Practical Plastic Surgery
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94. |
Cubital Tunnel Syndrome ........................................... |
574 |
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David Rosenberg and Gregory A. Dumanian |
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95. |
Trigger Finger Release................................................. |
580 |
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Hakim Said and Gregory A. Dumanian |
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96. |
Ganglion Cysts ........................................................... |
583 |
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Hakim Said and Thomas Wiedrich |
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97. |
Stenosing Tenosynovitis .............................................. |
586 |
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Zol B. Kryger |
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98. |
Radial Artery Harvest ................................................. |
589 |
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Zol B. Kryger and Gregory A. Dumanian |
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99. |
Common Anomalies of the Hand and Digits ............. |
592 |
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Zol B. Kryger |
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100. |
Dupuytren’s Disease.................................................... |
597 |
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Oliver Kloeters and John Y.S. Kim |
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101. |
Reflex Sympathetic Dystrophy ................................... |
601 |
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Zol B. Kryger and Gregory A. Dumanian |
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Appendix I— |
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Part A: Important Flaps and Their Harvest ................ |
607 |
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Zol B. Kryger and Mark Sisco |
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Groin Flap ........................................................................................... |
607 |
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Rectus Abdominis Flap ........................................................................ |
611 |
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Fibula Composite Flap ......................................................................... |
612 |
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Pectoralis Major Flap ............................................................................ |
614 |
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Latissimus Dorsi Flap ........................................................................... |
615 |
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Serratus Flap ........................................................................................ |
616 |
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Omental Flap ....................................................................................... |
617 |
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Gracilis Flap ......................................................................................... |
618 |
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Radial Forearm Flap ............................................................................. |
619 |
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Gluteus Flap ......................................................................................... |
620 |
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Anterolateral Thigh (ALT) Flap ............................................................ |
621 |
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Part B: Radial Forearm Free Flap ................................ |
622 |
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Peter Kim and John Y.S. Kim |
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Appendix II—Surgical Instruments ............................ |
625 |
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Zol B. Kryger and Mark Sisco |
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Index ........................................................................... |
633 |
Editors
Zol B. Kryger, M.D., Resident
Division of Plastic Surgery
Northwestern University Feinberg School of Medicine
Chicago, Illinois, U.S.A.
Mark Sisco, M.D., Resident
Division of Plastic Surgery
Northwestern University Feinberg School of Medicine
Chicago, Illinois, U.S.A.
Contributors
Robert J. Allen, M.D., |
Arnulf Baumann, M.D., D.D.S., Ph.D., |
Professor and Chief |
Resident |
Division of Plastic Surgery |
Division of Plastic Surgery |
Louisiana State University |
University of Miami |
New Orleans, Louisiana, U.S.A. |
Miami, Florida, U.S.A. |
and |
Chapters 34, 65 |
The Center for Microsurgical Breast |
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Reconstruction |
David Bentrem, M.D., |
Mount Pleasant, South Carolina, U.S.A. |
Assistant Professor |
Chapter 10 |
Department of Surgery |
|
Division of Surgical Oncoloty |
Avanti Ambekar, M.D., Fellow |
Northwestern University |
in Musculoskeletal Imaging |
Feinberg School of Medicine |
Department of Radiology |
Chicago, Illinois, U.S.A. |
UCSF School of Medicine |
Chapter 25 |
San Francisco, California, U.S.A. |
|
Chapter 78 |
Craig Birgfeld, M.D., Resident |
|
Division of Plastic Surgery |
Philip S. Barie, M.D., |
University of Pennsylvania |
Professor of Surgery and Chief |
Medical School |
Division of Critical Care and Trauma |
