Verfügbarkeit: Mohs micrographic surgery: from layers to reconstruction

Mohs micrographic surgery: from layers to reconstruction:

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Bibliographische Detailangaben
Hauptverfasser:	Harmon, Christopher B. (VerfasserIn), Tolkachjov, Stanislav N. (VerfasserIn)
Format:	Buch
Sprache:	English
Veröffentlicht:	Stuttgart Thieme [2023]
Schlagworte:	Hautchirurgie Hautkrebs
Online-Zugang:	Inhaltsverzeichnis Inhaltsverzeichnis
Beschreibung:	xviii, 250 Seiten 813 Illustrationen 28 cm, 991 g
ISBN:	9783132420175 3132420174

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245	1	0	\|a Mohs micrographic surgery: from layers to reconstruction \|c Christopher B. Harmon, MD, FAAD, FACMS, Stanislav N. Tolkachjov, MD, FAAD, FACMS
264		1	\|a Stuttgart \|b Thieme \|c [2023]
264		4	\|c © 2023
300			\|a xviii, 250 Seiten \|b 813 Illustrationen \|c 28 cm, 991 g
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Datensatz im Suchindex

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adam_text	CONTENTS VIDEOS ............................................................................................................................................. XII FOREWORD ......................................................................................................................................... XIV PREFACE ............................................................................................................................................ XV ACKNOWLEDGMENTS ........................................................................................................................ XVI CONTRIBUTORS ................................................................................................................................. XVII 1. MOHS MICROGRAPHIC SURGERY ................. 1.1 BEFORE THE FIRST STAGE ............................ 1 NICHOLAS GOLDA AND GEORGE HRUZA 1.1.1 TUMOR SELECTION ........................................... 1 1.1.2 DOCUMENTATION OF SITE ................................ 2 1.1.3 TIME-OUT ..................................................... 3 1.2 PROCEDURES BEFORE THE FIRST STAGE ........ 3 NICHOLAS GOLDA AND GEORGE HRUZA 1.2.1 CURETTAGE ...................................................... 3 1.2.2 SHARP DEBULKING ........................................... 5 1.3 THE FIRST STAGE ........................................ 5 NICHOLAS GOLDA AND GEORGE HRUZA 1.3.1 ESSENTIALS OF THE FIRST STAGE ......................... 5 1.3.2 INCOMPLETE EXCISION AND RECURRENCE ......... 9 1.4 TISSUE PROCESSING ................................... 9 NICHOLAS GOLDA AND GEORGE HRUZA 1.4.1 TISSUE TRANSFER ............................................. 9 1.4.2 RELAXING INCISIONS AND DIVIDING .................. 9 1.4.3 TISSUE INKING .............................................. 11 1 1.5 HISTOLOGIC INTERPRETATION/MAPPING .. 12 NICHOLAS GOLDA AND GEORGE HRUZA 1.5.1 INITIAL SLIDE QUALITY REVIEW ....................... 12 1.5.2 HISTOLOGIC INTERPRETATION .......................... 13 1.5.3 TISSUE MAPPING .......................................... 14 1.6 SUBSEQUENT LAYERS ............................... 16 NICHOLAS GOLDA AND GEORGE HRUZA 1.6.1 SUBSEQUENT LAYERS WHEN MALIGNANCY IS PRESENT ONLY IN THE DEEP TISSUE ............... 16 1.7 NONSTANDARD SITUATIONS ....................... 17 NICHOLAS GOLDA AND GEORGE HRUZA 1.8 MOHS LAYERS IN SPECIAL SITES ............... 17 THOMAS HOCKER 1.8.1 EYELID ........................................................... 18 1.8.2 LIP ................................................................ 21 1.8.3 EAR ............................................................... 22 1.8.4 NOSE ............................................................. 23 1.8.5 PERIOSTEUM/BONE ....................................... 24 1.8.6 NAIL ............................................................... 25 1.8.7 ANOGENITAL REGION ..................................... 26 2. FACIAL SUBUNIT RECONSTRUCTIVE PRINCIPLES AND GENERAL CONSIDERATIONS ...................... 