UID:
almafu_9961151248502883
Umfang:
1 online resource (272 pages)
Ausgabe:
1st ed.
ISBN:
3-13-243702-6
,
3-13-242018-2
Inhalt:
A systematic approach to Mohs surgery and reconstruction from renowned skin cancer surgeons More than 5.4 million cases of nonmelanoma skin cancer, most notably basal cell, squamous cell carcinoma, and melanoma, occur annually in the United States alone. The Mohs technique, developed in the 1950s and refined over the years, has the highest cure rate of any treatment for nonmelanoma skin cancer, is used increasingly for melanoma, and the lowest recurrence rate. Mohs Micrographic Surgery: From Layers to Reconstruction by renowned dermatologic and Mohs surgeons Christopher Harmon and Stanislav Tolkachjov provides a detailed yet succinct road map to learning and mastering Mohs and reconstruction. The algorithmic organization coupled with instructive photographs and illustrations provide a reader-friendly format conducive to learning. The two opening chapters describe the principles of Mohs surgery including: progressive layer excision to determine if wound margins are cancer free, associated pitfalls, recurrences, special sites, reconstructive principles, and general considerations. The subsequent eight chapters are organized by facial site, from the nose to the eyelid/eyebrow. The final two chapters discuss combination reconstructions stretching over multiple subunits and perioperative management and wound care. Key Highlights An impressive group of global Mohs and reconstruction experts provide firsthand pearls that guide optimal treatment Relevant anatomical aspects that impact excision and reconstruction are detailed, including structures, skin tension lines, tissue planes, and dangers zones More than 20 procedural videos provide hands-on guidance on how to perform specific steps in Mohs and reconstruction This unique resource will help residents, fellows, and surgeons in dermatology, plastic surgery, and facial plastic surgery master
Inhalt:
nuances of Mohs reconstructive techniques to achieve the most functional and aesthetically pleasing outcomes for patients.
Anmerkung:
Mohs Micrographic Surgery: From Layers to Reconstruction -- MedOne Access Information -- Title Page -- Copyright -- Dedication -- Contents -- Videos -- Foreword -- Preface -- Acknowledgments -- Contributors -- 1 Mohs Micrographic Surgery -- 1.1 Before the First Stage -- 1.1.1 Tumor Selection -- 1.1.2 Documentation of Site -- 1.1.3 Time-Out -- 1.2 Procedures before the First Stage -- 1.2.1 Curettage -- 1.2.2 Sharp Debulking -- 1.3 The First Stage -- 1.3.1 Essentials of the First Stage -- 1.3.2 Incomplete Excision and Recurrence -- 1.4 Tissue Processing -- 1.4.1 Tissue Transfer -- 1.4.2 Relaxing Incisions and Dividing -- 1.4.3 Tissue Inking -- 1.5 Histologic Interpretation/Mapping -- 1.5.1 Initial Slide Quality Review -- 1.5.2 Histologic Interpretation -- 1.5.3 Tissue Mapping -- 1.6 Subsequent Layers -- 1.6.1 Subsequent Layers When Malignancy is Present Only in the Deep Tissue -- 1.7 Nonstandard Situations -- 1.8 Mohs Layers in Special Sites -- 1.8.1 Eyelid -- 1.8.2 Lip -- 1.8.3 Ear -- 1.8.4 Nose -- 1.8.5 Periosteum/Bone -- 1.8.6 Nail -- 1.8.7 Anogenital Region -- 2 Facial Subunit Reconstructive Principles and General Considerations -- 2.1 Design Principles of Facial Reconstruction -- 2.1.1 Overview -- 2.1.2 Free Margins -- 2.1.3 Contour -- 2.1.4 Cosmetic Subunit Junction Lines -- 2.1.5 Relaxed Skin Tension Lines -- 2.1.6 Color and Texture -- 2.2 Principles of Tissue Biomechanics -- 2.2.1 Overview -- 2.2.2 Preferred Vectors to Move Facial Tissue -- 2.2.3 How Different Reconstructions Affect Location of Tension Relative to the Primary Defect -- 2.2.4 Tissue Planes for Undermining and Elevating Flaps -- 2.3 Key Principles of Anatomy -- 2.3.1 Overview -- 2.3.2 Blood Supply to the Face -- 2.3.3 Superficial Musculoaponeurotic System -- 2.4 Systematic Approach to Assessing Facial Wounds and Choosing Reconstruction -- 2.4.1 Overview.