Philadelphia, Pennsylvania, U.S.A. |
Weill Medical College |
Chapter 83 |
Cornell University |
|
New York, New York, U.S.A. |
Sean Boutros, M.D. |
Chapter 15 |
Houston Plastic and Cranofacial Surgery |
|
Houston, Texas, U.S.A. |
Bruce S. Bauer, M.D., Professor |
Chapter 12 |
Division of Plastic Surgery |
|
Northwestern University |
Richard J. Brown, M.D., Resident |
Feinberg School of Medicine |
Department of Surgery |
and |
Northwestern University |
Chief, Division of Plastic Surgery |
Feinberg School of Medicine |
Children’s Memorial Hospital |
Chicago, Illinois, U.S.A. |
Chicago, Illinois, U.S.A. |
Chapters 66-68 |
Chapter 13 |
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Louis P. Bucky, M.D., |
Gregory A. Dumanian, M.D., |
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Assistant Professor |
Associate Professor |
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Division of Plastic Surgery |
Division of Plastic Surgery |
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University of Pennsylvania |
Northwestern University |
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Medical School |
Feinberg School of Medicine |
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Philadelphia, Pennsylvania, U.S.A. |
Chicago, Illinois, U.S.A. |
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Chapter 73 |
Chapters 5, 18, 20, 50, 51, 91, 93-95, 98, |
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101 |
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Benjamin Chang, M.D., |
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Associate Professor |
Elof Eriksson, M.D. Ph.D., |
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Division of Plastic Surgery |
Professor and Chief |
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University of Pennsylvania |
Division of Plastic Surgery |
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Medical School |
Brigham and Women’s Hospital |
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Philadelphia, Pennsylvania, U.S.A. |
Harvard Medical School |
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Chapters 24, 83 |
Boston, Massachusetts, U.S.A. |
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Chapter 63 |
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Constance M. Chen, M.D., M.P.H., |
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Resident |
Julius Few, M.D., Assistant Professor |
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Division of Plastic Surgery |
Division of Plastic Surgery |
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New York-Presbyterian Hospital |
Northwestern University |
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New York, New York, U.S.A. |
Feinberg School of Medicine |
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Chapters 10, 11, 27 |
Chicago, Illinois, U.S.A. |
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Chapter 14, 74 |
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Jana Cole, M.D., Assistant Professor |
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Division of Plastic Surgery |
Neil A. Fine, M.D., Associate Professor |
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University of Washington |
Division of Plastic Surgery |
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Seattle, Washington, U.S.A. |
Northwestern University |
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Chapter 27 |
Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
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Patrick Cole, M.D., Resident |
Chapters 9, 41, 45 |
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General Surgery |
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University of Miami/JMH |
Roberto L. Flores, M.D., Resident |
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Miami, Florida, U.S.A. |
NYU Medical Center |
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Chapter 34 |
Institute of Reconstructive |
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Plastic Surgery |
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Kevin J. Cross, M.D., Resident |
New York, New York, U.S.A. |
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Division of Plastic Surgery |
Chapters 16, 43 |
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Weill Medical College |
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Cornell University |
Robert D. Galiano, M.D., |
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New York, New York, U.S.A. |
Assistant Professor |
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Chapters 15, 17 |
Division of Plastic Surgery |
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Northwestern University |
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Daniel Danahey, M.D. Ph.D., |
Feinberg School of Medicine |
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Assistant Professor |
Chicago, Illinois, U.S.A. |
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Department of Otolaryngology |
Chapters 1, 12, 26 |
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Northwestern University |
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Feinberg School of Medicine |
Jerome Garden, M.D., Professor |
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Chicago, Illinois, U.S.A. |
Department of Dermatology |
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Chapter 36 |
Northwestern University |
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Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
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Chapter 71 |
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Paul Gigante, B.S., Medical Student |