28 CHRISTOPHER]. MILLER, JOSEPH F. SOBANKO, NICOLE HOWE, THUZAR SHIN, JEREMY R. ETZKORN, AND H. WILLIAM HIGGINS II 2.1 DESIGN PRINCIPLES OF FACIAL RECONSTRUCTION ..................................... 28 2.1.1 OVERVIEW .................................................... 28 2.1.2 FREE MARGINS .............................................. 28 2.1.3 CONTOUR ....................................................... 29 2.1.4 COSMETIC SUBUNIT JUNCTION LINES .............. 29 2.1.5 RELAXED SKIN TENSION LINES ....................... 29 2.1.6 COLOR AND TEXTURE ....................................... 31 2.2 PRINCIPLES OF TISSUE BIOMECHANICS ........ 32 2.2.1 OVERVIEW .................................................... 32 2.2.2 PREFERRED VECTORS TO MOVE FACIAL TISSUE .. 32 CONTENTS 2.2.3 HOW DIFFERENT RECONSTRUCTIONS AFFECT LOCATION OF TENSION RELATIVE TO THE PRIMARY DEFECT ........................... 34 2.2.4 TISSUE PLANES FOR UNDERMINING AND ELEVATING FLAPS .......................................... 34 2.3 KEY PRINCIPLES OF ANATOMY .................. 35 2.3.1 OVERVIEW .................................................... 35 2.3.2 BLOOD SUPPLY TO THE FACE ........................... 35 2.3.3 SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM . 36 2.4 SYSTEMATIC APPROACH TO ASSESSING FACIAL WOUNDS AND CHOOSING RECONSTRUCTION ...................................... 36 2.4.1 OVERVIEW .................................................... 36 3. NOSE .............................................................. EVAN STIEGEL AND JOHN ZITELLI 3.1 INTRODUCTION .......................................... 42 3.2 ANATOMY ................................................. 43 3.3 NASAL TIP ................................................. 44 3.3.1 SECOND INTENTION HEALING ............................. 44 3.3.2 PRIMARY CLOSURE .......................................... 45 3.3.3 BILOBEDFLAP ................................................... 46 3.3.4 DORSAL NASAL (RIEGER S) FLAP ....................... 48 3.3.5 FOREHEAD FLAP ............................................. 49 3.3.6 PRELAMINATED AND PREFOLDED FOREHEAD FLAP .............................................................. 52 3.3.7 CONCHAL BOWL FULL-THICKNESS SKIN GRAFT. . 53 3.4 NASAL ALA ................................................. 54 3.4.1 SECOND INTENTION ........................................ 54 3.4.2 GRAFTS ............................................................ 54 3.4.3 MEDIAL-BASED BILOBED FLAP ......................... 55 3.4.4 SPIRAL FLAP .................................................... 56 3.4.5 CHEEK-TO-NOSE INTERPOLATION FLAP ............ 56 2.4.2 DEFINE WHAT IS MISSING ............................. 36 2.4.3 PRIORITIZE PRINCIPLES FOR RECONSTRUCTION DESIGN ............... 36 2.4.4 CHOOSE AMONG RECONSTRUCTION OPTIONS .. 36 2.5 RECONSTRUCTION OPTIONS FOR FACIAL RECONSTRUCTION ...................................... 36 2.5.1 OVERVIEW .................................................... 36 2.5.2 SECOND INTENTION HEALING ........................... 36 2.5.3 LINEAR CLOSURE ............................................. 37 2.5.4 SKIN GRAFTS ................................................... 37 2.5.5 SLIDING FLAPS ................................................. 37 2.6 CONCLUSION .............................................. 40 .................................................................................... 42 3.4 .6 SPEAR FLAP ..................................................... 58 3.4 .7 TECHNIQUE .................................................... 58 3.5 SOFT TRIANGLE/COLUMELLA ........................ 59 3.5.1 TURNOVER FLAP ............................................... 59 3.5.2 NASAL TIP ROTATION FLAP ............................... 60 3.6 NASAL DORSUM ......................................... 60 3.7 NASAL ROOT/LOWER GLABELLA ................... 62 3.8 NASAL SIDEWALL ......................................... 62 3.8.1 RHOMBIC TRANSPOSITION FLAP ...................... 62 3.8.2 SUPERIOR-BASED BILOBED FLAP ...................... 