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2.4.2 Define What Is Missing -- 2.4.3 Prioritize Principles for Reconstruction Design -- 2.4.4 Choose among Reconstruction Options -- 2.5 Reconstruction Options for Facial Reconstruction -- 2.5.1 Overview -- 2.5.2 Second Intention Healing -- 2.5.3 Linear Closure -- 2.5.4 Skin Grafts -- 2.5.5 Sliding Flaps -- 2.6 Conclusion -- 3 Nose -- 3.1 Introduction -- 3.2 Anatomy -- 3.3 Nasal Tip -- 3.3.1 Second Intention Healing -- 3.3.2 Primary Closure -- 3.3.3 Bilobed Flap -- 3.3.4 Dorsal Nasal (Rieger's) Flap -- 3.3.5 Forehead Flap -- 3.3.6 Prelaminated and Prefolded Forehead Flap -- 3.3.7 Conchal Bowl Full-Thickness Skin Graft -- 3.4 Nasal Ala -- 3.4.1 Second Intention -- 3.4.2 Grafts -- 3.4.3 Medial-Based Bilobed Flap -- 3.4.4 Spiral Flap -- 3.4.5 Cheek-to-Nose Interpolation Flap -- 3.4.6 Spear Flap -- 3.4.7 Technique -- 3.5 Soft Triangle/Columella -- 3.5.1 Turnover Flap -- 3.5.2 Nasal Tip Rotation Flap -- 3.6 Nasal Dorsum -- 3.7 Nasal Root/Lower Glabella -- 3.8 Nasal Sidewall -- 3.8.1 Rhombic Transposition Flap -- 3.8.2 Superior-Based Bilobed Flap -- 3.8.3 Lateral-Based Rotation Flap/Crescentic Advancement Flap/Cheek-Based Burow's Advancement Flap -- 3.8.4 V-Y Flap -- 3.8.5 Single-Stage Nasolabial Flap -- 3.9 Complications and Revisions -- 4 Forehead and Temple Reconstruction -- 4.1 Forehead and Temple Anatomy -- 4.1.1 Boundaries of the Forehead and Temple Subunits -- 4.1.2 Muscles of the Forehead and Temple -- 4.1.3 Blood Supply to the Forehead and Temple -- 4.2 Preservation of Sensory and Motor Function -- 4.2.1 Sensory Function -- 4.2.2 Motor Function -- 4.3 Achieving Reproducibly Excellent Cosmetic Results -- 4.4 Evaluating Wounds on the Forehead and Temple -- 4.5 Reconstruction Options for the Forehead and Temple -- 4.5.1 Second Intention -- 4.5.2 Linear Closure -- 4.5.3 Local Flaps -- 4.5.4 Sliding Flaps -- 4.5.5 Transposition Flaps.
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4.5.6 Skin Grafts -- 4.6 Complications -- 4.7 Conclusion -- 5 Scalp -- 5.1 Relevant Anatomy -- 5.1.1 Skin -- 5.1.2 Subcutis -- 5.1.3 Galea Aponeurotica -- 5.1.4 Subgaleal Loose Connective Tissue -- 5.1.5 Periosteum -- 5.2 Reconstructive Options -- 5.2.1 Algorithm for Scalp Reconstruction -- 5.2.2 Second Intention Healing -- 5.2.3 Skin Grafts -- 5.2.4 Local Flaps -- 5.3 Complications -- 6 Cheek -- 6.1 Introduction -- 6.2 Relevant Anatomy -- 6.3 Aesthetic Subunits and Defects -- 6.4 Reconstructive Options -- 6.4.1 Primary Closures -- 6.4.2 Flaps -- 6.4.3 Second Intention Healing -- 6.4.4 Full-Thickness Skin Graft -- 6.5 Complications and Revisions -- 7 Auricular Reconstruction -- 7.1 Introduction -- 7.2 Relevant Anatomy -- 7.3 Reconstructive Options -- 7.3.1 Superior Helix -- 7.3.2 Mid Helix -- 7.3.3 Lobule -- 7.3.4 Antihelix -- 7.3.5 Concha -- 7.3.6 Tragus -- 7.3.7 Remainder of the Posterior Ear -- 7.4 Complications and Revisions -- 8 Lip (Perioral) Reconstruction -- 8.1 Introduction -- 8.2 Cosmetic Subunits and Relevant Anatomy -- 8.3 Reconstructive Algorithm -- 8.3.1 Vermilion -- 8.3.2 Cutaneous Lateral Upper Lip -- 8.3.3 Philtrum -- 8.3.4 Cutaneous Lower Lip -- 8.4 Complications and Revisions -- 9 Chin Reconstruction -- 9.1 Relevant Anatomy -- 9.2 Aesthetic Subunits and Defects -- 9.3 Reconstructive Options -- 9.3.1 Algorithm -- 9.3.2 Healing by secondary intention -- 9.3.3 Primary closure -- 9.3.4 Bilateral Advancement (O-T flap) -- 9.3.5 V-Y Advancement Flap -- 9.3.6 Rotation flaps -- 9.3.7 Transposition flaps -- 9.3.8 Full-Thickness Skin Grafts -- 9.4 Complications and Revisions -- 10 Reconstruction of the Eyelids and Eyebrows -- 10.1 Introduction -- 10.2 Surgical Anatomy of the Eyelids and Eyebrows -- 10.2.1 Superficial Topography of the Lids and Eyebrows -- 10.2.2 Orbicularis Oculi Muscle (OOM).