William Y. Hoffman, M.D., |
Harvard Medical School |
Professor and Chief |
Boston, Massachusetts, U.S.A. |
Division of Plastic |
Chapter 30 |
and Reconstructive Surgery |
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UCSF School of Medicine |
Robert T. Grant, M.D., |
San Francisco, California, U.S.A. |
Associate Professor and Chief |
Chapters 47-49 |
Division of Plastic Surgery |
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Weill Medical College |
Keren Horn, M.D., Resident |
Cornell University |
Department of Dermatology |
New York, New York, U.S.A. |
Northwestern University |
Chapter 17 |
Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
Anandev Gurjala, M.D., Resident |
Chapters 71, 72 |
Division of Plastic Surgery |
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Northwestern University |
Michael A. Howard, M.D., |
Feinberg School of Medicine |
Assistant Professor |
Chicago, Illinois, U.S.A. |
Division of Plastic Surgery |
Chapters 3, 76 |
Northwestern University |
|
Feinberg School of Medicine |
Geoffrey C. Gurtner, M.D., |
Chicago, Illinois, U.S.A. |
Associate Professor |
Chapters 2, 3, 6, 21, 52 |
Department of Plastic Surgery |
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Stanford University School of Medicine |
Darrin M. Hubert, M.D., Resident |
Stanford, California, U.S.A. |
Division of Plastic Surgery |
Chapter 26 |
University of Pennsylvania |
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Medical School |
Jeffrey A. Hammoudeh, M.D. D.D.S., |
Philadelphia, Pennsylvania, U.S.A. |
Resident |
Chapters 24, 73 |
Division of Plastic Surgery |
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University of Miami/JMH |
Matthew Jacobsen, D.M.D., M.D. |
Miami, Florida, U.S.A. |
Division of OMFS |
Chapters 34, 40, 53, 54, 65 |
Massachusetts General Hospital |
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Boston, Massachusetts, U.S.A. |
Hongshik Han, M.D. |
Chapter 54 |
Private Practice |
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Fresno, California, U.S.A. |
John Y.S. Kim, M.D., Assistant Professor |
Chapters 80, 92 |
Division of Plastic Surgery |
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Northwestern University |
Peter E. Hoepfner, M.D., |
Feinberg School of Medicine |
Assistant Professor |
Chicago, Illinois, U.S.A. |
Departmnet of Orthopedic Surgery |
Chapters 61, 66-68, 81, 82, 85, 86, 88, |
Northwestern University |
97, 99, 100, Appendix IB |
Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
Peter Kim, M.D., Resident |
Chapters 84, 87, 89, 90 |
Division of Plastic Surgery |
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Northwestern University |
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Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
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Chapters 4, 5, Appendix IB |
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Timothy W. King, M.D. Ph.D., Resident |
Robert T. Lancaster, M.D., Resident |
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NYU Medical Center |
Department of Surgery |
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Institute of Reconstructive |
Massachusetts General Hospital |
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Plastic Surgery |
Boston, Massachusetts, U.S.A. |
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New York, New York, U.S.A. |
Chapter 63 |
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Chapters 44, 46 |
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Jonathan L. Le, M.D., Resident |
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Oliver Kloeters, M.D., Resident |
Division of Plastic Surgery |
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Department of Hand, Plastic |
UCSF School of Medicine |
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and Reconstructive Surgery |
San Francisco, California, U.S.A. |
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BG-Burn and Trauma Center |
Chapter 47 |
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University of Heidelberg |
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Ludwigshafen, Germany |
Bernard T. Lee, M.D., |
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Chapters 85, 100 |
Instructor in Surgery |
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Division of Plastic Surgery |
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Jason H. Ko, M.D., Resident |
Beth Israel Deaconess Medical Center |
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Division of Plastic Surgery |
Harvard Medical School |
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Northwestern University |
Boston, Massachusetts, U.S.A. |
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Feinberg School of Medicine |
Chapters 30, 31 |
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Chicago, Illinois, U.S.A. |
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Chapter 14 |
Jamie P. Levine, M.D., Assistant Professor |
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NYU Medical Center |
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Kristina D. Kotseos, M.D., Resident |
Institute of Reconstructive |
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Division of Plastic Surgery |
Plastic Surgery |
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Northwestern University |
New York, New York, U.S.A. |
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Feinberg School of Medicine |
Chapters 43, 44, 46 |
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Chicago, Illinois, U.S.A. |
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Chapters 41, 45 |
Victor L. Lewis, M.D., |
