The keystone perforator island flap concept:
Gespeichert in:
| Hauptverfasser: | , , |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Sydney [u.a.]
Churchill Livingstone Elsevier
2012
|
| Schriftenreihe: | Western Health
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis Klappentext |
| Beschreibung: | XV, 227 S. zahlr. Ill., graph. Darst. 1 DVD-Video (12 cm) |
| ISBN: | 9780729539715 0729539717 |
Internformat
MARC
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| 700 | 1 | |a Lo, Cheng Hean |e Verfasser |4 aut | |
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Datensatz im Suchindex
| _version_ | 1804148520511340544 |
|---|---|
| adam_text | Contents
Foreword by Wayne A Morrison
v
Foreword by Peter
С
Doherty
vi
Preface
xi
Acknowledgments
xii
Contributors and reviewers
xiv
Section
1
The Fundamentals of Keystone Island Flaps
ι
Chapter
1
Introduction to the keystone island flap
з
THE DEVELOPMENT OF THE KEYSTONE ISLAND FLAP
4
Chapter
2
Anatomy and applied physiology of fasciocutaneous flaps
ю
INTRODUCTION
10
THE ANATOMY OF FASCIOCUTANEOUS TISSUES
10
Cutaneous vascularisation patterns 1
1
Cutaneous neurovascularisation patterns
13
Cutaneous microcirculation
16
CUTANEOUS VASCULAR PHYSIOLOGY
16
APPLIED PHYSIOLOGY: VASCULAR REGULATION WITHIN KEYSTONE ISLAND FLAPS
17
Keystone island flap elevation
18
Neural mediation of keystone island flap
perfusion
20
Haemodynamic changes in the keystone flap during islanding
25
THE ROLE OF TENSION IN KEYSTONE ISLAND FLAP CLOSURE
26
SUMMARY
27
Chapter
3
Design principles and the keystone technique
28
INTRODUCTION
28
PLANNING A KEYSTONE ISLAND FLAP
28
The keystone design
28
Placement, size and orientation of keystone island flaps
28
Flap elevation
30
Flap inset and defect closure
30
Classification
31
Technical refinements
32
Design variations
34
The Keystone Perforator Island Flap Concept
Handling of the deep fascia/panniculus carnosus remnants
34
Shape of the skin incision
34
Type of flap movement into the defect
35
De-epithelialisation and flap subdivision
35
A NOTE ON ISLANDING
35
CLINICAL CASES
35
SUMMARY
35
Section
2
Clinical Applications of Keystone Island Flaps:
Anatomical Regions
53
Chapter
4
Head and neck
55
INTRODUCTION
55
PRINCIPLES OF FLAP ELEVATION IN THE HEAD AND NECK
57
Anatomical layers of the face: preservation of the facial nerve
57
Neurovascular anatomy
58
Zones in head and neck reconstruction
60
MULTIPLE SUBUNIT RECONSTRUCTION
94
SUMMARY
97
Chapter
5
The upper limb
98
INTRODUCTION
98
PRINCIPLES OF FLAP ELEVATION IN THE UPPER LIMB
98
NEUROVASCULAR ANATOMY AND ZONES IN UPPER LIMB RECONSTRUCTION
99
Deltoid region
99
The forearm
100
Dorsum of hand and fingers
1
00
The palm
102
CLINICAL CASES
103
SUMMARY
113
Chapter
6
The trunk: the clavicles to the groin
їм
INTRODUCTION
114
THE BACK
114
Capturing a blood supply
115
Principles of flap elevation in the back
115
Contents ix
THE CHEST WALL AND BREAST
116
Cutaneous blood supply of the chest wall and breast
117
Principles of flap elevation in the chest wall and breast
118
ABDOMINAL RECONSTRUCTION
120
Cutaneous vascular anatomy of the anterior abdominal wall
120
Principles of flap elevation in the abdomen
121
THE PERINEUM
127
Cutaneous vascular anatomy of the perineum
127
BUTTOCK AND
PERIANAL
RECONSTRUCTION
131
Cutaneous vascular anatomy of the buttock region
131
Principles of flap elevation in the buttock region
131
SUMMARY
134
Chapter
7
The lower limb
135
INTRODUCTION
135
CUTANEOUS VASCULAR ANATOMY OF THE LOWER LIMB
136
The thigh
136
The knee
137
The leg
137
The ankle and dorsum of the foot
141
The plantar surface of the foot
143
FLAP ELEVATION IN THE LOWER LIMB
143
Flap elevation in the groin and thigh
143
Flap elevation around the knee
143
Flap elevation in the leg
148
Flap elevation in the ankle and dorsum of the foot
150
Flap elevation in the plantar foot
152
SUMMARY
155
Section
3
Special Applications of Keystone Island Flaps
157
Chapter
8
Melanoma
159
INTRODUCTION
159
IMPORTANT PRINCIPLES IN KEYSTONE FLAP CLOSURE OF MELANOMA DEFECTS
160
Correct pathology and staging
160
The role of sentinel lymph node biopsy at the time of keystone reconstruction
160
Use of DRAPE in keystone closure
161
Timely commencement of adjuvant therapies in keystone flap closures
162
Quality of life and early functional recovery with low morbidity surgery
163
USE OF KEYSTONE FLAPS FOR NODAL
METASTASES
163
The Keystone Perforator Island Flap Concept
REVISIONAI.
