Handbook of Lower Extremity Reconstruction: Clinical Case-Based Review and Flap Atlas

✍ Scribed by Scott T. Hollenbeck (editor), Peter B. Arnold (editor), Dennis P. Orgill (editor)

• Publisher: Springer
• Year: 2020
• Tongue: English
• Leaves: 313
• Category: Library

✦ Synopsis

This focused, concise book offers an in-depth analysis of lower extremity reconstruction alongside region-specific photos and illustrations. As an anatomical atlas, it seeks to aid the visual learner in showcasing the key steps in setting up and raising the flap for a given defect.

Organized into two sections, opening chapters are arranged by general location, focusing specifically on the lower limb. Each general location of a wound is accompanied by an examination of relevant anatomy, including blood supply, nerve supply, arc of rotation of the tissue, and local flap options. Following a description of the anatomy, subsequent paragraphs explain the application of relevant local flap options. Section two incorporates flap demonstration and application into each chapter, offering a more detailed description, true and specific to each anatomical site of the technique.
Supplemented by high-quality images and figures, Handbook of Lower Extremity Reconstruction: Clinical Case-Based Review and Flap Atlas is an invaluable reference for practicing plastic and orthopedic surgeons and residents in training.

✦ Table of Contents

Preface
Acknowledgments
Contents
Contributors
Part I: Clinical
Chapter 1: Introduction to Lower Extremity Reconstruction: Historical Perspectives, Advances in the Field, and the Future
Background
Historical Perspectives
Advances in the Field
Future Directions
References
Chapter 2: Essential Anatomy of the Lower Extremity
The Thigh
Thigh Skeletal Structure
Thigh Fascial Layers
Thigh Musculature
Thigh Vascular System
Thigh Innervation
The Leg
Leg Skeletal Structure
Leg Fascial Layers
Leg Musculature
Leg Vascular System
Leg Innervation
The Ankle and Foot
Ankle and Foot Skeletal Structure
Ankle and Foot Fascial Layers
Foot Musculature
Foot and Ankle Vascular System
Foot and Ankle Innervation
The Venous Anatomy of the Lower Extremity
References
Chapter 3: The Traumatized Leg
Acute Trauma Principles
Compartment Pressure Evaluation and Treatment
Vascular and Orthopedic Intervention
Osteomyelitis
Deciding Between Limb Amputation vs. Salvage
Timing of Reconstruction
Complications and Pitfalls
Conclusion
References
Chapter 4: Orthopaedic Principles of Lower Extremity Injuries
Fracture Fixation
Osseous Healing
External Fixation in the Setting of Acute Trauma
Bone Loss after Trauma
Bone Reconstruction: Small-Scale Defects
Bone Reconstruction: Large-Scale Defects
Summary
References
Chapter 5: Reconstruction of Oncologic Defects
General Principles
Bony Reconstruction
Soft Tissue Reconstruction
Muscular Reconstruction
Arterial and Venous Reconstruction
Nerve Reconstruction
Dead Space Reconstruction, Prosthesis Coverage, and Cutaneous Reconstruction
Postoperative Care
Summary
References
Chapter 6: Reconstruction of the Diabetic Limb
Scope of the Problem
The Singularity of the Diabetic Foot
Diabetic Vasculopathy
Preoperative Evaluation of Flow and Tissue Perfusion
Management of Infection and Inflammation
Serial Surgical débridement with Tissue Culture
The Use of Antibiotics
The Timing of Flap Coverage After Vascular Intervention
The Timing of Flap Coverage After Infection Control
Soft Tissue Reconstruction
Recipient Vessel Selection
Flap Selection
Microanastomosis and Vessel Insetting
Selection of Patients
Summary
References
Chapter 7: Technological Advances to Simplify Lower Extremity Reconstruction
Introduction
Negative Pressure Wound Therapy (NPWT) Devices
Tape Dermatogenesis and Tissue Expansion
Bioengineered Skin
Placenta-Derived Constructs
Dermal Scaffolds
Summary
Chapter 8: Flap Principles Applied to Lower Extremity Reconstruction
Muscle vs. Fasciocutaneous Flaps
Flap Timing
Local vs. Free Flaps
Overall Free Flap Approach
Technical Considerations for Free Flaps
Postoperative Care
References
Chapter 9: Local Skin Flaps for Lower Extremity Wounds
Perfusion of the Skin
Principles of Skin Flaps
Delay Principles: Skin and Vascular
Perforator Flaps
Reverse Flaps
Geometric Design of Flaps
Summary
References
Chapter 10: Principles of Local Muscle Flaps for Lower Extremity Wounds
Principles of Muscle Flaps
Mathes and Nahai Muscle Classification