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Professor of Surgery |
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Dzifa S. Kpodzo, M.D., Resident |
Division of Plastic Surgery |
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Division of Plastic Surgery |
Northwestern University |
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Harvard Medical School |
Feinberg School of Medicine |
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Boston, Massachusetts, U.S.A. |
Chicago, Illinois, U.S.A. |
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Chapter 33 |
Chapters 19, 32, 39, 62 |
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Gil S. Kryger, M.D., Resident |
Christopher Low, M.D., Resident |
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Department of Plastic Surgery |
General Surgery |
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Stanford University School of Medicine |
University of Miami/JMH |
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Stanford, California, U.S.A. |
Miami, Florida, U.S.A. |
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Chapters 25, 84 |
Chapter 65 |
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Zol B. Kryger, M.D., Resident |
Leonard Lu, M.D., Resident |
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Division of Plastic Surgery |
Division of Plastic Surgery |
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Northwestern University |
Northwestern University |
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Feinberg School of Medicine |
Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
Chicago, Illinois, U.S.A. |
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Chapters 2, 7-9, 13, 19, 22, 23, 29, 35, |
Chapters 1, 74 |
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38, 55-57, 70, 75, 77-82, 87-90, 92, |
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97-99, 101, Appendix IA, Appendix II |
Edgar S. Macias, B.S., Medical Student |
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Harvard Medical School |
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Boston, Massachusetts, U.S.A. |
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Chapter 33 |
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Theodore C. Marentis, M.S.E.E., |
Nirm Nathan, B.S., Medical Student |
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Medical Student |
University of Miami |
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Harvard Medical School |
Miami, Florida, U.S.A. |
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Boston, Massachusetts, U.S.A. |
Chapter 40 |
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Chapter 30 |
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John Nigriny, M.D., D.D.S., Resident |
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Michael S. Margiotta, M.D., |
Department of Plastic Surgery |
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Assistant Professor |
Stanford University School of Medicine |
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NYU Medical Center |
Stanford, California, U.S.A. |
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Institute of Reconstructive |
Chapter 37 |
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Plastic Surgery |
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New York, New York, U.S.A. |
Millicent Odunze, M.D., Resident |
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Chapter 16 |
Division of Plastic Surgery |
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Northwestern University |
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Alex Margulis, M.D., Associate Professor |
Feinberg School of Medicine |
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Department of Plastic Surgery |
Chicago, Illinois, U.S.A. |
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Haddassah Hospital |
Chapter 91 |
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Jerusalem, Israel |
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Chapters 58, 59 |
Pravin K. Patel, M.D., |
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Assistant Professor |
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James W. May, Jr., M.D., |
Division of Plastic Surgery |
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Professor and Chief |
Northwestern University |
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Division of Plastic Surgery |
Feinberg School of Medicine |
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Massachusetts General Hospital |
and |
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Harvard Medical School |
Chief, Division of Plastic Surgery |
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Boston, Massachusetts, U.S.A. |
Shriner’s Hospital for Sick Children |
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Chapter 60 |
Chicago, Illinois, U.S.A. |
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Chapter 55 |
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Margaret L. McNairy, B.S., |
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Medical Student |
Ziv M. Peled, M.D., Resident |
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Harvard Medical School |
Division of Plastic Surgery |
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Boston, Massachusetts, U.S.A. |
Harvard Medical School |
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Chapter 42 |
Boston, Massachusetts, U.S.A. |
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Chapter 64 |
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Babak J. Mehrara, M.D., |
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Assistant Professor |
Bohdan Pomahac, M.D., |