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10.2.3 Orbital Septum (OS) and Postseptal Fat Compartments -- 10.2.4 Tarsoligamentous Sling -- 10.2.5 Eyelid Retractors -- 10.2.6 Conjunctiva -- 10.2.7 Lacrimal System -- 10.2.8 Neurovascular and Lymphatic System of the Lids -- 10.2.9 Orbit -- 10.2.10 Eyebrow Anatomy -- 10.3 Principles and Aims of Periocular Reconstruction -- 10.4 Perioperative Surgical Tips, Instrumentations, and Sutures in Periocular Reconstruction -- 10.5 Surgical Assessment of the Periocular Defect and Reconstruction Guidelines -- 10.6 Secondary Intention Healing -- 10.7 Grafts in Periocular Reconstruction -- 10.8 Repair of Superficial Nonmarginal Eyelid Defects -- 10.9 Reconstruction of the Full-Thickness Eyelid Defects -- 10.9.1 Primary Closure of the Full-Thickness Defects of the Eyelids -- 10.9.2 Semicircular Flap (Tenzel) -- 10.9.3 Tarsoconjunctival Flap for Lower Eyelid Reconstruction (Hughes Flap) -- 10.9.4 Tarsal Transposition Flap for Lateral Upper Eyelid Reconstruction -- 10.9.5 Cutler-Beard Flap for Complete Upper Eyelid Reconstruction -- 10.10 Lower Lid Tightening Procedures -- 10.11 Wound Dressing and Postoperative Care in Periocular Surgery Patients -- 10.12 Lacrimal Canalicular System Assessment and Reconstruction -- 10.13 Complications of Eyelid Reconstructions -- 10.14 Aims and Principles of Eyebrow Reconstruction -- 10.14.1 Primary Closure of Brow Defects -- 10.14.2 Advancement Flaps -- 10.14.3 Island-Pedicle Flaps -- 10.14.4 Transposition Flaps -- 10.14.5 Pedicle Flaps -- 10.14.6 Free Hair-Bearing Grafts (Composite Grafts-Skin and Hair) -- 10.15 Conclusion -- 11 Combination Reconstruction -- 11.1 Introduction -- 11.2 Combination of Primary and Graft Reconstruction -- 11.2.1 Arm/Hand -- 11.2.2 Temple -- 11.2.3 Cheek -- 11.3 Combination of Flap and Graft Reconstruction -- 11.3.1 Lateral Infraocular Cheek -- 11.3.2 Periauricular Cheek/Ear.
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11.3.3 Upper Cutaneous Lip/Philtrum/Alar Sill -- 11.3.4 Medial Cheek/Nasal Sidewall -- 11.3.5 Forehead/Temple -- 11.3.6 Large Nasal Defects -- 11.4 Combination of Flaps for Reconstruction of Single and Multiple Defects -- 11.4.1 Large Nasal Defects -- 11.4.2 Lip -- 11.5 Reconstruction of Multiple Defects -- 11.5.1 Multiple Defects Repaired as One -- 11.5.2 "West by East-West" -- 11.5.3 O-T Advancement Flap, Scalp/Forehead Rotation Flap, and Paramedian Forehead Flap -- 11.5.4 "Combo-Z" Flap -- 11.5.5 Multiple Defects Repaired with Burow's Grafts -- 11.5.6 The "Kitchen Sink": When Combination Reconstruction and Granulation Gets Us Out of a Jam -- 11.6 Summary -- 12 Perioperative Management and Wound Care -- 12.1 Preoperative Considerations -- 12.1.1 Antibiotic Prophylaxis -- 12.1.2 Anticoagulants -- 12.1.3 Conscious Sedation/Analgesia -- 12.1.4 Implantable Devices -- 12.2 Postoperative Care -- 12.2.1 Granulation/Second-Intention Healing -- 12.2.2 Porcine Xenografts and Biologic Dressings -- 12.2.3 Bolster Sutures -- 12.2.4 Postdermabrasion Care -- 12.2.5 Postprimary Closure on the Lower Extremity -- 12.2.6 Postflap Care -- 12.3 Hematoma Management -- 12.4 Infection Management -- 12.4.1 Infection -- 12.4.2 Antimicrobial Selection -- 12.5 Pain Management -- Index -- Additional MedOne Access Information.
Weitere Ausg.:
Print version: Harmon, Christopher B. Mohs Micrographic Surgery: from Layers to Reconstruction NEW YORK : Thieme Medical Publishers, Incorporated,c2022 ISBN 9783132420175
Sprache:
Englisch
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