Pedicled Muscle Flap
Upper Leg
Lower Leg
References
Chapter 11: Soft Tissue Reconstruction of the Thigh
Thigh Anatomy and Function
Free Flaps Versus Local Flaps
Local Flaps for the Hip
Local Flaps for Groin Reconstruction
Local Flaps for the Upper Knee
Summary
References
Chapter 12: Knee and Proximal Lower Leg Wounds
Knee Anatomy and Function
Muscle and Fasciocutaneous Flaps
Free Tissue Transfer
Injuries of the Extensor Mechanism
Postoperative Care and Complications
Summary
References
Chapter 13: Soft Tissue Reconstruction of the Middle Third of the Leg
Leg Anatomy and Function
Muscle and Fasciocutaneous Flaps
Perforator Flaps for the Medial Third of the Leg
Free Tissue Transfer
Summary
References
Chapter 14: Soft Tissue Reconstruction of the Distal Third of the Lower Extremity
Relevant Surgical Anatomy of the Lower Leg
Free Flaps Versus Local Flaps
Local and Regional Flaps
Free Tissue Transfer
Postoperative Care
Summary
References
Chapter 15: Soft Tissue Reconstruction of the Foot
Foot Anatomy and Function
Free Flaps Versus Local Flaps
Local and Regional Flaps for the Heel
Free Flaps for the Heel
Flaps for the Dorsal Foot
Postoperative Care
Summary
References
Chapter 16: Amputation Principles and Targeted Muscle Reinnervation
Fundamentals of Amputation
Level of Amputation
Soft Tissue Management
Multidisciplinary Care
Fundamentals of Targeted Muscle Reinnervation (TMR)
Technical Pearls of TMR
Hip Disarticulation
Above-Knee Amputation (Transfemoral Amputation)
Below-Knee Amputation (Transtibial Amputation)
Amputations of the Foot
Summary
References
Part II: Flap Atlas
Chapter 17: Soft Tissue Reconstruction of the Medial Thigh and Groin
Overview of the Sartorius Flap
Markings for the Sartorius Flap
Sartorius Flap Elevation
Wound Closure
Overview of the Gracilis Flap
Markings for the Gracilis Flap
Gracilis Flap Elevation
Wound Closure
Overview of the Rectus Femoris Flap
Markings for the Rectus Femoris Flap
Rectus Femoris Flap Elevation
Wound Closure
Overview of the ALT Flap
Markings for the ALT Flap
ALT Flap Elevation
Wound Closure
References
Chapter 18: Soft Tissue Reconstruction of the Lateral Thigh and Hip
Overview of the Tensor Fascia Lata (TFL) Flap
Markings for the TFL Flap
TFL Flap Elevation
Wound Closure
Overview of the Anterolateral Thigh (ALT) Flap
Markings for the ALT Flap
ALT Flap Elevation
Wound Closure
Suggested Reading
Chapter 19: Soft Tissue Reconstruction of the Distal Thigh and Proximal Knee
Overview of the Saphenous Flap
Markings for the Saphenous Flap
Saphenous Flap Elevation
Wound Closure
Overview of the Medial and Lateral Thigh Propeller Flap
Markings for the Medial Thigh Propeller Flap
Medial Thigh Propeller Flap Elevation
Wound Closure
Overview of the Reverse Anterolateral Thigh (ALT) Flap
Markings for the Reverse ALT Flap
Reverse ALT Flap Elevation
Wound Closure
References
Chapter 20: Soft Tissue Reconstruction for the Knee and Proximal Tibia
Overview of the Gastrocnemius and Medial Sural Artery Perforator (mSAP) Flap
Markings for the Gastrocnemius and mSAP Flap
Gastrocnemius Flap Elevation
Wound Closure
References
Chapter 21: Soft Tissue Reconstruction of the Middle Third of the Tibia
Soleus Flap
Markings for the Soleus Flap
Soleus Flap Elevation
Wound Closure
Tibialis Anterior Flap
Markings for the Tibialis Anterior Flap
Elevation of the Tibialis Anterior Flap
Wound Closure
References
Chapter 22: Soft Tissue Reconstruction of the Distal Third Tibia
Overview of the Reverse Sural Artery Flap
Markings for the Reverse Sural Flap
Reverse Sural Flap Elevation
Wound Closure
Overview of Local Transposition and Rotational Flaps
Bipedicled Flap
Propeller Flap
Keystone Flap
Wound Closure
References
Chapter 23: Soft Tissue Reconstruction of the Foot
Dorsal Wounds
Dorsalis Pedis Flap
Markings for the Dorsalis Pedis Flap
Dorsalis Pedis Flap Elevation
Wound Closure
Wounds of the Heel
Medial Plantar Flap
Markings for the Medial Plantar Flap
Medial Plantar Flap Elevation
Flexor Digitorum Brevis Flap
Markings for the Flexor Digitorum Brevis Flap
Flexor Digitorum Brevis Flap Elevation
Wound Closure
References
Chapter 24: Recipient Vessels for Lower Extremity Free Flap Reconstruction
Overview of the Medial Thigh
Overview of the Lateral Thigh and Lateral Circumflex Femoral Vessels
Overview of the Distal Thigh and Knee
Overview of the Anterior Lower Leg
Overview of the Medial Lower Leg
Suggested Reading
Index