Introduction Peripheral nerve injuries are common and can be functionally devastating. Improved understanding of nerve topography, injury, and regeneration has led to advances in peripheral nerve surgery and increased treatment options for our patients. Traditionally, when a tensionless repair cannot…
Introduction More than 89 upper extremities and 30 face transplants have been performed worldwide since 1998, proving that vascularized composite allotransplantation (VCA) is technically feasible and guarantees long-term survival under currently available immunosuppressive regimens. VCA is not a lifesaving procedure,…
Introduction Composite tissue allotransplantation (CTA) involves transplantation of various complex tissues embryologically derived from different layers that can include musculoskeletal structures (nerve, bone, muscle, etc.), skin and mucosa, and their adnexal extensions. These differ from well-known solid organ allotransplantations, which…
Introduction Hand and upper extremity transplantation is the most common form of vascularized composite allotransplantation (VCA) or reconstructive transplantation and has evolved from a procedure only performed at the distal forearm level to a procedure now being performed above the…
Introduction The notion of drastically improving the treatment of catastrophic facial injuries, regardless of the cause, has motivated surgeons to pursue the development of facial transplantation in addition to other types of vascularized composite allotransplantation (VCA) over the past few…
Introduction The purpose of this chapter is to discuss the general principles, challenges, and opportunities in establishing a reconstructive transplant program. The authors bring the experience of two centers in two different countries with significantly differing healthcare systems: the United…
Introduction Reconstructive surgery has, as its premise, the principle of restoring form and function utilizing surrounding or distant tissues while minimizing morbidity at the donor site. While muscle flaps remain a viable option for reconstructive surgery, their use has become…
Figure 61.1 Posterior tibial artery perforator flap. Open full size image Introduction In the field of reconstructive surgery, not a day goes by without a skin flap being used. The earliest description of skin flaps was by Sushruta in 600…
Figure 60.1 Tensor fascia lata perforator flap. Open full size image Introduction The tensor fascia lata (TFL) flap is one of the well-known flaps with a reliable and constant pedicle. This flap has served as a workhorse flap for a…
Figure 59.1 (Left) Anterolateral thigh flap; (Right) Anteromedial thigh flap. Open full size image Introduction In 1984, Song and colleagues introduced the anterolateral thigh flap based on septocutaneous branches of the descending branch of the lateral circumflex femoral artery. Since…