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Division of Plastic Surgery |
Instructor in Surgery |
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Memorial Sloan Kettering |
Division of Plastic Surgery |
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New York, New York, U.S.A. |
Harvard Medical School |
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Chapter 11 |
Brigham and Women’s Hospital |
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Boston, Massachusetts, U.S.A. |
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Ankit I. Mehta, B.S., Medical Student |
Chapters 33, 42, 69 |
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Harvard Medical School |
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Boston, Massachusetts, U.S.A. |
Jason Pomerantz, M.D., Resident |
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Chapter 30 |
Division of Plastic Surgery |
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UCSF School of Medicine |
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Thomas A. Mustoe, M.D., |
San Francisco, California, U.S.A. |
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Professor and Chief |
Chapters 48, 49 |
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Division of Plastic Surgery |
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Northwestern University |
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Feinberg School of Medicine |
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Chicago, Illinois, U.S.A. |
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Chapter 4, Foreword |
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Joseph Raviv, M.D., Resident |
Amir H. Taghinia, M.D., Resident |
Department of Otolaryngology |
Harvard Plastic Surgery |
Northwestern University |
Residency Program |
Feinberg School of Medicine |
Harvard Medical School |
Chicago, Illinois, U.S.A. |
Boston, Massachusetts, U.S.A. |
Chapter 36 |
Chapters 30, 31, 33, 42, 69 |
Russell R. Reid, M.D. Ph.D., Assistant |
Seth Thaller, M.D., D.M.D., |
Professor and Bernard Sarnat Scholar |
Professor and Chief |
Section of Plastic Surgery |
Division of Plastic Surgery |
University of Chicago |
University of Miami/JMH |
Chicago, Illinois, U.S.A. |
Miami, Florida, U.S.A. |
Chapter 18 |
Chapter 40 |
David S. Rosenberg, M.D., Resident |
Stephen M. Warren, M.D., |
Division of Plastic Surgery |
Associate Professor |
Northwestern University |
Institute of Reconstructive |
Feinberg School of Medicine |
Plastic Surgery |
Chicago, Illinois, U.S.A. |
NYU Medical Center |
Chapters 93, 94 |
New York, New York, U.S.A. |
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Chapters 60, 63, 64 |
Bauback Safa, M.D., Resident |
|
Department of Plastic Surgery |
Thomas Wiedrich, M.D., |
Stanford University School of Medicine |
Associate Professor |
Stanford, California, U.S.A. |
Division of Plastic Surgery |
Chapter 28 |
Northwestern University |
|
Feinberg School of Medicine |
Hakim Said, M.D., Resident |
Chicago, Illinois, U.S.A. |
Division of Plastic Surgery |
Chapter 96 |
Northwestern University |
|
Feinberg School of Medicine |
David Wrone, M.D., Assistant Professor |
Chicago, Illinois, U.S.A. |
Department of Dermatology |
Chapters 95, 96 |
Northwestern University |
|
Feinberg School of Medicine |
Clark F. Schierle, M.D., Ph.D., Resident |
Chicago, Illinois, U.S.A. |
Division of Plastic Surgery |
Chapter 72 |
Northwestern University |
|
Feinberg School of Medicine |
Ted Yagmour, M.D., Associate Professor |
Chicago, Illinois, U.S.A. |
Department of Anesthesia |
Chapters 32, 39, 61, 62 |
Northwestern University |
|
Feinberg School of Medicine |
Mark Sisco, M.D., Resident |
Chicago, Illinois, U.S.A. |
Division of Plastic Surgery |
Chapter 7 |
Northwestern University |
|
Feinberg School of Medicine |
Michael J. Yaremchuk, M.D., Professor |
Chicago, Illinois, U.S.A. |
Division of Plastic Surgery |
Chapters 6, 20, 21, 28, 50-53, 86, |
Massachusetts General Hospital |
Appendix IA, Appendix II |
Harvard Medical School |
|
Boston, Massachusetts, U.S.A. |
|
Chapter 64 |
Foreword
At first glance, it would seem that the field of plastic and reconstructive surgery is so inundated with texts that there is hardly a need for one more. First impressions, however, can be deceiving. There is a book that has been lacking—until now. Practical Plastic Surgery was conceived to address the need for a comprehensive, compact, and concise handbook. One that is as useful in the “trenches” as it is for the In-Service exam preparation.
One hundred chapters and two extremely useful appendices have been authored by most of the residents and faculty in the Division of Plastic Surgery at Northwestern University, as well as by many of our colleagues around the country. Over the course of several years this collaborative effort has evolved into an outstanding text for fellows, residents, students, and other physicians interested in the practical aspects of our field. I predict that this book will find a place close to every plastic surgery resident’s fingertips, and that its usefulness will apply to other areas of surgery as well.
Thomas A. Mustoe, M,D.
Professor and Chief, Division of Plastic Surgery
Northwestern University Feinberg School of Medicine
Chicago, Illinois, U.S.A.
Preface
What attracted us to plastic surgery are its tremendous scope and the multitude of approaches for every clinical situation. Yet precisely these aspects of plastic surgery make its study and teaching especially challenging. Although there are several excellent atlases and texts, we have come across few references that are compact, affordable, timely, and focus on the practical, day-to-day practice of plastic surgery.
