Reconstructive Microvascular Surgery

1 Technique of Microvascular Surgery and Preliminary Experimental Studies.- I. Development of Microvascular Surgery.- II. Technical Equipment.- 1. Operating Microscope.- 2. Accessories and Documentation.- 3. Operating Seats.- 4. Instruments.- 5. Suture Material.- III. Experimental Microvascular Surgery.- IV. Suture Technique in Microvascular Surgery.- 1. Preliminary Remarks.- 2. End-to-End Anastomosis.- 3. End-to-Side Anastomosis.- V. Complications of Microvascular Suture.- 1. Assessment of Microvascular Anastomosis.- 2. Patency Test.- 3. Microthrombectomies.- 4. Micro-vein Grafts.- a) Indications for Micro-vein Grafts.- b) Donor Sites for Micro-vein Grafts.- c) Rules for Micro-vein Grafts.- VI. Micromorphological Evidence at the Site of Anastomosis in Small Vessels.- VII. Medical Prophylaxis and Treatment of Vessel Thrombosis and Spasm.- 1. Local Measures.- 2. Systemic Measures.- References.- 2 Clinical Microvascular Surgery.- A Replantation with Microvascular Anastomosis (micro-replantation).- I. Definitions and Nomenclature.- 1. Replantation.- 2. Amputation.- 3. Total Amputation.- 4. Subtotal Amputation.- 5. Revascularisation.- 6. Replantation: Macro- and Micro-replantation.- II. Classification of Amputations in the Hand.- III. Indications for Replantation.- IV. Guide-lines for the Primary Treatment of Amputation Injuries.- V. Replantation Technique.- 1. Wound Debridement.- 2. Bone Shortening.- 3. Osteosynthesis.- 4. Suturing of the Flexor Tendon and Tendon Sheath.- 5. Arterial Anastomosis.- 6. Nerve Suturing.- 7. Management of the Extensor Tendon Apparatus.- 8. Vein Anastomosis.- 9. Skin Closure.- 10. Dressings.- 11. Medicinal Treatment.- VI. Considerations of Differing Levels and Mechanisms of Amputation.- 1. Levels of Amputation in the Hand.- 2. Guillotine Amputations.- 3. Crushing Injuries.- 4. Severe Crushing and Combination Injuries with Damage to the Amputated Part.- 5. Avulsion Injuries.- 6. Degloving Injuries.- VII. Primary Replacement of Destroyed Phalangeal Joints.- VIII. Primary Finger Transplantation.- IX. Post-operative Management.- X. Physical Management.- XI. Secondary Operations.- XII. Results.- XIII. Microreplantation of Other Parts of the Body - (e.g., toes, ears, scalping injuries, and penile amputations).- XIV. Replantation Service.- B Tissue Transplantation with Microvascular Anastomosis.- I. Development of Tissue Transplantation Using Microvascular Anastomosis.- II. Definitions and Nomenclature.- III. Indications for Free Tissue Transplantation.- IV. Preparations for Tissue Transplantation.- V. Operating Technique.- 1. General Operative Plan.- 2. Medicinal Treatment.- 3. Post-operative Treatment and Supervision.- 4. Complications.- VI. Free Flap Transplantation.- 1. Development.- 2. Advantages and Disadvantages of Free Flap Transplantation.- 3. Special Requirements for Free Flap Transplantation.- 4. Donor Sites.- a) Groin Flaps (fat flap, iliac flaps).- b) Dorsalis Pedis Flaps (interdigital fold flap, toe pulp flap).- c) Delto-Pectoral Flap.- d) Temporal Flaps.- e) Axillary Flaps.- f) Retro-Auricular Flaps.- VII. Combined Skin and Muscle Flap Transplantation (musculo-cutaneous flaps).- VIII. Combined Skin Flap with Bone Transplantation (osteocutaneous flaps).- IX. Bone Transplantation.- X. Muscle Transplantation.- XI. Transplantation of the Omentum.- XII. Toe Transplantation.- References.