Flaps and Reconstructive Surgery

Flap Re-exploration and Salvage

Introduction Achieving success in microvascular free tissue transfers requires more than the technical ability to proficiently perform microvascular anastomoses. Preoperative planning, choice of recipient vessels, intraoperative execution of dissection, elevation and insetting, along with postoperative monitoring are all equally important…

Avoiding Complications

Introduction It is something of a dent to personal pride to be singled out among so many internationally distinguished contributors to write a chapter on complications in microsurgery. How did the editors know we were so experienced in complications? We…

Thinning and Tailoring

Purposes of Skin Flap Surgery The purposes of flap transfer are classified into four categories: surface coverage; volume restoration; framework creation; and functional reconstruction. Category one is surface coverage of the defect without the need for significant thickness. In clinical…

Vessels

Introduction It is more than a century since Alexis Carrel introduced the techniques of vessel repair in 1906. The triangulation technique founded by him was used for the repair of major vessels. The origin of modern microvascular practice is credited…

Nerves

Introduction and Historical Notes The peripheral nervous system (PNS) embodies unique anatomical structure and function that contributes immensely to human quality of life. Through the ages, the importance of the PNS has been recognized, but function and structure were often…

Functional Muscle Transfers for Various Purposes

Introduction Whereas in the past, reconstructive microsurgery mainly consisted of defect coverage by free tissue transfer, today this technique allows a continual integration of improved aesthetic appearance and functional reconstruction. Thus, the main goal of functional reconstructive surgery is to…

Lower Extremity Reconstruction

Introduction In this chapter we present the topic of reconstruction of soft tissue and bone defects in the lower extremity. We present the multiple indications for lower extremity reconstruction and review the decision-making process for proceeding with limb amputation versus…

Adult Brachial Plexus Injury (A-BPI) Reconstruction

Introduction The surgical management of adult brachial plexus injury (A-BPI) reconstruction has evolved substantially over the last century. The advancement of the operative microscope and surgical loupe magnification, micro-instruments and stitches, nerve stimulators, chemistry, molecular biology, and pharmacology has enabled…

Upper Extremity Reconstruction

Introduction The many specialized structures of the hand and upper extremity work in intimate synchrony to provide a harmonious interplay of precision motor biomechanics with fine tactile senses. Our hands are subject to many common occupational and domestic injuries, including…

Pelvic and Urogenital Reconstruction

Introduction Perineal and urogenital reconstruction has particular challenges due to the anatomic and functional complexity and differences between the male and female genitalia. Furthermore, genital defects and abnormalities are associated with psychological and social implications, which must be considered by…