The purpose of Practical Plastic Surgery is to provide a guide to plastic surgery as it is practiced in academic medical centers. As such, it is written with the resident and fellow in mind. It is also our intention that this book be useful to general surgeons and other healthcare providers. Many of the chapters, such as Basic Concepts in Wound Repair and Dressings provide information relevant to all surgical specialties.
The book contains over a hundred chapters organized into eight sections that cover the breadth of plastic surgery, starting with General Principles, The Problematic Wound and Integument. The next five sections address the principle disciplines, and include Head and Neck, Trunk and Lower Extremity, Craniofacial Surgery, Aesthetic Surgery, concluding with Hand and Upper Extremity. The book concludes with two large appendices and a comprehensive index. Appendix I lists most of the commonly used flaps and their harvest and has many illustrations of these flaps. Appendix II is comprised of illustrations and the names of the common surgical instruments used by most plastic surgeons.
The text is written by over 75 authors, many of whom are considered among the leaders in their respective fields. Each chapter is concise and focused on the practical aspects of the topic. Historical and out-dated procedures are largely ignored. Every chapter concludes with a section titled “pearls and pitfalls,” as well as a handful of important references.
Tremendous efforts have been made to ensure the accuracy and verify the information provided in this text. However, the art and science of plastic surgery are dynamic and constantly evolving. Procedures that are standard of care today may fall out of favor tomorrow. Therefore, this book should serve as a guide and not as an authoritative text.
We hope you enjoy reading and using this text as much as we enjoyed editing it. We welcome any comments that may help us improve future editions.
Zol Kryger and Mark Sisco
Chapter 1
Wound Healing and Principles of Wound Care
Leonard Lu and Robert D. Galiano
Introduction
Wound healing involves a broad range of overlapping cellular and metabolic processes that are orchestrated as a fundamental homeostatic response to injury. An understanding of these concepts is essential to care for wounds in all disciplines of surgery. Plastic surgeons are often consulted by other practitioners to deal with difficult, nonhealing, compromised wounds. Therefore, an understanding of the basic science of wound healing allows one to identify the variables involved in a given wound, and ultimately modulate the process to restore the structure and function of the injured tissue.
Classically, wound healing is divided into three distinct phases: inflammatory, proliferative and remodeling (Table 1.1). Even though each phase is described as a separate event, there is a large degree of temporal overlap and variability in these phases. Factors that influence the timing and length of these events include ischemia, age of the host, nutrition, radiation, smoking, systemic diseases such as diabetes, contamination or infection, desiccation, and the amount of devitalized or necrotic tissue in the wound. This chapter outlines the cellular, vascular and physiologic events underlying wound healing, focusing on the clinically relevant aspects.
Inflammatory Phase
Immediately after injury, bleeding occurs as a result of disruption of the blood vessels. Hemostasis is obtained by initial transient vasoconstriction and subsequent platelet plug and clot formation. Platelet degranulation of alpha and dense granules releases various substances, including platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β), which ignite the chemotaxis and proliferation of inflammatory cells that characterize this phase of wound healing. Following the period of vasoconstriction, the migration of cells to the site of injury is aided by vasodilation and increased endothelial permeability (mediated by histamine, prostacyclin and other substances).
The first cells to arrive are the polymorphonuclear leukocytes (PMNs), which increase in numbers over the first 24 hours. These cells aid in the process of clearing the wound of debris and bacteria. Over the next 2-3 days, macrophages replace the PMNs as the predominant cell type. Macrophages have several critical roles in healing wound, including phagocytosis, release of multiple growth factors and cytokines, and recruitment of additional inflammatory cells. The importance of macrophages is exemplified by studies that have shown that wound healing is significantly impaired without their participation. In contrast, blocking or destroying PMNs during the inflammatory phase still results in a normally healing wound in the absence of bacteria. Finally, lymphocytes populate the wound, although their direct role in wound healing requires further investigation.
Practical Plastic Surgery, edited by Zol B. Kryger and Mark Sisco. ©2007 Landes Bioscience.