Facial Reconstruction After Mohs Surgery

 
 
Thieme (Verlag)
  • 1. Auflage
  • |
  • erschienen am 21. Februar 2018
  • |
  • 228 Seiten
 
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
978-1-62623-735-3 (ISBN)
 

The growing worldwide incidence of melanoma and nonmelanoma skin cancers has driven the development of effective treatment methodologies. Mohs is the gold standard surgical treatment for excision of skin cancers on the head and neck. While Mohs surgery has a 99% effectiveness rate for new cancers and 95% for recurrences, more than 90% of reconstructed patients desire some improvement in their operative scars.

Facial Reconstruction after Mohs Surgery by James Thornton and Jourdan Carboy summarizes 15 years and 12,000 cases in a surgical practice devoted to post-Mohs facial reconstruction. Step-by-step guidance is provided on efficacious, aesthetically pleasing, and functionally complete repairs, respective of a patient's age, anesthesia considerations, and available resources. In addition to succinct chapters on lip, ear, cheek, scalp, and nasal reconstruction, subspecialty chapters cover anesthesia, Mohs surgery, oculoplastic surgery, and microvascular reconstruction. Throughout the text, complete and concise clinical algorithms serve as a framework to help simplify difficult clinical concepts.

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
  • Additional procedural guidance provided in 20 high quality video clips posted in the Thieme MediaCenter
  • Nearly 500 full-color photos and precise drawings add a rich visual dimension and show stepwise operative sequences

This book is comprehensive resource on tried and true techniques for soft tissue reconstruction after Mohs cancer resection. It is essential reading for plastic surgery, facial plastic surgery and dermatology residents and clinicians with practices devoted to facial plastic surgery.

