sensorimotor examination\n Gait analysis and skeletal stability\n Management\n Compartment syndrome\n Wound infection and directed antibiotic therapy\n Biofilm\n Acute vs. chronic wounds\n Surgical preparation of the wound bed\n Wound healing adjuncts\n External fixation\n Surgical techniques for soft-tissue reconstruction\n Options for wound closure\n Reconstruction by anatomic location\n Anterior ankle and dorsal foot\n Extensor digitorum brevis muscle flap\n Lateral supramalleolar flap\n Free tissue transfer\n Plantar forefoot\n Local fasciocutaneous flaps\n Fillet of toe flap\n Free tissue transfer\n Forefoot amputations\n Plantar midfoot\n Local fasciocutaneous flaps\n Local muscle flaps\n Free tissue transfer\n Midfoot amputations\n Plantar hindfoot and medial/lateral ankle\n Intrinsic muscle flaps\n Abductor hallucis brevis muscle flap\n Flexor digitorum brevis muscle flap\n Abductor digiti minimi muscle flap\n Medial plantar artery flap\n Posterior heel pad flaps\n Lateral calcaneal flap\n Sural artery flap\n Free tissue transfer\n Hindfoot amputations\n Achilles/malleolar region\n Local fasciocutaneous and pedicled flaps\n Free tissue transfer\n Below-knee amputation\n Below-knee amputation technique\n Postoperative care\n Outcomes\n Summary\n References\n9-1\n 9.1 Diabetic foot: introduction\n Introduction\n Scope and trends\n Mortality\n Costs\n Risk factors for diabetic foot wounds\n Neuropathy\n Ischemia\n Deformity\n Patient-centered outcomes\n Multidisciplinary team and beyond\n IWGDF practical guidelines\n Conclusion\n REFERENCES\n9-2\n 9.2 Diabetic foot: management of wounds and considerations in biomechanics and amputations\n Principles of wound healing\n General\n Wound bed management\n Eradication of infection\n Debridement\n Topical products and dressings\n Skin substitute grafts\n Negative pressure wound therapy\n Hyperbaric oxygen therapy\n Optimization of tissue healing potential\n Biomechanical considerations\n General\n Normal gait\n Pathologic gait\n Deformity and balance\n Accommodative treatment modalities\n Total contact casts\n Removable walking casts\n Miscellaneous offloading strategies\n External fixation\n Corrective treatment modalities\n Soft-tissue correction\n Osseous correction\n Examples of corrective treatment modalities\n Increased ankle plantarflexion (equinus)\n Tendo-Achilles lengthening (TAL)\n Gastrocnemius recession (GR) and gastrocnemius–soleus recession (GSR)\n Increased ankle dorsiflexion (calcaneus)\n Increased (flexible) foot varus\n Anterior tibial tendon transfer\n Posterior tibial tendon transfer\n Increased (rigid and/or severe) foot varus/valgus\n Partial foot amputations\n General\n Tissue handling\n Toe amputation\n Partial ray amputation\n Transmetatarsal amputation\n Lisfranc amputation\n Chopart amputation\n Partial calcanectomy amputation\n Conclusion\n References\n9-3\n 9.3 Diabetic foot: management of vascularity and considerations in soft-tissue reconstruction\n Introduction\n Reconstructive options\n Reconstructive ladder and elevator\n Superficial wounds and skin grafts\n Local flaps\n Free tissue transfer\n Flap composition\n Functional and aesthetic considerations\n Donor site morbidity\n Free tissue transfer in the patient with diffuse vascular calcifications\n Surgical planning\n Vascular considerations\n Angiosomes\n Preoperative evaluation and optimization for free flap reconstruction\n Infection control and wound bed preparation\n Vascular\n Thrombophilia assessment\n Medical optimization\n Biomechanical examination\n Cases\n References\n10\n 10 Trunk anatomy\n Surface anatomy and skin considerations (Fig. 10.1)\n Skin perfusion and angiosome concept (Fig. 10.2)\n Anterior chest\n Axilla\n Back\n Abdomen and flank\n Groin\n Perineum\n