Textbook of Plastic and Reconstructive Surgery: Basic Principles and New Perspectives

Foreword 1
Foreword 2
Preface
Contents
List of Videos
Part I: Principles in Plastic Surgery
1: Anatomy and Physiology of the Skin
1.1 Introduction
1.2 Epidermis
1.2.1 Keratinocytes
1.2.2 Melanocytes
1.2.3 Langerhans Cells
1.2.4 Merkel Cells
1.3 Dermoepidermal Junction
1.4 Adnexa
1.4.1 Eccrine Sweat Units
1.4.2 Apocrine Units
1.4.3 Hair Follicles
1.4.4 Sebaceous Glands
1.4.5 Nails
1.5 Dermis
1.5.1 Vasculature
1.5.2 Muscles
1.5.3 Nerves
1.5.4 Mast Cells
1.6 Subcutaneous Tissue
1.7 Functions of the Skin
References
2: Wound Healing: Physiology and Pathology
2.1 Introduction
2.2 Types of Wound Healing
2.3 Phases of Wound Healing
2.3.1 Hemostasis
2.3.2 Inflammation
2.3.3 Proliferation
2.3.4 Remodeling
2.4 Factors Influencing Wound Healing
2.4.1 Systemic Factors
2.4.2 Local Factors
2.5 Pathological Wound Healing
2.5.1 Insufficient Scarring
2.5.2 Exuberant Scarring
2.5.2.1 Predisposing Factors to the Formation of Hypertrophic Scars
2.6 Scar Classification [13]
2.7 Exuberant Scar Treatment
References
3: Complicated Wounds
3.1 Introduction
3.2 Ulcers
3.2.1 Classification
3.2.2 Diagnosis
3.3 The Diabetic Foot Etiology
3.3.1 Diagnosis
3.3.2 Possible Complications of Complicated Wounds
3.3.3 Treatment of Complicated Wounds [8–14]
3.4 Osteomyelitis [15–22]
References
4: Suture Techniques
4.1 Introduction
4.2 General Principles
4.2.1 Handwashing and Patient Preparation
4.2.2 Surgical Instruments
4.2.3 Tissue Handling
4.2.4 Incision Placement and Planning
4.3 Closure Materials
4.3.1 Sutures
4.3.2 Needles
4.3.3 Alternative to Suturing
4.4 Basic Suture Techniques
4.4.1 Simple Interrupted Suture
4.4.2 Simple Running Suture
4.4.3 Vertical Mattress Suture
4.4.4 Horizontal Mattress Suture
4.4.5 Intradermal Suture
4.4.6 Deep Closure
4.5 Postoperative Dressing
References
Further Reading
5: Dressings and Dermal Substitutes
5.1 Introduction
5.2 Standard Dressings
5.3 Hydrogel
5.4 Hydrocolloids and Hydrofibers
5.5 Sodium Alginate
5.5.1 Foams
5.6 Film Dressings
5.7 Advanced Dressings and Wound Types
5.7.1 Tie-Over Dressings
5.8 Dermal Substitutes
References
6: Grafts in Plastic Surgery
6.1 Introduction
6.2 Graft Classification
6.3 Physiology of Revascularization
6.3.1 Phase 1: Imbibition
6.3.2 Phase 2: Revascularization
6.3.3 Phase 3: Maturation
6.4 Complications in the Grafting Process
6.5 Skin Graft
6.5.1 Adnexa Grafts
6.6 Dermal Graft
6.7 Fat Graft
6.7.1 Bone Graft
6.8 Cartilage Graft
6.9 Vascular Graft
6.10 Nerve Graft
6.11 Fascial and Tendon Graft
6.12 Tissue Engineering
References
Further Reading
7: History of Reconstructive Microsurgery: From Myth to Reality
7.1 Introduction
7.2 History on Free Flap Transfers in Japan
7.3 Introducing Perforator Flap and Fighting Against Traditional Microsurgery by the Authority
7.4 History on Nerve Flap
7.5 Surgery for Lymphedema
7.6 Nano-Microsurgery
References
8: Evolution of Soft Tissue Flaps Over Time
8.1 Introduction
References
9: Flaps in Plastic Surgery
9.1 Introduction
9.2 Definition
9.3 Classification of Flaps
9.4 Indication
9.5 Principle of Flap Surgery
9.5.1 The Reconstructive Elevator
9.5.2 The Guide for Reconstruction Using Flaps
9.6 Clinical Cases
References
10: Microsurgical Procedures in Plastic Surgery
10.1 Tools
10.1.1 Magnification System
10.1.2 Microsurgical Instruments
10.1.3 Sutures