1. Auflage
  • Englisch
  • NEW YORK
  • |
  • Deutschland
  • 24,80 MB
978-1-62623-735-3 (9781626237353)
1626237352 (1626237352)
weitere Ausgaben werden ermittelt
  • Facial Reconstruction After Mohs Surgery
  • Media Center Information
  • Title Page
  • Copyright
  • Contents
  • Video Contents
  • Preface
  • Acknowledgments
  • Contributors
  • Part 1: Introduction
  • 1 Special Considerations for Mohs Patients
  • 1.1 General Principles.
  • 1.2 Conduct of the Operation
  • References
  • 2 Anesthesia for Reconstruction of Facial Mohs Defects
  • 2.1 General Principles
  • 2.2 Types of Anesthesia
  • 2.2.1 Monitored Anesthesia Care
  • 2.2.2 General Anesthesia
  • 2.3 Recovery
  • 2.3.1 Obstructive Sleep Apnea
  • 2.3.2 Malignant Hyperthermia
  • 2.4 Operating Room Fires
  • 2.5 Postoperative Cognitive Dysfunction
  • 2.6 A Note on Office-Based Anesthesia
  • References
  • 3 Mohs Micrographic Surgery
  • 3.1 Introduction
  • 3.2 History
  • 3.3 Preoperative Considerations
  • 3.4 Description of Technique
  • 3.5 Postoperative Considerations
  • 3.6 Complications
  • 3.6.1 Nonmelanoma Skin Cancers
  • 3.6.2 Basal Cell Carcinoma
  • 3.6.3 Squamous Cell Carcinoma
  • 3.6.4 Melanoma
  • 3.6.5 Other Tumors
  • 3.7 Conclusion
  • References
  • 4 Cellular and Tissue-Based Wound Care
  • 4.1 Algorithm
  • 4.1.1 General Considerations
  • 4.2 Integra
  • 4.3 Cellular and Tissue-Based Products
  • References
  • 5 Full-Thickness Skin Grafts
  • 5.1 Algorithm
  • 5.1.1 General Considerations
  • 5.2 Selection of Donor Site
  • 5.3 Graft Elevation and Inset
  • 5.3.1 Bolstering the Graft
  • 5.3.2 Postoperative Care
  • References
  • 6 Split-Thickness Skin Grafting
  • 6.1 General Considerations
  • 6.2 Donor-Site Selection
  • 6.3 Harvest Technique.
  • 6.4 Graft Inset
  • References
  • 7 Cartilage Grafts
  • 7.1 General Considerations
  • 7.2 Donor-Site Selection
  • 7.2.1 Conchal Bowl Donor Site
  • 7.2.2 Rib Cartilage Donor Site
  • 7.2.3 Septal Cartilage Donor Site
  • 7.2.4 Banked Frozen Allograft Cartilage
  • References
  • 8 Pedicled Flaps
  • 8.1 General Considerations
  • 8.1.1 Nasolabial Flap
  • 8.1.2 Paramidline Forehead Flap
  • 8.2 Postoperative Care
  • References
  • 9 Local Flaps
  • 9.1 General Considerations
  • 9.2 Linear Closure
  • 9.3 Rotation Flaps
  • 9.4 Advancement Flaps
  • 9.5 Transposition Flaps
  • 9.6 Bilobed Flap
  • 9.7 Dorsal Nasal Flap
  • 9.8 Melolabial Flap
  • 9.9 Note Flap
  • References
  • Part 2: Techniques for Specific Anatomic Location
  • 10 Scalp Reconstruction
  • 10.1 Algorithm For Closure
  • 10.1.1 General Considerations
  • 10.2 Commonly Applied Methods of Closure
  • 10.2.1 Bone Exposure and Calvarial Defects
  • 10.2.2 Direct Closure
  • 10.3 Postoperative Management
  • References
  • 11 Forehead Reconstruction
  • 11.1 Algorithm for Closure
  • 11.1.1 General Considerations
  • 11.2 Commonly Applied Methods of Closure
  • 11.2.1 Delayed Healing/Acellular Adjuncts
  • 11.2.2 Direct Closure
  • 11.2.3 Defects Involving the Eyebrow
  • 11.3 Postoperative Management
  • References
  • 12 Introduction to Nose and Simple Nasal Defects
  • 12.1 General Principles of Nasal Reconstruction
  • 12.1.1 Regional Considerations: Upper Two-Thirds versus Lower One-Third of the Nose
  • 12.2 General Techniques for Closure of Simple Nasal Defects
  • 12.2.1 Secondary Healing
  • 12.2.2 Full-Thickness Skin Grafting
  • 12.2.3 Primary Closure and Local Flaps for Simple Defects
  • 12.3 Seven Local Flap Options
  • 12.3.1 Primary Closure
  • 12.3.2 Note Flap
  • 12.3.3 Bilobed Flap
  • 12.3.4 Dorsal Nasal Flap
  • 12.3.5 V-Y Advancement Flap
  • 12.3.6 Melolabial Flap
  • 12.3.7 Postoperative Management
  • References
  • 13 Complex Nasal Defects
  • 13.1 General Principles in Complex Nasal Defects and Reconstruction
  • 13.1.1 Nasolabial Flaps
  • 13.1.2 Forehead Flaps
  • 13.2 Special Considerations: Three-Stage Forehead Flap