Buttock\n Bones\n References\n11\n 11 Reconstruction of the chest\n Introduction\n Etiology\n Infected sternotomy wounds and mediastinitis\n Ventricular assist device infections\n Cardiac implantable electronic device infections\n Empyema and bronchopleural fistula\n Chest wall tumors\n Osteoradionecrosis\n Traumatic chest wall wounds\n Chest wall biomechanics and pathophysiology\n Respiration\n Sternal continuity\n Flail chest\n Sternal–rib stability\n Evaluation of the defect and functional goals\n Medical optimization and preparation of the wound bed\n Skeletal reconstruction\n Sternal fixation\n Management of sternal defects\n Rib fixation\n Management of rib defects\n Soft-tissue reconstruction\n Pectoralis major\n Rectus abdominis\n Latissimus dorsi\n Serratus anterior\n External oblique\n Omentum\n Free tissue transfer\n Postoperative care\n Congenital chest wall deformities\n Pectus excavatum\n Pectus carinatum\n Poland syndrome\n Anterior thoracic hypoplasia\n Sternal cleft\n Conclusion\n References\n12\n 12 Reconstruction of the posterior trunk\n Introduction\n Anatomy\n Posterior trunk perforators\n Principles of perforasome theory\n Principle 1\n Principle 2\n Principle 3\n Principle 4\n Flaps for reconstruction of the posterior trunk\n Trapezius\n Scapular and parascapular\n Latissimus dorsi\n Paraspinous muscle\n Intercostal artery perforator\n Lumbar artery perforator\n Gluteus maximus\n Multi-perforator\n Other flaps\n Pull-through VRAM\n Omental flap\n External oblique flap\n Special clinical scenarios\n Spinal surgery, pseudomeningocele, and cerebrospinal fluid leaks\n Congenital malformations\n Perioperative care\n Preoperative assessment and planning\n Operative approach and action\n Postoperative care and follow-through\n Techniques for soft-tissue reconstruction in the posterior trunk\n Adjacent tissue transfer/pedicled perforator flaps\n Free tissue transfer\n Algorithmic approach to reconstruction of the posterior trunk\n Midline wounds\n Non-midline wounds\n Non-midline cervical wounds\n Non-midline upper thoracic wounds\n Non-midline middle thoracic wounds\n Non-midline lumbar wounds\n Conclusion\n References\n13\n 13 Abdominal wall reconstruction\n Introduction\n Abdominal wall anatomy and physiology\n Blood supply to the abdominal skin and musculature\n Nerve supply and innervation of the muscles\n Abdominal wall muscle function\n Tissue apposition\n Midline laparotomy closure\n Tissue interaction with sutures\n Optimal midline closure technique\n Midline hernia repair\n Umbilical and epigastric hernia repair\n Midline incisional hernia repair\n The need for mesh\n Mesh types\n Mesh coatings, mesh placement, and fibrovascular ingrowth\n Optimal hernia closure with mesh (Algorithm 13.1)\n Surgical technique for clean open midline incisional hernia repair\n Surgical technique for clean midline incisional hernia repair under tension\n Surgical technique for clean-­contaminated, contaminated, and dirty midline hernias\n Flank hernias\n Abdominal wall soft-­tissue management (Algorithm 13.2)\n Conclusion\n References\n14-1\n 14.1 Gender confirmation surgery: diagnosis and management\n Epidemiology\n Change in coverage over time – Affordable Care Act\n WPATH\n Expanded societal support/paradigm shift\n Terminology\n WPATH Standards of Care\n Mental health practitioners\n Adolescent therapy\n Hormone therapy\n Multidisciplinary treatment\n Patient satisfaction following gender confirmation surgery\n Barriers to patient care\n Preoperative assessment\n Goals of therapy\n Congruent genitalia\n Surgical goals\n Vaginoplasty\n Chest surgery\n Phalloplasty/metoidioplasty\n Arrangements for aftercare\n Conclusion\n REFERENCES\n14-2\n 14.2 Gender confirmation surgery, male to female: vaginoplasty\n Preoperative