62 3.8.3 LATERAL-BASED ROTATION FLAP/CRESCENTIC ADVANCEMENT FLAP/CHEEK-BASED BUROW S ADVANCEMENT FLAP .................................... 63 3.8.4 V-YFLAP ........................................................ 63 3.8.5 SINGLE-STAGE NASOLABIAL FLAP ...................... 64 3.9 COMPLICATIONS AND REVISIONS............... 65 4. FOREHEAD AND TEMPLE RECONSTRUCTION .................................................................................. 66 JOSEPH F. SOBANKO, ASHWIN AGARWAL, AND CHRISTOPHER J. MILLER 4.1 FOREHEAD AND TEMPLE ANATOMY ......... 66 4.1.1 BOUNDARIES OF THE FOREHEAD AND TEMPLE SUBUNITS ..................................................... 66 4.1.2 MUSCLES OF THE FOREHEAD AND TEMPLE .... 66 4.1.3 BLOOD SUPPLY TO THE FOREHEAD AND TEMPLE ........................................................ 67 4.2 PRESERVATION OF SENSORY AND MOTOR FUNCTION ................................................ 67 4.2.1 SENSORY FUNCTION ........................................ 67 4.2.2 MOTOR FUNCTION ........................................... 68 CONTENTS 4.3 4.4 4.5 4.5.1 5. 5.1 5.1.1 5.1.2 5.1.3 5.1.4 5.1.5 6. 6.1 6.2 6.3 7. 7.1 7.2 7.3 7.3.1 7.3.2 8. 8.1 ACHIEVING REPRODUCIBLY EXCELLENT COSMETIC RESULTS .................................. 69 EVALUATING WOUNDS ON THE FOREHEAD AND TEMPLE ........................................... 69 RECONSTRUCTION OPTIONS FOR THE FOREHEAD AND TEMPLE .......................... 69 SECOND INTENTION ...................................... 70 4.5.2 LINEAR CLOSURE ............................................. 70 4.5.3 LOCAL FLAPS .................................................. 72 4.5.4 SLIDING FLAPS ................................................. 73 4.5.5 TRANSPOSITION FLAPS .................................... 74 4.5.6 SKIN GRAFTS .................................................. 77 4.6 COMPLICATIONS ......................................... 77 4.7 CONCLUSION .............................................. 81 SCALP ................................................................................................................................................. 83 DAVID ZLOTY, IREN KOSSINTSEVA, AND VICTORIA GODINEZ-PUIG RELEVANT ANATOMY 84 5.2 RECONSTRUCTIVE OPTIONS ...................... 88 SKIN ............................................................ 84 5.2.1 SUBCUTIS ....................................................... 84 5.2.2 GALEA APONEUROTICA ................................... 86 5.2.3 SUBGALEAL LOOSE CONNECTIVE TISSUE ......... 87 5.2.4 PERIOSTEUM ................................................. 87 ALGORITHM FOR SCALP RECONSTRUCTION ....... 88 SECOND INTENTION HEALING ......................... 88 SKIN GRAFTS ................................................. 91 LOCAL FLAPS ................................................. 93 COMPLICATIONS ....................................... 99 CHEEK ............................................................................................................................................ 102 JONATHAN CAPPEL INTRODUCTION ...................................... 102 RELEVANT ANATOMY ........................... 102 AESTHETIC SUBUNITS AND DEFECTS .... 103 6.4 RECONSTRUCTIVE OPTIONS .................... 105 6.4.1 PRIMARY CLOSURES .................................... 105 6.4.2 FLAPS ......................................................... 107 6.4.3 SECOND INTENTION HEALING ....................... 110 6.4.4 FULL-THICKNESS SKIN GRAFT ....................... 110 6.5 COMPLICATIONS AND REVISIONS.......... ILL AURICULAR RECONSTRUCTION ........................................................................................................ 112 DAVID C. BRODLAND AND MOLLY POWERS INTRODUCTION ...................................... 112 RELEVANT ANATOMY ........................... 112 RECONSTRUCTIVE OPTIONS ................... 113 SUPERIOR HELIX ........................................ 113 MID HELIX ................................................. 120 7.3.3 LOBULE ..................................................... 123 7.3.4 ANTIHELIX ................................................. 