10.2 Lifestyle and Ergonomics
10.3 Categories of Microsurgery
10.3.1 Microneural
10.3.2 Microvascular
10.4 Pictures of Microvascular Anastomosis
10.4.1 Microlymphatic
10.4.2 Microtubular Surgery
10.5 Replantation and Tissue Transplantation
10.6 Multidisciplinary Applications
10.6.1 Orthopedics
10.6.2 Neurosurgery
10.6.3 Head and Neck Surgery
10.6.4 Ophthalmology
10.6.5 General Surgery
10.6.6 Gynecology/Urology
10.7 Current and Future Perspectives
References
11: An Algorithm for Approaching Soft Tissue Coverage in the Twenty-First Century
11.1 Introduction
References
Part ll: Plastic Surgery Approaches to Malformation
12: Craniofacial Malformations
12.1 Introduction
12.2 Craniofacial Clefts
12.3 Cleft Lip and Palate
12.4 Craniosynostosis
12.5 Craniofacial Syndromes
12.5.1 Syndromic Craniosynostosis
12.5.2 Facial Syndromes
12.5.3 Craniofacial Microsomia
12.5.4 Frontonasal Malformations
12.6 Microtia
12.7 Micrognathia
12.8 Craniofacial Malformation Surgery
12.9 Cleft Lip and Palate Treatment
12.10 Surgical Management of Craniosynostosis
12.11 Management of Craniofacial Syndromes
12.12 Ear Reconstruction
12.13 Glossectomy for Macroglossia
References
Further Reading
13: Malformations of the Hand
13.1 Introduction
13.2 Principles Governing Pediatric Management
13.2.1 Reconstruction of Congenital Differences of the Hand
13.2.1.1 Timing of Treatment
13.3 Epidemiology
13.4 Embryology of Limb Development
13.5 Classification
13.5.1 Failure of Formation of Parts: Transverse Arrest
13.5.1.1 Transverse Deficiencies
13.5.2 Proximal Transverse Deficiencies
13.5.3 Transverse Arrest of the Digits Distal to the Metacarpal Level
13.5.4 Failure of Formation of Parts: Longitudinal Arrest
13.5.4.1 Radial Longitudinal Deficiency
13.5.4.2 Ulnar Longitudinal Deficiency
13.5.4.3 Central Ray Deficiency
13.5.5 Undergrowth
13.5.5.1 Hypoplastic Thumb
13.5.6 Failure of Separation of Parts
13.5.6.1 Syndactyly
13.5.6.2 Radioulnar Synostosis
13.5.6.3 Symphalangism
13.5.6.4 Duplication (Polydactyly)
13.5.7 Overgrowth
13.5.7.1 Macrodactyly
13.5.8 Congenital Constriction Ring Syndrome
13.5.8.1 Constriction Rings
13.5.9 Flexion Deformities
13.5.9.1 Camptodactyly
13.5.9.2 Congenital Clasped Thumb
13.5.9.3 Arthrogryposis
13.5.10 Pediatric Trigger Finger
13.6 Trigger Thumb
13.7 Trigger Finger
13.7.1 Physiotherapy
13.7.2 Psychological Aspects
13.8 Conclusions
References
14: Malformations of the External Genitalia
14.1 Introduction
14.2 Embryology
14.2.1 External Genitalia
14.2.2 Indifferent Stage
14.2.3 Different Stage
14.2.3.1 External Genitalia in Male
14.2.3.2 External Genitalia in the Female
14.3 Risk Factors
14.4 Main Malformations
14.4.1 Hypospadias
14.4.2 Etiology
14.5 Clinical Evaluation
14.6 Classification
14.7 Treatment
14.8 Sliding and Advancement
14.9 Mathieu Urethroplasty
14.10 Standoli Preputial Island Flap
14.11 Snodgrass One-Stage Repair
14.12 Braka Two-Stage Repair
14.13 Outcomes
References
Part lll: Plastic Surgery for Trauma
15: Wounds
15.1 Introduction
15.2 Mechanism, Etiology, and Classification
15.2.1 Bite, Sting, and Puncture Wounds
15.2.1.1 Mammalian Bites
15.2.1.2 Snakebites
15.2.1.3 Spider Bites
15.2.1.4 Bee and Wasp Stings
15.3 Clinical Evaluation
15.3.1 History
15.3.2 Wound Evaluation
15.3.3 Laboratory Studies
15.3.4 Imaging
15.3.5 Diagnostic Tests
15.4 Treatment
15.4.1 Wound Debridement and Preparation
15.4.2 Wound Closure
