By Joseph M. Serletti, Peter J. Taub, Liza C. Wu, David J. Slutsky
Authored by means of best specialists within the box, present Reconstructive surgical procedure is a entire source that prepares you for the main not easy circumstances, whereas supplying you with an effective seize of the basics. The content material of the book--logically prepared via anatomic region--is supported via greater than 1,300 cutting-edge illustrations and images, the vast majority of that are in complete color.
Current Reconstructive surgical procedure starts with a useful evaluation of the rules of wound therapeutic and wound fix. Its next chapters meticulously research pertinent reconstructive issues and current the newest surgical protocols for all accidents and disabilities, from burn reconstruction and cranium base surgical procedure to the administration of hand infections. present Reconstructive surgical procedure grants insights derived from the authors' sizeable event as practitioners, mixed with information from new and landmark reviews. This unique advisor has every thing you want to optimistically practice either universal and unusual reconstructive procedures--so you could increase functionality and approximate a standard visual appeal to your sufferers.
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Extra info for Current Reconstructive Surgery
Indirect musculocutaneous perforator ﬂaps will have to be raised by opening the deep fascia, splitting the donor muscle, preserving its other vascularization and motor innervation, and eventually, exposing its source artery. In a direct perforator ﬂap, like the groin ﬂap, the perforators do not run through a speciﬁc intermuscular septum. A speciﬁc septum is not looked for and the microsurgical technique is different from the technique used to harvest a septocutaneous ﬂap. Perforator ﬂaps have allowed the transfer of the patients’ own skin and fat in a reliable manner with minimal donor site morbidity for more than a decade.
The perforator dissection proceeds through the muscle until a pedicle of sufﬁcient length and with sufﬁcient vessel caliber is obtained to allow microsurgical anastomosis. This usually occurs when the perforating vessels join the descending branch of the inferior gluteal artery. The sciatic nerve is usually not visualized. Some small sensory branches of the posterior femoral cutaneous nerve may be divided in pedicle dissection. The typical pedicle length is 8 to 11 cm, the arterial diameter greater than 2 mm and the venous diameter is 3 to 4 mm.
This allows for the thicker part of the ﬂap to lie medially on the chest wall. The operating microscope is brought into position. For the venous anastomosis, we use an anastomotic coupling device. The coupling device makes the anastomosis easier and faster, and has the additional beneﬁt of stenting the vein open after the vessels are joined. The arterial anastomosis is typically performed manually with interrupted sutures. After the anastomosis is complete, the ﬂap is checked for bleeding and capillary reﬁll.