127 7.3.5 CONCHA ..................................................... 130 7.3.6 TRAGUS ..................................................... 132 7.3.7 REMAINDER OF THE POSTERIOR EAR ............ 133 7.4 COMPLICATIONS AND REVISIONS........... 133 LIP (PERIORAL) RECONSTRUCTION ................................................................................................. 135 NICOLA A. QUATRANO AND THOMAS E. ROHRER INTRODUCTION ...................................... 135 8.2 COSMETIC SUBUNITS AND RELEVANT ANATOMY ............................................ 135 CONTENTS 8.3 RECONSTRUCTIVE ALGORITHM ................. 137 8.3.1 VERMILION ................................................. 138 8.3.2 CUTANEOUS LATERAL UPPER LIP .................. 139 8.3.3 PHILTRUM .................................................. 146 8.3.4 CUTANEOUS LOWER LIP .............................. 152 8.4 COMPLICATIONS AND REVISIONS ........... 155 9. CHIN RECONSTRUCTION ................................................................................................................. 157 CHRISTOPHER B. HARMON AND RANDALL PROCTOR 9.1 RELEVANT ANATOMY .......................... . 157 9.3.4 9.3.5 BILATERAL ADVANCEMENT (O-T FLAP) ....... V-Y ADVANCEMENT FLAP ......................... 9.2 AESTHETIC SUBUNITS AND DEFECTS ... . 158 9.3.6 ROTATION FLAPS ........................................ 9.3.7 TRANSPOSITION FLAPS ................................. 9.3 RECONSTRUCTIVE OPTIONS ................. . 159 9.3.8 FULL-THICKNESS SKIN GRAFTS .................... 160 161 162 162 162 9.3.1 ALGORITHM ................................................ 159 9.3.2 HEALING BY SECONDARY INTENTION ............ 159 9.3.3 PRIMARY CLOSURE ........................................ 159 9.4 COMPLICATIONS AND REVISIONS.......... 163 10. RECONSTRUCTION OF THE EYELIDS AND EYEBROWS ................................................................... 164 GABRIELA M. ESPINOZA AND ALEKSANDAR L. KRUNIC 10.1 INTRODUCTION ..................................... 164 10.2 SURGICAL ANATOMY OF THE EYELIDS AND EYEBROWS .................................... 165 10.2.1 SUPERFICIAL TOPOGRAPHY OF THE LIDS AND EYEBROWS ............................................... 165 10.2.2 ORBICULARIS OCULI MUSCLE (OOM) .......... 167 10.2.3 ORBITAL SEPTUM (OS) AND POSTSEPTAL FAT COMPARTMENTS ...................................... 168 10.2.4 TARSOLIGAMENTOUS SLING ......................... 170 10.2.5 EYELID RETRACTORS .................................... 171 10.2.6 CONJUNCTIVA ........................................... 171 10.2.7 LACRIMAL SYSTEM .................................... 171 10.2.8 NEUROVASCULAR AND LYMPHATIC SYSTEM OF THE LIDS ............................................... 172 10.2.9 ORBIT ........................................................ 175 10.2.10 EYEBROW ANATOMY ................................ 175 10.3 PRINCIPLES AND AIMS OF PERIOCULAR RECONSTRUCTION .................................. 176 10.4 PERIOPERATIVE SURGICAL TIPS, INSTRUMENTATIONS, AND SUTURES IN PERIOCULAR RECONSTRUCTION .............. 177 10.5 SURGICAL ASSESSMENT OF THE PERIOCULAR DEFECT AND RECONSTRUCTION GUIDELINES ........................................... 178 10.7 GRAFTS IN PERIOCULAR RECONSTRUCTION 180 10.8 REPAIR OF SUPERFICIAL NONMARGINAL EYELID DEFECTS .................................... 182 10.9 RECONSTRUCTION OF THE FULL-THICKNESS EYELID DEFECTS .................................... 185 10.9.1 PRIMARY CLOSURE OF THE FULL-THICKNESS DEFECTS OF THE EYELIDS ................................. 185 10.9.2 SEMICIRCULAR FLAP (TENZEL) ..................................... 189 10.9.3 TARSOCONJUNCTIVAL FLAP FOR LOWER EYELID RECONSTRUCTION (HUGHES FLAP) ............... 189 10.9.4 TARSAL TRANSPOSITION FLAP FOR LATERAL UPPER EYELID RECONSTRUCTION .. 192 10.9.5 CUTLER-BEARD FLAP FOR COMPLETE UPPER EYELID RECONSTRUCTION ............. 194 10.10 LOWER LID TIGHTENING PROCEDURES .. 195 10.11 WOUND DRESSING AND POSTOPERATIVE CARE IN PERIOCULAR SURGERY PATIENTS 196 10.12 LACRIMAL CANALICULAR SYSTEM ASSESSMENT AND RECONSTRUCTION ......... 