SURGERY
178
SUMMARY
178
Chapter
9
Radiotherapy
179
INTRODUCTION
179
RADIOTHERAPY EFFECTS
179
Acute radiotherapy effects
179
Consequential effects of radiotherapy (chronic effects of acute
toxicity)
180
Late effects of radiotherapy
180
PRESENTATIONS INVOLVING RECONSTRUCTION AND RADIOTHERAPY
180
Reconstruction in previously irradiated tissues
181
Reconstruction of radionecrosis
195
SUMMARY
198
Chapter
10
Trauma
199
INTRODUCTION
199
THE NATURE AND SEVERITY OF TRAUMA
199
Isolated trauma versus multi-trauma
200
Low-energy versus high-energy trauma
200
Simple versus complex mechanisms
200
Acute versus chronic trauma
200
SPECIFIC SITES
201
Lower third of leg
201
Hand trauma
201
MANAGEMENT OF THE PRIMARY DEFECT
201
CLINICAL CASES
205
SUMMARY
220
INDEX
22!
The
Keystone Perforator
Island Flap
Concept
This text presents an easy-to-understand guide to the development, design and surgical
application of the keystone island flap. Extensive use is made of clinical cases accompanied
by intraoperative videos and detailed photography showing the operative sequence and
post-operative results (with any complications detailed), in order to maximise the reader s
understanding. Additional information is included throughout, such as the history,
neurovascular anatomy based on dermatomal delineations, the reconstructive alternatives,
and technical refinements.
The book discusses in detail the design elements including flap physiology upon which the
keystone island flap is based. Following a general discussion of the flap and the basis of how
it works, including hypothesis (the subject of separate investigation), the authors examine
specific defects in various regions of the body and show how keystone island flaps have
been used successfully in a wide range of applications. The use of the keystone island flap
for specific surgical specialities, including head and neck, melanoma, trauma (including
compound fractures of the lower limb) and even irradiated tissue is also addressed.
This surgical method can be a valuable supplement to the reconstructive
repertoire in the field of reparative surgery.
Features
•
case-oriented approach
Ш
TLC
(Time, Life quality and Complications) summaries after each surgical procedure
•
DVD containing surgical techniques
•
end of chapter summaries
The authors
Felix Behan FRCS,
FRACS
Plastic and Reconstructive Surgeon in Head and Neck and Melanoma Surgery
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne
Head of Unit; Western Hospital; Melbourne, Vic
Michael Findlay MBBS, PhD,
FRACS
(Plast)
Plastic, Reconstructive and Hand Surgeon
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne
Western Health, Austin Health, Peninsula Health
Adjunct Senior Lecturer, Department of Surgery, Monash University, Melbourne, Vic
Cheng Heart
Lo MBBS
Registrar, Plastic, Hand and Faciomaxtllary Surgery Unit
The Alfred Hospital, Melbourne, Vic
|
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| illustrated | Illustrated |
| indexdate | 2024-07-10T00:08:26Z |
| institution | BVB |
| isbn | 9780729539715 0729539717 |
| language | English |
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| spellingShingle | Behan, Felix Findlay, Michael Lo, Cheng Hean The keystone perforator island flap concept Operationstechnik (DE-588)4215428-5 gnd Lappenplastik (DE-588)4202810-3 gnd Wiederherstellungschirurgie (DE-588)4065971-9 gnd |
| subject_GND | (DE-588)4215428-5 (DE-588)4202810-3 (DE-588)4065971-9 |
| title | The keystone perforator island flap concept |
| title_auth | The keystone perforator island flap concept |
| title_exact_search | The keystone perforator island flap concept |
| title_full | The keystone perforator island flap concept Felix C. Behan ; Michael Findlay ; Cheng Hean Lo |
| title_fullStr | The keystone perforator island flap concept Felix C. Behan ; Michael Findlay ; Cheng Hean Lo |
| title_full_unstemmed | The keystone perforator island flap concept Felix C. Behan ; Michael Findlay ; Cheng Hean Lo |
| title_short | The keystone perforator island flap concept |
| title_sort | the keystone perforator island flap concept |
| topic | Operationstechnik (DE-588)4215428-5 gnd Lappenplastik (DE-588)4202810-3 gnd Wiederherstellungschirurgie (DE-588)4065971-9 gnd |
| topic_facet | Operationstechnik Lappenplastik Wiederherstellungschirurgie |
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