Facial Reconstruction After Mohs Surgery

 

Description:

Facial Reconstruction after Mohs Surgery

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.

 

Table of Contents:

 

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 without Wedge 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 Flap Wedge 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

 

 

An aparitie	7 Feb. 2018
Autor	James Thornton, Jourdan Carboy
Dimensiuni	27.94 x 21.59 cm
Editura	Thieme Medical Publisher
Format	Hardcover
ISBN	9781626237346
Limba	Engleza
Nr pag	228