196 10.13 COMPLICATIONS OF EYELID RECONSTRUCTIONS ................... 198 10.6 SECONDARY INTENTION HEALING ............. 179 CONTENTS 10.14 AIMS AND PRINCIPLES OF EYEBROW RECONSTRUCTION .................................. 198 10.14.1 PRIMARY CLOSURE OF BROW DEFECTS ......... 198 10.14.2 ADVANCEMENT FLAPS ............................... 199 10.14.3 ISLAND-PEDICLE FLAPS ............................... 199 11. COMBINATION RECONSTRUCTION ............... STANISLAV N. TOLKACHJOV 11.1 INTRODUCTION ..................................... 207 11.2 COMBINATION OF PRIMARY AND GRAFT RECONSTRUCTION .................................. 207 11.2.1 ARM/HAND .............................................. 208 11.2.2 TEMPLE .................................................... 208 11.2.3 CHEEK ...................................................... 209 11.3 COMBINATION OF FLAP AND GRAFT RECONSTRUCTION .................................. 209 11.3.1 LATERAL INFRAOCULAR CHEEK ..................... 209 11.3.2 PERIAURICULAR CHEEK/EAR ....................... 209 11.3.3 UPPER CUTANEOUS LIP/PHILTRUM/ALAR SILL... 209 11.3.4 MEDIAL CHEEK/NASAL SIDEWALL .............. 209 11.3.5 FOREHEAD/TEMPLE .................................. 210 11.3.6 LARGE NASAL DEFECTS .............................. 211 11.4 COMBINATION OF FLAPS FOR RECONSTRUCTION OF SINGLE AND MULTIPLE DEFECTS ............................... 215 10.14.4 TRANSPOSITION FLAPS ............................... 201 10.14.5 PEDICLE FLAPS .......................................... 201 10.14.6 FREE HAIR-BEARING GRAFTS (COMPOSITE GRAFTS - SKIN AND HAIR) ........................... 202 10.15 CONCLUSION ......................................... 202 ................................................................................. 206 11.4.1 LARGE NASAL DEFECTS ............................... 215 11.4.2 LIP ............................................................ 215 11.5 RECONSTRUCTION OF MULTIPLE DEFECTS 215 11.5.1 MULTIPLE DEFECTS REPAIRED AS ONE ....... 215 11.5.2 WEST BY EAST-WEST ............................. 215 11.5.3 O-T ADVANCEMENT FLAP, SCALP/FOREHEAD ROTATION FLAP, AND PARAMEDIAN FOREHEAD FLAP ........................................ 221 11.5.4 COMBO-Z FLAP ...................................... 221 11.5.5 MULTIPLE DEFECTS REPAIRED WITH BUROW S GRAFTS ........................................ 221 11.5.6 THE KITCHEN SINK : WHEN COMBINATION RECONSTRUCTION AND GRANULATION GETS US OUT OF A JAM ............................. 225 11.6 SUMMARY ........................................... 225 12. PERIOPERATIVE MANAGEMENT AND WOUND CARE ................................................................. 227 JASON R. CASTILLO, JENNIFER L. HANSON, AND RANDALL K. ROENIGK 12.1 PREOPERATIVE CONSIDERATIONS ........... 227 12.1.1 ANTIBIOTIC PROPHYLAXIS ............................ 227 12.1.2 ANTICOAGULANTS ....................................... 229 12.1.3 CONSCIOUS SEDATION/ANALGESIA ............... 232 12.1.4 IMPLANTABLE DEVICES .............................. 233 12.2 POSTOPERATIVE CARE ............................ 235 12.2.1 GRANULATION/SECOND-INTENTION HEALING 236 12.2.2 PORCINE XENOGRAFTS AND BIOLOGIC DRESSINGS ............................................... 236 12.2.3 BOLSTER SUTURES ....................................... 237 12.2.4 POSTDERMABRASION CARE ........................ 238 12.2.5 POSTPRIMARY CLOSURE ON THE LOWER EXTREMITY ............................................... 238 12.2.6 POSTFLAP CARE ........................................ 238 12.3 HEMATOMA MANAGEMENT .............. 239 12.4 INFECTION MANAGEMENT ................... 241 12.4.1 INFECTION ............................................... 241 12.4.2 ANTIMICROBIAL SELECTION ...................... 242 12.5 PAIN MANAGEMENT .......................... 242 INDEX 247