  • 13.2.1 Special Considerations: Lining and Cartilage Support
  • 13.2.2 Postoperative Management
  • 13.3 Free Tissue Transfer
  • 13.3.1 Potential Approaches
  • 13.3.2 Technique
  • 13.4 Problems and Complications
  • References
  • 14 Nasal Reconstruction Based on Subunits
  • 14.1 Algorithm for Closure
  • 14.1.1 Sidewall
  • References
  • 15 Eyelid Reconstruction
  • 15.1 Anatomical Considerations
  • 15.2 Algorithm for Closure
  • 15.3 Defects Involving the Canthus
  • 15.3.1 Medial Canthal Defects
  • 15.3.2 Lateral Canthal Defects
  • 15.4 Defects Not Involving the Canthus
  • 15.4.1 Upper and Lower Eyelid: Partial-Thickness Defects
  • 15.4.2 Upper and Lower Eyelid: Full-Thickness Defects
  • References
  • 16 Cheek Reconstruction
  • 16.1 Algorithm for Closure
  • 16.1.1 General Considerations
  • 16.1.2 Commonly Applied Methods of Closure
  • 16.2 Primary Closure
  • 16.3 V-Y Advancement Flap
  • 16.4 Perialar Crescentic Advancement Flap
  • 16.5 Cervicofacial Advancement Flaps
  • 16.6 Full-Thickness Skin Grafts
  • 16.7 Postoperative Management.
  • References
  • 17 Chin Reconstruction
  • 17.1 Algorithm for Closure
  • 17.2 Commonly Applied Methods of Closure
  • 17.2.1 Primary Closure
  • 17.2.2 Bilobed Flaps
  • 17.3 V-Y Advancement Flap
  • 17.4 Full-Thickness Skin Grafts
  • 17.5 Postoperative Management
  • References
  • 18 Lip Reconstruction
  • 18.1 Algorithm for Closure
  • 18.1.1 Anatomy
  • 18.2 Commonly Applied Methods of Closure
  • 18.2.1 Mucosal-Only Defects
  • 18.3 Skin-Only Defects.
  • 18.3.1 Direct Closure
  • 18.4 Combined Skin and Mucosal Defects
  • 18.4.1 Direct Closure with or withoutWedge Resection
  • 18.4.2 Central Defects of the Upper Lip: Abbe and Rotation Flaps
  • 18.4.3 Lateral Commissure Defects: Advancement Closure
  • 18.4.4 Large Defects of the Upper or Lower Lip: Karapandzic Flap
  • 18.4.5 Upper and Lower Lip Mismatch: AlloDerm Placement
  • 18.5 Postoperative Management
  • References
  • 19 Ear Reconstruction
  • 19.1 Algorithm for Ear Reconstruction
  • 19.1.1 Anatomical Considerations
  • 19.2 Commonly Applied Methods of Closure
  • 19.2.1 Secondary Closure
  • 19.2.2 Full-Thickness Skin Grafting
  • 19.2.3 Local FlapWedge or Local Flap Closure
  • 19.2.4 Folded Postauricular Two-Stage Ear Flap Reconstruction (Dieffenbach Flap)
  • 19.2.5 Postoperative Care
  • 19.3 Total Ear Reconstruction
  • 19.3.1 Medpor Technique
  • 19.3.2 General Operative Setup
  • 19.3.3 Procedure Details
  • 19.3.4 Dressings
  • References
  • Part 3: Management of Complications and Revisions
  • 20 Intraoperative Complications and Initial Management
  • 20.1 General Principles.
  • 20.1.1 A Note on Patient Consent
  • 20.2 Intraoperative Complications
  • 20.2.1 Fire
  • 20.2.2 Bronchospasm
  • 20.2.3 Perioperative Anaphylaxis
  • 20.2.4 Corneal Injuries
  • 20.2.5 Nerve Injury
  • References
  • 21 Management of Complications in the Acute Healing Stage
  • 21.1 General Principles
  • 21.1.1 Hematoma
  • 21.1.2 Infection
  • 21.1.3 Dermatitis
  • 21.1.4 Chondritis
  • 21.1.5 Flap Failure
  • References
  • 22 Management of Complications in the Late Healing Stage
  • 22.1 General Considerations
  • 22.1.1 Hypo- and Hyperpigmentation
  • 22.1.2 Contour Abnormalities
  • 22.1.3 Cancer Recurrence
  • References
  • 23 Skin Graft Revisions
  • 23.1 General Principles
  • 23.1.1 Initial Postoperative Visit
  • 23.1.2 Unacceptable Color Match or Scar Contour
  • 23.1.3 Dermabrasion
  • References
  • 24 Local Flap Revisions
  • 24.1 Complications and Their Management
  • 24.1.1 Noninvasive Management
  • 24.1.2 Revision Surgery
  • 24.1.3 Z-Plasty
  • References
  • 25 Pedicled Flap Revisions
  • 25.1 Introduction
  • 25.2 General Principles
  • 25.2.1 Early Healing Stage.
  • 25.2.2 Contour Abnormalities and Late Healing Stage Revisions
  • 25.2.3 Autologous Fat Grafting
  • References
  • Index

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