assessment\n Penile inversion vaginoplasty\n Patient positioning and preparation\n Harvest of skin flaps and grafts\n Penile disassembly and inversion\n Dissection of vaginal cavity\n Creation of neoclitoris\n Inset of grafts/flaps and closure\n Intestinal vaginoplasty\n Peritoneal flaps\n Complications\n Postoperative care\n Role of the pelvic floor physical therapist\n Benefits of postoperative vaginal dilation\n Conclusion\n References\n14-3\n 14.3 Gender affirmation surgery, female to male: phalloplasty and correction of male genital defects\n Patient selection\n Mental health\n Hormone replacement therapy\n Preoperative evaluation\n Phalloplasty\n Perineal masculinization – reconstruction of the pars fixa urethra, vaginectomy, and scrotoplasty\n Radial forearm phalloplasty\n Preoperative considerations\n Surgical markings\n Surgical technique\n Flap harvest\n Tubing\n Glansplasty\n Groin preparation\n Forearm donor site closure\n Pars fixa and pendulans anastomosis: radial forearm free flap (RFFF)\n ALT phalloplasty\n Preoperative considerations\n Surgical markings\n Surgical technique\n Flap harvest\n Tubing\n Glansplasty\n Groin preparation and flap transfer\n Donor site closure\n Urethral anastomosis and closure: ALT\n Postoperative care\n Secondary procedures\n Glansplasty and coronaplasty\n Debulking\n Urethral tube formation\n Phallopexy\n Erectile implant placement\n Fat grafting\n Tattooing\n Complications of phalloplasty\n Meatal stenosis\n Urethral strictures\n Urethrocutaneous fistula\n Urethral hair or residual suture\n Metoidioplasty\n Surgical technique\n Secondary procedures\n Complications of metoidioplasty\n Considerations in other genital defects\n Genital flaps\n Genital replantation\n References\n14-4\n 14.4 Breast, chest wall, and facial considerations in gender affirmation\n Introduction\n WPATH guidelines\n Chest masculinization\n Preoperative considerations\n Technique selection\n Periareolar technique\n Circumareolar or extended circumareolar techniques\n Double incision with free nipple grafts\n Inferior pedicle technique\n Postoperative considerations and complications\n Breast augmentation\n Preoperative considerations\n Operative principles\n Facial feminization surgery\n Anatomy\n Preoperative planning\n Hairline, forehead, and brow\n Midface\n Rhinoplasty\n Lips\n Chin and mandible\n Laryngeal prominence\n Adjunct cosmetic procedures\n Conclusions\n References\n15\n 15 Reconstruction of acquired vaginal defects\n Introduction\n Historical perspective\n Anatomic considerations\n Diagnosis\n Patient selection/preoperative considerations\n Treatment/surgical technique\n Additional surgical considerations\n Postoperative care\n Immediate perioperative period\n Long-term care\n Complications, prognosis, and outcomes\n Complications\n Prognosis and outcomes\n References\n16\n 16 Pressure sores\n Introduction\n Terminology\n Epidemiology and cost\n Anatomic distribution\n Historical perspective\n Basic science\n Pressure\n Shear and friction\n Moisture\n Malnutrition\n Neurological injury\n Biofilm and inflammatory milieu\n Diagnosis\n Staging (Table 16.1, Fig. 16.4)\n Patient evaluation\n Osteomyelitis\n Psychological evaluation\n Patient selection\n Treatment\n Prevention\n Risk assessment\n Skin care\n Incontinence\n Spasticity\n Pressure relief\n Nutrition\n Medical management\n Pressure relief\n Spasticity\n Malnutrition\n Tobacco and electronic cigarette use\n Infection\n Wound care (Table 16.3)\n Negative-pressure wound therapy\n Glucose control\n Manipulating the local wound milieu\n Surgical management\n Setting expectations\n Surgical guidelines\n Debridement\n Procedure selection\n Muscle and myocutaneous flaps\n Fasciocutaneous and perforator flaps\n Free flaps\n Tissue