adam_txt	CONTENTS VIDEOS . XII FOREWORD . XIV PREFACE . XV ACKNOWLEDGMENTS . XVI CONTRIBUTORS . XVII 1. MOHS MICROGRAPHIC SURGERY . 1.1 BEFORE THE FIRST STAGE . 1 NICHOLAS GOLDA AND GEORGE HRUZA 1.1.1 TUMOR SELECTION . 1 1.1.2 DOCUMENTATION OF SITE . 2 1.1.3 TIME-OUT . 3 1.2 PROCEDURES BEFORE THE FIRST STAGE . 3 NICHOLAS GOLDA AND GEORGE HRUZA 1.2.1 CURETTAGE . 3 1.2.2 SHARP DEBULKING . 5 1.3 THE FIRST STAGE . 5 NICHOLAS GOLDA AND GEORGE HRUZA 1.3.1 ESSENTIALS OF THE FIRST STAGE . 5 1.3.2 INCOMPLETE EXCISION AND RECURRENCE . 9 1.4 TISSUE PROCESSING . 9 NICHOLAS GOLDA AND GEORGE HRUZA 1.4.1 TISSUE TRANSFER . 9 1.4.2 RELAXING INCISIONS AND DIVIDING . 9 1.4.3 TISSUE INKING . 11 1 1.5 HISTOLOGIC INTERPRETATION/MAPPING . 12 NICHOLAS GOLDA AND GEORGE HRUZA 1.5.1 INITIAL SLIDE QUALITY REVIEW . 12 1.5.2 HISTOLOGIC INTERPRETATION . 13 1.5.3 TISSUE MAPPING . 14 1.6 SUBSEQUENT LAYERS . 16 NICHOLAS GOLDA AND GEORGE HRUZA 1.6.1 SUBSEQUENT LAYERS WHEN MALIGNANCY IS PRESENT ONLY IN THE DEEP TISSUE . 16 1.7 NONSTANDARD SITUATIONS . 17 NICHOLAS GOLDA AND GEORGE HRUZA 1.8 MOHS LAYERS IN SPECIAL SITES . 17 THOMAS HOCKER 1.8.1 EYELID . 18 1.8.2 LIP . 21 1.8.3 EAR . 22 1.8.4 NOSE . 23 1.8.5 PERIOSTEUM/BONE . 24 1.8.6 NAIL . 25 1.8.7 ANOGENITAL REGION . 26 2. FACIAL SUBUNIT RECONSTRUCTIVE PRINCIPLES AND GENERAL CONSIDERATIONS . 28 CHRISTOPHER]. MILLER, JOSEPH F. SOBANKO, NICOLE HOWE, THUZAR SHIN, JEREMY R. ETZKORN, AND H. WILLIAM HIGGINS II 2.1 DESIGN PRINCIPLES OF FACIAL RECONSTRUCTION . 28 2.1.1 OVERVIEW . 28 2.1.2 FREE MARGINS . 28 2.1.3 CONTOUR . 29 2.1.4 COSMETIC SUBUNIT JUNCTION LINES . 29 2.1.5 RELAXED SKIN TENSION LINES . 29 2.1.6 COLOR AND TEXTURE . 31 2.2 PRINCIPLES OF TISSUE BIOMECHANICS . 32 2.2.1 OVERVIEW . 32 2.2.2 PREFERRED VECTORS TO MOVE FACIAL TISSUE . 32 CONTENTS 2.2.3 HOW DIFFERENT RECONSTRUCTIONS AFFECT LOCATION OF TENSION RELATIVE TO THE PRIMARY DEFECT . 34 2.2.4 TISSUE PLANES FOR UNDERMINING AND ELEVATING FLAPS . 34 2.3 KEY PRINCIPLES OF ANATOMY . 35 2.3.1 OVERVIEW . 35 2.3.2 BLOOD SUPPLY TO THE FACE . 35 2.3.3 SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM . 36 2.4 SYSTEMATIC APPROACH TO ASSESSING FACIAL WOUNDS AND CHOOSING RECONSTRUCTION . 36 2.4.1 OVERVIEW . 36 3. NOSE . EVAN STIEGEL AND JOHN ZITELLI 3.1 INTRODUCTION . 42 3.2 ANATOMY . 43 3.3 NASAL TIP . 44 3.3.1 SECOND INTENTION HEALING . 44 3.3.2 PRIMARY CLOSURE . 45 3.3.3 BILOBEDFLAP . 46 3.3.4 DORSAL NASAL (RIEGER ' S) FLAP . 48 3.3.5 FOREHEAD FLAP . 49 3.3.6 PRELAMINATED AND PREFOLDED FOREHEAD FLAP . 52 3.3.7 CONCHAL BOWL FULL-THICKNESS SKIN GRAFT. . 53 3.4 NASAL ALA . 54 3.4.1 SECOND INTENTION . 54 3.4.2 GRAFTS . 54 3.4.3 MEDIAL-BASED BILOBED FLAP . 55 3.4.4 SPIRAL FLAP . 56 3.4.5 CHEEK-TO-NOSE INTERPOLATION FLAP . 56 2.4.2 DEFINE WHAT IS MISSING . 36 2.4.3 PRIORITIZE PRINCIPLES FOR RECONSTRUCTION DESIGN . 36 2.4.4 CHOOSE AMONG RECONSTRUCTION OPTIONS . 36 2.5 RECONSTRUCTION OPTIONS FOR FACIAL RECONSTRUCTION . 36 2.5.1 OVERVIEW . 36 2.5.2 SECOND INTENTION HEALING . 36 2.5.3 LINEAR CLOSURE . 37 2.5.4 SKIN GRAFTS . 37 2.5.5 SLIDING FLAPS . 37 2.6 CONCLUSION . 40 . 42 3.4 .6 SPEAR FLAP . 58 3.4 .7 TECHNIQUE . 58 3.5 SOFT TRIANGLE/COLUMELLA . 59 3.5.1 TURNOVER FLAP . 59 3.5.2 NASAL TIP ROTATION FLAP . 60 3.6 NASAL DORSUM . 60 3.7 NASAL ROOT/LOWER GLABELLA . 62 3.8 NASAL SIDEWALL . 62 3.8.1 RHOMBIC TRANSPOSITION FLAP . 62 3.8.2 SUPERIOR-BASED BILOBED FLAP . 62 3.8.3 LATERAL-BASED ROTATION FLAP/CRESCENTIC ADVANCEMENT FLAP/CHEEK-BASED BUROW ' S ADVANCEMENT FLAP . 63 3.8.4 V-YFLAP . 63 3.8.5 SINGLE-STAGE NASOLABIAL FLAP . 64 3.9 COMPLICATIONS AND REVISIONS. 65 4. FOREHEAD AND TEMPLE RECONSTRUCTION . 66 JOSEPH F. SOBANKO, ASHWIN AGARWAL, AND CHRISTOPHER J. MILLER 4.1 FOREHEAD AND TEMPLE ANATOMY . 66 4.1.1 BOUNDARIES OF THE FOREHEAD AND TEMPLE SUBUNITS . 66 4.1.2 MUSCLES OF THE FOREHEAD AND TEMPLE . 66 4.1.3 BLOOD SUPPLY TO THE FOREHEAD AND TEMPLE . 67 4.2 PRESERVATION OF SENSORY AND MOTOR FUNCTION . 67 4.2.1 SENSORY FUNCTION . 67 4.2.2 MOTOR FUNCTION . 68 CONTENTS 4.3 4.4 4.5 4.5.1 5. 5.1 5.1.1 5.1.2 5.1.3 5.1.4 5.1.5 6. 6.1 6.2 6.3 7. 7.1 7.2 7.3 7.3.1 7.3.2 8. 8.1 ACHIEVING REPRODUCIBLY EXCELLENT COSMETIC RESULTS . 69 EVALUATING WOUNDS ON THE FOREHEAD AND TEMPLE . 69 RECONSTRUCTION OPTIONS FOR THE FOREHEAD AND TEMPLE . 69 SECOND INTENTION . 70 4.5.2 LINEAR CLOSURE . 70 4.5.3 LOCAL FLAPS . 