15.4.2.1 Secondary Intention
15.4.2.2 Primary Closure
15.4.2.3 Skin Grafting and Local Flaps
15.4.2.4 Free Tissue Transfer
15.4.3 Wound Dressing
References
16: Upper Limb Trauma
16.1 Generalities
16.1.1 Introduction
16.1.2 Essential Surgical Anatomy
16.1.3 Aetiology, Classification and Principles of Treatment
16.2 Upper Limb Trauma
16.2.1 Bone
16.2.2 Tendons
16.2.3 Nerves
16.2.4 Skin
16.2.5 Mangled Upper Limb and Amputations
References
17: Lower Limb Trauma
17.1 Introduction
17.2 History
17.3 Surgical Anatomy
17.3.1 Bones
17.3.2 Fascial Compartments and Lower Leg Muscles
17.3.3 Arteries
17.3.4 Nerves
17.4 Aetiology
17.5 Classification
17.6 Orthoplastic Concept and Lower Limb Trauma Score
17.7 Treatment
17.8 Clinical Cases (Figs. 17.8, 17.9, 17.10, and 17.11)
Further Reading
18: Burns: Classification and Treatment
18.1 Introduction
18.2 Etiology and Risk Factors
18.3 Skin Pathophysiology
18.4 Clinical Evaluation
18.5 Severe Burn Injury (SBI)
18.5.1 Resuscitation Phase
18.5.2 Hyperdynamic Hypermetabolic Phase
18.6 Acute Burn Trauma Management
18.7 Fluid Resuscitation
18.8 Hypermetabolic Phase Management
18.9 Management of the Burn Wound
18.10 Debridement
18.11 Wound Coverage
18.12 Burn Sequelae
References
Further Reading
19: Extravasation
19.1 Introduction
19.1.1 Chemotherapy Extravasation
19.1.2 Extravasation Injury in Neonatal and Pediatric Patients
19.1.3 Chemotherapy Extravasation Injury Classification
19.1.4 Classification of Extravasation Injuries in Pediatric Patients [25–27]
19.2 Key Points
19.2.1 Extravasation Management
19.2.2 Technique of Saline Solution Infiltration [12–15]
19.2.2.1 Adults
19.2.2.2 Neonates and Infants
References
20: Radiodermatitis: Prevention and Treatment
20.1 Introduction
20.2 Clinical Presentation and Classification
20.3 Prevention and Treatment
References
21: Maxillofacial Surgery
21.1 Introduction
21.2 Emergency Management
21.2.1 Primary Diagnostic-Therapeutic Approach
21.2.1.1 Upper Airway Obstruction
21.2.1.2 Arrest of Bleeding
21.2.2 Secondary Diagnostic-Therapeutic Approach
21.2.3 Tertiary Diagnostic-Therapeutic Approach
21.3 Maxillofacial Fractures
21.4 Fractures of the Upper Third
21.4.1 Clinical Presentation
21.4.2 Surgical Treatment
21.4.3 Complications
21.5 Fractures of the Middle Third
21.5.1 Clinical Presentation
21.5.2 Surgical Treatment
21.5.3 Complications
21.6 Fractures of the Lower Third
21.6.1 Clinical Presentation
21.6.2 Surgical Treatment
21.6.2.1 Conservative Treatment
21.6.2.2 Surgical Treatment
21.6.3 Complications
References
Further Reading
Part lV: Plastic Surgery in Cancer Therapy
22: Plastic Surgery for Skin Cancer
22.1 Introduction
22.2 Keratoacanthoma
22.3 Solitary Keratoacanthoma
22.4 Histopathology
22.5 Treatment
22.6 Basal Cell Carcinoma
22.6.1 Clinical Features
22.6.2 Natural History
22.6.3 Etiology and Pathogenesis
22.6.4 Histopathology
22.7 Differential Diagnosis
22.7.1 Treatment
22.8 Squamous Cell Carcinoma
22.8.1 Clinical Features
22.8.2 Histopathology
22.8.3 Differential Diagnosis
22.8.4 Treatment
22.9 Excisional Technique
22.10 Wound Healing, Flaps, and Grafts
22.10.1 Healing by Second Intention
22.10.2 Dermal Matrices
22.10.3 Flaps
22.10.3.1 Advancement Flap (Fig. 22.7)
22.10.3.2 Rotation Flap (Fig. 22.8)
22.10.3.3 Transposition Flaps (Fig. 22.9, Video 22.3)
22.10.4 Skin Grafts
22.10.4.1 Split-Thickness Skin Grafts
22.10.4.2 Full-Thickness Skin Grafts