expansion\n Reconstruction by anatomic site\n Sacral pressure ulcer\n Selected technique: gluteal myocutaneous rotation flap (Fig. 16.13, Box 16.2)\n Ischial pressure ulcer\n Selected flap: V–Y hamstring advancement (Fig. 16.14)\n Trochanteric pressure ulcer\n Selected procedure: V–Y tensor fasciae latae flap tensor fasciae latae rotation flap\n Hip joint infection\n Heel pressure ulcer\n Bone resection\n Postoperative care\n Outcomes, prognosis, and complications\n Complications\n Secondary procedures\n References\n17\n 17 Perineal reconstruction\n Introduction\n History of perineal reconstruction\n Basic science/disease process\n Diagnosis/patient presentation\n Patient selection\n Treatment/surgical technique\n Skin graft reconstruction\n Regional skin flaps\n Rectus-based reconstruction\n Gracilis flap\n Anterolateral thigh flap\n Singapore flap\n Posterior thigh flap\n Perforator flaps\n Free flap\n Minimally invasive flap harvest\n Special considerations – sphincter reconstruction\n Postoperative care\n Outcomes, prognosis, complications\n References\n18\n 18 Burn, chemical, and electrical injuries\n SYNOPSIS\n Epidemiology\n Risk factors\n Evolution of burn medicine\n Pathophysiology of burn injuries\n Thermal (high temperature) burns\n Flash and flame burns\n Scald burns\n Hot object “contact burns”\n Tar and asphalt burns\n Electrical injury\n Radiation Injuries\n Frostbite\n Burn injury in children\n Chemical injuries and burns\n Acid burns\n Hydrochloric and sulfuric acids\n Nitric acid\n Chromic acid\n Hydrofluoric acid\n Alkali burns\n Sodium hypochlorite\n Cement (calcium hydroxide)\n Physiological consequences of thermal skin burns\n Zones of burn tissue injury\n Local injury progression\n Systemic injury progression\n Acute burn trauma management\n Initial evaluation and treatment in the field\n Initial hospital management\n Initial burn wound diagnosis and management\n Epidermal (superficial) burn wounds\n Superficial partial-thickness burn wounds\n Deep partial-thickness burn wounds\n Full-thickness burn wounds\n Facial burn considerations\n Quantifying the fractional area of the burn wounds\n Inhalation injury\n Carbon monoxide intoxication\n Cyanide intoxication\n Airway management\n Fluid resuscitation\n Resuscitation fluid composition and administration\n Vital organ function monitoring\n Management of the burn wound\n Wound dressings\n Topical antimicrobials\n Physiological wound dressings\n Biological wound dressings or grafts\n Operative wound closure\n Management of tar burns\n Treatment of electrical injuries\n Treatment of radiation injury\n Treatment of chemical injuries\n Effect of burn trauma on metabolism30–32\n Nutritional management\n Nutrition formulae\n Pain control\n Complications\n Skin graft loss\n Invasive wound infection\n Adrenal insufficiency\n Circumferential limb compression with vascular compromise\n Compartment syndromes\n Deep venous thrombosis\n Systemic inflammatory response syndrome\n Sepsis\n Rehabilitation\n Managing scar hypertrophy and contracture\n References\n19\n 19 Extremity burn reconstruction\n Introduction\n Burns of the upper extremity\n Edema\n Infection\n Operative wound management of acute burns of the extremities\n Tangential excision\n Fascial excision\n Salvage surgery in acute fourth degree burns\n Correction of post-burn deformities of the hand\n Management of individual deformities\n Dorsal hand contractures\n Volar hand and digital contractures\n First web contracture\n Deformities of the thumb\n Swan neck deformities\n Boutonnière deformity\n The burns syndactyly\n The burnt little finger\n Management of digital losses\n Management of heterotopic ossification in burns\n Electrical burns to the upper limb\n Reconstructive surgery for low