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Decision-Making in Reconstructive Surgery: Upper Extremity by G. Germann

By G. Germann

A new method of methodical and strategic pondering tissue reconstruction. the entire decision-making approaches are damaged down into algorithms in response to the authors' scientific event and the present literature. The atlas part describes the 25 most often used flaps, and indicates them in standardised picture shape in addition to many useful assistance and methods. New here's the inclusion within the illustrations of sensible feedback for the health care professional, in addition to rehabilitation protocols for post-operative administration. in brief, the e-book offers a greatest of data with at least text.

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Additional info for Decision-Making in Reconstructive Surgery: Upper Extremity

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Dynamic instability (Normal plain x-rays, diagnosis made on the basis of stress or motion studies and/or cineradiographs) II. Static (fixed) instability (seen on plain x-rays) III. t - - - - - - - - - Bone Skin Muscle Nerve Tendon Vessels What is required to stabilize patient? What is required to restore function? Is damaged structure essential? Is restoration of function required? I Yes No Anatomic repair Debride with minimal functional loss Structure repair I substitution I Free grafts (non -vascularized) Vascularized tissue transfer Composite tissue transfer Bone pp.

I Yes No Anatomic repair Debride with minimal functional loss Structure repair I substitution I Free grafts (non -vascularized) Vascularized tissue transfer Composite tissue transfer Bone pp. 43 -46, 59 - 61, 70 -83 Tendons pp. 62 -64, 92 -1'4 Vessels pp. 65,66, 116-120 Nerves pp. 67,122-129 Soft tissue pp. 37 -40, 132 -154 Nerve, tendon, artery, vein, bone, skin Is soft tissue coverage required? 10 closure 2 intention healing 0 STSG FSTG Local! regional flap Distant pedicle flap Free flap Rehabilitation Stable skeleton less stable skeleton Unstable skeleton Vigorous motion Delayed physical therapy, less vigorous motion Careful.

67,122-129 Soft tissue pp. 37 -40, 132 -154 Nerve, tendon, artery, vein, bone, skin Is soft tissue coverage required? 10 closure 2 intention healing 0 STSG FSTG Local! regional flap Distant pedicle flap Free flap Rehabilitation Stable skeleton less stable skeleton Unstable skeleton Vigorous motion Delayed physical therapy, less vigorous motion Careful. guided, passive motion General Strategy 37 Skin and Soft Tissue Loss Epidermal Dermal Full thickness (Frequently seen in crush and degloving injuries) Volar Dorsal Volar Dorsal Spontaneous healing or STSG STSG (take rate is acceptable on subcutaneous tissue in the upper extremity) Spontaneous healing If not: Split thickness skin graft (STSG meshed / non meshed) Male Any appropriate donor site Female Preferred donor site: Scalp Buttocks Pubic mound Arch of foot Volar Dorsal Flap coverage If paratenon intact STSG possible If not or if better contour is desired: flap coverage (See pp.

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