22.10.4.3 Composite Grafts
22.11 Mohs Micrographic Surgery
Bibliography
Skin Cancer
Skin Surgery
23: Plastic Surgery in Melanoma Patients
23.1 Introduction
23.2 Etiology and Risk Factors
23.3 Clinical Evaluation
23.4 Histological Classification
23.5 Surgical Biopsy of a Suspicious Lesion
23.6 Prognostic Factors for Primary Lesion
23.7 Wide Local Excision
23.8 Sentinel Lymph Node Biopsy
23.9 Lymph Node Dissection
23.10 Melanoma Metastases
23.11 TNM Staging
23.12 Locoregional Treatment
23.13 Follow-Up
References
24: Sarcoma
24.1 Introduction and Background
24.2 Aetiology and Incidence
24.3 Soft Tissue Tumour Classification
24.3.1 Benign Lumps
24.3.2 Intermediate Lumps
24.3.3 Sarcomas
24.4 Diagnosing Sarcoma
24.5 Referral Pathway for Suspected Sarcoma
24.6 Staging and Grading Sarcoma
24.7 Management of Soft Tissue Sarcomas
24.8 Surgical Management
24.8.1 Example 1: Free Flaps
24.8.2 Example 2: Chimeric Free Flaps
24.9 Radiotherapy
24.10 Chemotherapy
24.11 Prognosis
24.12 Useful Reading
References
Part V: Reconstructive Plastic Surgery
25: Breast Reconstructive Surgery
25.1 General Considerations
25.2 Breast Reconstruction with Prosthetic Devices
25.2.1 Direct-to-Implant Reconstruction
25.2.2 Tissue Expander/Implant-Based Reconstruction
25.2.2.1 Limitations
25.3 Breast Reconstruction with Autologous Tissue
25.3.1 Types of Autologous Reconstruction
25.3.2 Donor Sites
25.3.2.1 LDM Flap
25.3.2.2 TRAM Flap
25.3.2.3 DIEAP Flap
25.3.2.4 SIEA Flap
25.3.2.5 SGAP Flap
25.3.2.6 LAP Flap
25.3.2.7 TDAP Flap
25.3.2.8 Thigh Flaps
25.4 Secondary Refinements for the Reconstructed Breast
References
26: Abdominal Wall Surgery
26.1 Introduction
26.2 Surgical Anatomy
26.2.1 Anatomy of the Integument
26.2.2 Anatomy of the Myofascial System
26.2.3 Anatomy of Vessels, Nerves, and Lymphatics
26.3 Classification of the Abdominal Wall Defects
26.3.1 Congenital Defects
26.3.1.1 Omphalocele
26.3.1.2 Gastroschisis
26.3.1.3 Bladder Exstrophy
26.3.1.4 Umbilical Hernia
26.3.2 Acquired Defects
26.3.2.1 Partial Defects
Diastasis Recti
Hernia
Postoperative or Incisional Hernia
26.3.2.2 Full-Thickness Defects
Traumatic Defects
Oncological Defects
26.4 Surgical Treatment
26.4.1 Repair of Congenital Defects
26.4.2 Repair of Acquired Defects
26.4.2.1 Repair of Partial Defects
Diastasis Repair
Hernia Repair
Postoperative or Incisional Hernia Repair
26.4.2.2 Repair of Full-Thickness Defects
Traumatic Defects Repair
Oncological Defects Repair
References
27: Lymphedema: Diagnosis and Treatment
27.1 Introduction
27.2 Types of Lymphedema
27.3 Patient Assessment
27.4 Limb Circumference and Volume
27.5 Imaging
27.6 Management of Lymphedema
27.6.1 Conservative Management
27.6.2 Surgical Management
27.7 Results
References
28: Nerve Surgery
28.1 Introduction
28.2 Nerve Anatomy
28.3 Nerve Injury Classification
28.4 Nerve Regeneration
28.5 Nerve Reconstruction
28.5.1 Timing
28.5.2 General Principles
28.5.3 Techniques
28.5.4 Sutures
28.5.4.1 End-to-End Sutures
Epineurial Suture
Perineurial Suture
Epiperineurial Combined Suture
28.5.4.2 End-to-Side Sutures
28.5.5 Nerve Grafts
28.5.5.1 Autograft
28.5.5.2 Allograft
28.5.5.3 Vascularized Nerve Grafts
28.5.6 Nerve Conduits
28.5.7 Nerve Transfer
28.5.7.1 Direct Neurotization
28.6 Other Techniques of Functional Restoration
28.6.1 Tendon Transfer
28.6.2 Functional Muscle Transfer
28.7 Facial Nerve Reconstruction
