Potential complications will also be addressed. Well-illustrated with more than 800 clinical photographs and with a website featuring surgical procedures, this book is an ideal reference for those new to practice and experts alike. Much of the breast reconstruction using your body's own tissue can be accomplished at the time of your mastectomy (immediate reconstruction), though sometimes it can be done as a separate procedure later (delayed reconstruction). Objective: To review new findings that have an impact on the planning and understanding of local flaps for the reconstruction of cutaneous defects of . 6, 8, 10 This determines the suitability of the flap, that is, if the closure of the second lobe is going to result in medial lower eyelid distortion to recruit tissue on the nasal sidewall, the flap design is unsuitable for this location. As a rule, any eyelid retraction or nasal alar retraction is a firm contraindication to linear closure, but mild lip retraction almost always resolves. 1 Meticulous and complete standing cone or dog-ear excision is required, given that standing cone rarely settles completely. Local Flaps in Head and Neck Reconstruction Microsurgical Reconstruction of the Head and Neck Two Volume Set Book Description : The classic first volume on Local Flaps in Head and Neck Reconstruction, by Dr. Ian T. Jackson, presents a simple, elegant approach to solving common reconstructive problems encountered by plastic surgeons at all levels of training. The reconstructive modality of choice will depend largely on the location, size, and depth of the surgical defect. When the skin is moved to a part of the body directly next to it (eg a piece of cheek skin is turned to fill a cheek wound), this is termed a local flap. 9.20, Fig. The handbook's format and style of presentation follows that of previous editions inspired by the Faye Brown approach to coding instruction. 9.4The flap begins with conversion of defect to a triangular configuration so that base of triangle forms a portion of the flap circumference. There are a number of different types of local flap, and can be described in various ways including the way the flap moves and its shape. It provides the advantage of immediate flap inset of color-matched and texture-matched tissue with often a direct linear closure of the donor site. Regional flapThis uses a section of tissue that is attached by a specific blood vessel. Regional flaps: Flaps located near the defect but are not in immediate proximity. Accompanying DVD contains "27 video clips [which offer] an unmatched tutorial that takes you through the preparation and successful use of facial flaps in multiple facial regions."--Page 4 of cover. The arc of rotation for both lobes is drawn as well as the planned standing cone excision. These include the head, neck, chest, or breast areas, arms and legs, and the The advantages of the local flaps are their ability to provide vascularized color- and texture-matched skin for reconstruction. One secondary option has been to transfer the LD muscle from the back as a local flap to cover a silicone breast implant, 5 or to take the skin overlying that muscle as a so-called musculocutaneous flap, which, if thick enough, can even avoid the use of an implant. It offers detailed visual guidance and unmatched expertise from prominent surgeons . plasms of the head and neck, 1. the repair of facial . Zitelli also described a planned dog-ear excision or a standing cone excision on the first lobe that is excised prior to flap elevation. 9.25, Fig. There really is no perceptible difference in final outcomes based on final skin closure techniques. Local flap reconstruction: oncoplastic techniques based on the use of pedicled local flaps for the supply of volume from nearby tissues, without using the gland itself. Breast reconstruction with flap surgery is a complex procedure performed by a plastic surgeon. Fig. 2011 Jan; 181093:01-08 . 9, 10. 6 The flap begins with conversion of defect to a triangular configuration so that base of triangle forms a portion of the flap circumference. Key Highlights General techniques including wound care, skin and cartilage grafts; and local and pedicled flaps The management of intraoperative, acute, and late healing stage complications; scar optimization and revision surgeries The second lobe is elevated and the defect is closed with the remaining lobe rotated into position on the inset and then tacking sutures can be utilized even along the pedicle of the flap to improve in particular alar contour. Systematic and practical, this book describes all relevant flap plasties of the hand and the upper extremity, both conventional and micro-vascular. The introduction presents the anatomical situation. In the case of the scalp, the repair of even small defects is complicated. 9.9, Fig. Local flaps can be used for reconstructing different areas of the body. Alternatively the wound might . Alternatively the wound might just be able to be closed but would be very tight, or could distort other features (eg eyebrow or lip) if closed directly. When the defect is large and deep, a muscle flap may be required to obliterate the dead space, but when the defect is limited in its size and complexity, a local fasciocutaneous flap may suffice. It includes the delicate superficial cervical fascia just deep to skin Inspect this work today, and you will be delighted with its comprehensive coverage, logical organization, appealing layout, and beautiful four-color illustrations. 9.19, Fig. This text provides a comprehensive overview of operative dictations in plastic, aesthetic, and reconstructive surgical procedures, which will serve as a valuable resource for residents, fellows, and practicing surgeons. The most common and useful example of advancement flaps is the V-Y advancement flap, where planned incisions can usually be placed within soft-tissue borders and ideal contour as well as color-matched skin and soft tissue can be advanced into the wound. That way the contour of the nose itself would not be interrupted or unnaturally distorted. Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm (14021) Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less (14040) Adjacent tissue transfer or rearrangement, forehead, cheeks, chin .
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