voltage electrical injuries\n Reconstructive surgery in high voltage electrical burns\n Surgery in the acute phase\n Provision of soft-tissue cover\n Timing of soft-tissue cover\n Type of soft-tissue cover\n Reconstruction of nerves and tendons\n Axillary contracture\n Elbow contracture\n Skin substitutes\n Marjolin ulcer\n Therapy considerations\n Pressure garments\n Silicone\n Emollients\n Scar massage\n Intralesional injections\n Lasers\n Reconstruction of lower extremity burns\n Surgery in the acute phase\n Surgery for wound healing and prevention of contractures\n Treatment of lower limb contractures\n References\n20\n 20 Management of the burned face and neck\n Introduction\n Anatomy and pathophysiology\n Acute facial burn management\n General principles\n Emergency care\n Burn wound dressing\n Surgical management of the facial burn wound – early excision\n Salient principles in early excision of facial burns\n Procedure of facial wound excision\n Post-excision options\n Allograft and split skin use\n Skin grafting – salient points\n Other options for post-excision cover\n Acellular dermis\n Xenograft\n Matriderm and Integra\n Cultured epithelial autograft\n Challenges of specific parts of the face\n Periocular burns\n Nose and ears\n Lips\n Scalp\n Neck burns\n Surgical management of the facial burn wound – delayed surgery\n Aftercare and early scar management\n Ancillary measures\n Psychosocial rehabilitation\n Management of facial post-burn deformities\n Presentation to the surgeon\n The consultation\n Planning\n Photography during planning\n General principles of post-burn facial reconstruction\n Timing of surgery\n Reconstructive options\n Skin grafts\n Flaps\n Z-plasty\n Tissue expansion and flap advancement\n Melanin transfer for hypopigmentation\n Serial excision\n Hair transplantation\n Fat grafting beneath scars\n Tattooing\n Lasers\n Management of keloids\n Reconstruction of specific areas\n Scalp\n Forehead\n Eyebrows\n Ears\n Eyelids/periorbital region\n Principles for eyelid contracture release\n Surgical technique of ectropion release\n Upper lid release (Video 20.2)\n Lower lid release\n Calculation of graft requirement (Video 20.2 )\n Postoperative care\n Partial or complete loss of the eyelids\n Nose\n Altered surface texture or discoloration\n Elevated nasal tip and alar margins\n Scarred and shortened columella\n Full-thickness loss of parts of the nose\n Cover\n Lining\n Skeletal support\n Nostril stenosis or complete block\n Cheeks\n Healing by secondary intention\n Primary closure and serial excision\n Skin grafts\n Tissue expansion\n Flap cover\n Lips and perioral region\n Minor hypertrophic scarring of the upper lip\n Scarring with/without shortening of the upper lip\n Lower lip ectropion with or without mandible deformities\n Microstomia\n Macrostomia\n Perioral scar bands\n Pseudomicrogenia\n Splints\n Neck\n Airway problems\n Technical pointers for a release of severe neck contracture\n Multi-part involvement of face\n Acid burns\n Future directions\n Stem cells\n Cell spray devices\n 3D printing\n Face transplantation\n Conclusion\n References\n21\n 21 Pediatric burns\n Introduction\n Basic science\n Epidemiology\n Risk factors\n Pathophysiology\n Prevention\n Initial assessment\n Primary survey\n Secondary survey\n Wound assessment\n Initiating fluid resuscitation\n Procedures\n Triage and disposition\n Minor burns\n Child abuse and neglect\n Wound management\n Wound care\n Surgical care\n Medical management\n Analgesia and sedation\n Inhalation injury\n Nutrition and metabolism\n Sepsis\n Rehabilitation\n Physical and occupation therapy\n Scar management\n Pruritus\n Reconstruction\n General principles\n Traditional burn reconstruction\n Laser\n References\nConfidence is ClinicalKey