28.7.1 Treatment of Facial Nerve Injury
28.7.1.1 Facial Nerve Repair
28.7.1.2 Muscle Transfer for Reanimation
28.7.1.3 Static Reconstruction
28.8 Peripheral Nerve Reconstruction
28.8.1 Brachial Plexus and Upper Limb
28.8.2 Lower Limb
28.9 Assessment of Peripheral Nerve Function
28.10 Bionic Reconstruction and Future Perspectives
References
Further Reading
29: Gender-Affirming Surgery
29.1 Terminology
29.2 Eligibility Criteria
29.3 Gender-Affirming Surgery in Transmasculine Individuals
29.3.1 Facial Masculinization
29.3.2 Gender-Affirming Mastectomy
29.3.3 Gender-Affirming Genital Surgery
29.3.3.1 Hysterectomy and Oophorectomy
29.3.3.2 Vaginectomy
29.3.3.3 Metoidioplasty
29.3.3.4 Phalloplasty
29.3.3.5 Additional Procedures
29.4 Gender-Affirming Surgery in Transfeminine Individuals
29.4.1 Facial Feminization
29.4.2 Gender-Affirming Augmentation Mammoplasty
29.4.3 Gender-Affirming Genital Surgery
29.4.3.1 Penile Inversion Vaginoplasty
29.4.3.2 Intestinal Vaginoplasty
29.4.3.3 Other Less Common Techniques
References
Further Reading
30: Regenerative Surgery
30.1 Introduction
30.1.1 History and Development of Regenerative Surgery
30.1.2 Principles and Techniques of Regenerative Surgery
30.1.2.1 Fat Grafting, the Vascular-Stromal Fraction, and ADSCs
30.1.2.2 Cell-Assisted Lipotransfer (CAL)
30.1.2.3 PRP and Platelet-Rich Lipotransfer (PRL)
30.1.2.4 Scaffolds and Tissue Engineering
30.1.3 Clinical Applications in Regenerative Surgery
30.1.3.1 Breast Surgery
30.1.3.2 Wound Healing and Scar Treatment
30.1.3.3 Facial Aesthetic and Reconstructive Surgery
30.1.3.4 Regulatory Issues
30.1.3.5 Future Perspectives
References
31: Advanced Reconstructive Plastic Surgery
31.1 Introduction
31.2 Perforator Flaps
31.2.1 Breast Reconstruction
31.2.2 Head and Neck Reconstruction
31.2.3 Perineum Reconstruction
31.2.4 Lower Extremity Reconstruction
31.2.5 Trunk Reconstruction
31.2.6 Freestyle Perforator Flaps
31.2.7 Supermicrosurgery
31.2.8 Combined Flaps (Conjoined Flaps, Composite Flaps, Chimeric Flaps)
31.2.8.1 Conjoined Flaps
31.2.8.2 Combined Flaps
31.2.8.3 Chimeric Flaps
31.2.9 Endoscopic Approaches
31.3 Diversion Loop for Reconstruction of Upper Esophagus in the Case of Epiglottis Injury
31.4 Voice Reconstruction with Intestinal Flaps
31.5 Lymphedema Treatment
31.6 Lymphatic Cable Flap for Chyloperitoneum
31.7 Composite Tissue Transplantation
References
32: Transplant and Plastic Surgery
32.1 Introduction
32.2 Hand Transplant
32.3 Face Transplant
32.4 Penile Transplant
32.5 Uterine Transplant
32.6 Abdominal Wall Transplant
32.7 Laryngeal Transplant
32.8 Unique Aspects of VCA
32.8.1 Ethical Concerns
32.8.2 Recipient Screening
32.9 Donor Selection
32.10 Nerve Regeneration
32.11 Virtual Surgical Planning and 3D-Printed Guides
32.12 Immunosuppression
References
Part VI: Aesthetic Plastic Surgery
33: Aesthetic Plastic Surgery
33.1 Mammary Gland
33.1.1 Augmentation Mammoplasty
33.1.2 Breast Reduction
33.1.3 Mastopexy (Breast Lift)
33.1.4 Gynecomastia Correction
33.2 Rhinoplasty
33.3 Liposuction
33.4 Abdominoplasty
33.5 Thighplasty
33.6 Brachioplasty
33.7 Gluteoplasty (Buttock Lift)
33.8 Facelift
33.9 Face Lipofilling
33.10 Blepharoplasty
33.11 Otoplasty
Bibliography
34: Plastic Surgery in the COVID-19 Era
34.1 Introduction
34.2 The Response of Plastic Surgery Services
34.3 Learning and Sharing Knowledge While Facing the COVID-19 Pandemic
References
Index