72 4.5.4 SLIDING FLAPS . 73 4.5.5 TRANSPOSITION FLAPS . 74 4.5.6 SKIN GRAFTS . 77 4.6 COMPLICATIONS . 77 4.7 CONCLUSION . 81 SCALP . 83 DAVID ZLOTY, IREN KOSSINTSEVA, AND VICTORIA GODINEZ-PUIG RELEVANT ANATOMY 84 5.2 RECONSTRUCTIVE OPTIONS . 88 SKIN . 84 5.2.1 SUBCUTIS . 84 5.2.2 GALEA APONEUROTICA . 86 5.2.3 SUBGALEAL LOOSE CONNECTIVE TISSUE . 87 5.2.4 PERIOSTEUM . 87 ALGORITHM FOR SCALP RECONSTRUCTION . 88 SECOND INTENTION HEALING . 88 SKIN GRAFTS . 91 LOCAL FLAPS . 93 COMPLICATIONS . 99 CHEEK . 102 JONATHAN CAPPEL INTRODUCTION . 102 RELEVANT ANATOMY . 102 AESTHETIC SUBUNITS AND DEFECTS . 103 6.4 RECONSTRUCTIVE OPTIONS . 105 6.4.1 PRIMARY CLOSURES . 105 6.4.2 FLAPS . 107 6.4.3 SECOND INTENTION HEALING . 110 6.4.4 FULL-THICKNESS SKIN GRAFT . 110 6.5 COMPLICATIONS AND REVISIONS. ILL AURICULAR RECONSTRUCTION . 112 DAVID C. BRODLAND AND MOLLY POWERS INTRODUCTION . 112 RELEVANT ANATOMY . 112 RECONSTRUCTIVE OPTIONS . 113 SUPERIOR HELIX . 113 MID HELIX . 120 7.3.3 LOBULE . 123 7.3.4 ANTIHELIX . 127 7.3.5 CONCHA . 130 7.3.6 TRAGUS . 132 7.3.7 REMAINDER OF THE POSTERIOR EAR . 133 7.4 COMPLICATIONS AND REVISIONS. 133 LIP (PERIORAL) RECONSTRUCTION . 135 NICOLA A. QUATRANO AND THOMAS E. ROHRER INTRODUCTION . 135 8.2 COSMETIC SUBUNITS AND RELEVANT ANATOMY . 135 CONTENTS 8.3 RECONSTRUCTIVE ALGORITHM . 137 8.3.1 VERMILION . 138 8.3.2 CUTANEOUS LATERAL UPPER LIP . 139 8.3.3 PHILTRUM . 146 8.3.4 CUTANEOUS LOWER LIP . 152 8.4 COMPLICATIONS AND REVISIONS . 155 9. CHIN RECONSTRUCTION . 157 CHRISTOPHER B. HARMON AND RANDALL PROCTOR 9.1 RELEVANT ANATOMY . . 157 9.3.4 9.3.5 BILATERAL ADVANCEMENT (O-T FLAP) . V-Y ADVANCEMENT FLAP . 9.2 AESTHETIC SUBUNITS AND DEFECTS . . 158 9.3.6 ROTATION FLAPS . 9.3.7 TRANSPOSITION FLAPS . 9.3 RECONSTRUCTIVE OPTIONS . . 159 9.3.8 FULL-THICKNESS SKIN GRAFTS . 160 161 162 162 162 9.3.1 ALGORITHM . 159 9.3.2 HEALING BY SECONDARY INTENTION . 159 9.3.3 PRIMARY CLOSURE . 159 9.4 COMPLICATIONS AND REVISIONS. 163 10. RECONSTRUCTION OF THE EYELIDS AND EYEBROWS . 164 GABRIELA M. ESPINOZA AND ALEKSANDAR L. KRUNIC 10.1 INTRODUCTION . 164 10.2 SURGICAL ANATOMY OF THE EYELIDS AND EYEBROWS . 165 10.2.1 SUPERFICIAL TOPOGRAPHY OF THE LIDS AND EYEBROWS . 165 10.2.2 ORBICULARIS OCULI MUSCLE (OOM) . 167 10.2.3 ORBITAL SEPTUM (OS) AND POSTSEPTAL FAT COMPARTMENTS . 168 10.2.4 TARSOLIGAMENTOUS SLING . 170 10.2.5 EYELID RETRACTORS . 171 10.2.6 CONJUNCTIVA . 171 10.2.7 LACRIMAL SYSTEM . 171 10.2.8 NEUROVASCULAR AND LYMPHATIC SYSTEM OF THE LIDS . 172 10.2.9 ORBIT . 175 10.2.10 EYEBROW ANATOMY . 175 10.3 PRINCIPLES AND AIMS OF PERIOCULAR RECONSTRUCTION . 176 10.4 PERIOPERATIVE SURGICAL TIPS, INSTRUMENTATIONS, AND SUTURES IN PERIOCULAR RECONSTRUCTION . 177 10.5 SURGICAL ASSESSMENT OF THE PERIOCULAR DEFECT AND RECONSTRUCTION GUIDELINES . 178 10.7 GRAFTS IN PERIOCULAR RECONSTRUCTION 180 10.8 REPAIR OF SUPERFICIAL NONMARGINAL EYELID DEFECTS . 182 10.9 RECONSTRUCTION OF THE FULL-THICKNESS EYELID DEFECTS . 185 10.9.1 PRIMARY CLOSURE OF THE FULL-THICKNESS DEFECTS OF THE EYELIDS . 185 10.9.2 SEMICIRCULAR FLAP (TENZEL) . 189 10.9.3 TARSOCONJUNCTIVAL FLAP FOR LOWER EYELID RECONSTRUCTION (HUGHES FLAP) . 189 10.9.4 TARSAL TRANSPOSITION FLAP FOR LATERAL UPPER EYELID RECONSTRUCTION . 192 10.9.5 CUTLER-BEARD FLAP FOR COMPLETE UPPER EYELID RECONSTRUCTION . 194 10.10 LOWER LID TIGHTENING PROCEDURES . 195 10.11 WOUND DRESSING AND POSTOPERATIVE CARE IN PERIOCULAR SURGERY PATIENTS 196 10.12 LACRIMAL CANALICULAR SYSTEM ASSESSMENT AND RECONSTRUCTION . 196 10.13 COMPLICATIONS OF EYELID RECONSTRUCTIONS . 198 10.6 SECONDARY INTENTION HEALING . 179 CONTENTS 10.14 AIMS AND PRINCIPLES OF EYEBROW RECONSTRUCTION . 198 10.14.1 PRIMARY CLOSURE OF BROW DEFECTS . 198 10.14.2 ADVANCEMENT FLAPS . 199 10.14.3 ISLAND-PEDICLE FLAPS . 199 11. COMBINATION RECONSTRUCTION . STANISLAV N. TOLKACHJOV 11.1 INTRODUCTION . 207 11.2 COMBINATION OF PRIMARY AND GRAFT RECONSTRUCTION . 207 11.2.1 ARM/HAND . 208 11.2.2 TEMPLE . 208 11.2.3 CHEEK . 209 11.3 COMBINATION OF FLAP AND GRAFT RECONSTRUCTION . 209 11.3.1 LATERAL INFRAOCULAR CHEEK . 209 11.3.2 PERIAURICULAR CHEEK/EAR . 209 11.3.3 UPPER CUTANEOUS LIP/PHILTRUM/ALAR SILL. 209 11.3.4 MEDIAL CHEEK/NASAL SIDEWALL . 209 11.3.5 FOREHEAD/TEMPLE . 210 11.3.6 LARGE NASAL DEFECTS . 211 11.4 COMBINATION OF FLAPS FOR RECONSTRUCTION OF SINGLE AND MULTIPLE DEFECTS . 215 10.14.4 TRANSPOSITION FLAPS . 201 10.14.5 PEDICLE FLAPS . 201 10.14.6 FREE HAIR-BEARING GRAFTS (COMPOSITE GRAFTS - SKIN AND HAIR) . 202 10.15 CONCLUSION . 202 . 206 11.4.1 LARGE NASAL DEFECTS . 215 11.4.2 LIP . 215 11.5 RECONSTRUCTION OF MULTIPLE DEFECTS 215 11.5.1 MULTIPLE DEFECTS REPAIRED AS ONE . 215 11.5.2 " WEST BY EAST-WEST " . 215 11.5.3 O-T ADVANCEMENT FLAP, SCALP/FOREHEAD ROTATION FLAP, AND PARAMEDIAN FOREHEAD FLAP . 221 11.5.4 " COMBO-Z " FLAP . 221 11.5.5 MULTIPLE DEFECTS REPAIRED WITH BUROW ' S GRAFTS . 221 11.5.6 THE " KITCHEN SINK " : WHEN COMBINATION RECONSTRUCTION AND GRANULATION GETS US OUT OF A JAM . 225 11.6 SUMMARY . 225 12. PERIOPERATIVE MANAGEMENT AND WOUND CARE . 227 JASON R. CASTILLO, JENNIFER L. HANSON, AND RANDALL K. ROENIGK 12.1 PREOPERATIVE CONSIDERATIONS . 227 12.1.1 ANTIBIOTIC PROPHYLAXIS . 227 12.1.2 ANTICOAGULANTS . 229 12.1.3 CONSCIOUS SEDATION/ANALGESIA . 232 12.1.4 IMPLANTABLE DEVICES . 233 12.2 POSTOPERATIVE CARE . 235 12.2.1 GRANULATION/SECOND-INTENTION HEALING 236 12.2.2 PORCINE XENOGRAFTS AND BIOLOGIC DRESSINGS . 236 12.2.3 BOLSTER SUTURES . 237 12.2.4 POSTDERMABRASION CARE . 238 12.2.5 POSTPRIMARY CLOSURE ON THE LOWER EXTREMITY . 238 12.2.6 POSTFLAP CARE . 238 12.3 HEMATOMA MANAGEMENT . 239 12.4 INFECTION MANAGEMENT . 241 12.4.1 INFECTION . 241 12.4.2 ANTIMICROBIAL SELECTION . 242 12.5 PAIN MANAGEMENT . 242 INDEX 247
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spelling	Harmon, Christopher B. Verfasser (DE-588)1284511510 aut Mohs micrographic surgery: from layers to reconstruction Christopher B. Harmon, MD, FAAD, FACMS, Stanislav N. Tolkachjov, MD, FAAD, FACMS Stuttgart Thieme [2023] © 2023 xviii, 250 Seiten 813 Illustrationen 28 cm, 991 g txt rdacontent n rdamedia nc rdacarrier Hautchirurgie (DE-588)4139427-6 gnd rswk-swf Hautkrebs (DE-588)4140169-4 gnd rswk-swf Hautkrebs (DE-588)4140169-4 s Hautchirurgie (DE-588)4139427-6 s DE-604 Tolkachjov, Stanislav N. Verfasser (DE-588)128451191X aut Georg Thieme Verlag KG (DE-588)1064287301 pbl Erscheint auch als Online-Ausgabe, EPUB 978-3-13-258252-1 Erscheint auch als Online-Ausgabe, PDF 978-3-13-242018-2 B:DE-101 application/pdf https://d-nb.info/1203898614/04 Inhaltsverzeichnis DNB Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=034635349&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis 1\p dnb 20230802 DE-101 https://d-nb.info/provenance/plan#dnb
spellingShingle	Harmon, Christopher B. Tolkachjov, Stanislav N. Mohs micrographic surgery: from layers to reconstruction Hautchirurgie (DE-588)4139427-6 gnd Hautkrebs (DE-588)4140169-4 gnd
subject_GND	(DE-588)4139427-6 (DE-588)4140169-4
title	Mohs micrographic surgery: from layers to reconstruction
title_auth	Mohs micrographic surgery: from layers to reconstruction
title_exact_search	Mohs micrographic surgery: from layers to reconstruction
title_exact_search_txtP	Mohs micrographic surgery: from layers to reconstruction
title_full	Mohs micrographic surgery: from layers to reconstruction Christopher B. Harmon, MD, FAAD, FACMS, Stanislav N. Tolkachjov, MD, FAAD, FACMS
title_fullStr	Mohs micrographic surgery: from layers to reconstruction Christopher B. Harmon, MD, FAAD, FACMS, Stanislav N. Tolkachjov, MD, FAAD, FACMS
title_full_unstemmed	Mohs micrographic surgery: from layers to reconstruction Christopher B. Harmon, MD, FAAD, FACMS, Stanislav N. Tolkachjov, MD, FAAD, FACMS
title_short	Mohs micrographic surgery: from layers to reconstruction
title_sort	mohs micrographic surgery from layers to reconstruction
topic	Hautchirurgie (DE-588)4139427-6 gnd Hautkrebs (DE-588)4140169-4 gnd
topic_facet	Hautchirurgie Hautkrebs
url	https://d-nb.info/1203898614/04 http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=034635349&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
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