Plastic & Hand Surgery in Clinical Practice (eBook)

Preface 6
Acknowledgements 8
Contents 9
Chapter 1 Fundamentals of Plastic Surgery 10
1.1 A “SURGICAL SIEVE” 10
1.2 THE “RECONSTRUCTIVE LADDER” (FIGURE 1.1) 10
1.3 FRAMEWORK FOR ANSWERING A QUESTION 11
1.4 CLASSIFICATION OF SKIN GRAFTS 12
1.5 CLASSIFICATION OF STAGES OF SPLIT SKIN GRAFT TAKE 12
1.6 CLASSIFICATION OF FLAPS: “THE FIVE CS” 13
1.7 CLASSIFICATION OF THEORETICAL LENGTH GAIN DEPENDING ON THE ANGLE OF DESIGN OF A Z-PLASTY 16
1.8 CLASSIFICATION OF FASCIOCUTANEOUS FLAPS: CORMACK AND LAMBERTY (FIGURE 1.9) 17
1.9 CLASSIFICATION OF FASCIAL AND FASCIOCUTANEOUS FLAPS: MATHES AND NAHAI (FIGURE 1.10) 19
1.10 CLASSIFICATION OF MUSCULOCUTANEOUS FLAPS: MATHES AND NAHAI (FIGURE 1.11) 20
1.11 CLASSIFICATION OF VENOUS FLAPS: THATTE AND THATTE (FIGURE 1.12) 20
1.12 CLASSIFICATION OF TYPES OF TRANSPLANT 22
1.13 CLASSIFICATION OF TYPES OF WOUND HEALING 23
1.14 CLASSIFICATION OF PHASES OF WOUND HEALING 23
1.15 CLASSIFICATION OF FACTORS AFFECTING WOUND HEALING 23
1.16 CLASSIFICATION OF TYPES OF WOUND AND ASSOCIATED INFECTION RISK 24
1.17 CLINICAL CLASSIFICATION OF SCARS 24
1.18 CLASSIFICATION OF SCAR ASSESSMENT 25
1.19 CLASSIFICATION OF MUSCLE 25
1.20 CLASSIFICATION OF CARTILAGE 25
1.21 CLASSIFICATION OF SOURCES OF AUTOLOGOUS CARTILAGE GRAFTS 26
1.22 CLASSIFICATION OF BONE TYPE 26
1.23 CLASSIFICATION OF PHASES OF FRACTURE HEALING 26
1.24 CLASSIFICATION OF TYPES OF BONE GRAFT 26
1.25 CLASSIFICATION OF NERVE INJURY 26
1.26 GRADING OF SENSORY RECOVERY (SUMMARY) 27
1.27 MRC GRADING OF MOTOR FUNCTION (SUMMARY) 27
1.28 CLASSIFICATION OF NERVE FIBRE TYPE 28
1.29 CLASSIFICATION OF SUTURES 28
1.30 CLASSIFICATION OF IMPLANT MATERIALS 29
1.31 CLASSIFICATION AND EXAMPLES OF DRESSINGS 29
1.32 ALPHABETICAL CLASSIFICATION OF IDEAL PROPERTIES OF DRESSINGS 29
1.33 CLASSIFICATION OF TISSUE EXPANDER BIOLOGY ACCORDING TO SKIN COMPONENTS 30
1.34 CLASSIFICATION OF TYPES OF TISSUE EXPANDER 30
1.35 TISSUE EXPANDER CAPSULE CLASSIFICATION – PAYSK 30
1.36 MICROSURGERY 30
1.37 CLASSIFICATION OF TYPES OF MICROVASCULAR ANASTOMOSIS 31
1.38 CLASSIFICATION OF FLAP MONITORING METHODS 31
1.39 CLASSIFICATION OF TECHNICAL REASONS FOR FLAP FAILURE 31
1.40 VIRCHOW’S TRIAD 32
1.41 ACLAND’S CLASSIFICATION OF FACTORS INFLUENCING PATENCY OF AN ANASTOMOSIS 32
1.42 OPTIONS FOR FLAP VIABILITY IMPROVEMENT: CLASSIFICATION OF INTERVENTION 32
1.43 LOCAL ANAESTHETICS: CLASSIFICATION ACCORDING TO STRUCTURE 32
1.44 LOCAL ANAESTHETICS: CLASSIFICATION ACCORDING TO LENGTH OF ACTION 32
1.45 AMERICAN SOCIETY OF ANESTHESIOLOGISTS’ PHYSICAL STATUS CLASSIFICATION (ASA GRADE) 33
1.46 LASER 33
1.47 CLASSIFICATION OF CLASSES OF LASER 33
1.48 CLASSIFICATION OF LASER APPLICATIONS IN PLASTIC SURGERY 34
1.49 HAIR 34
Chapter 2 Hand Surgery 37
2.1 CLASSIFICATION SYSTEMS OF CONGENITAL HAND DEFORMITY 37
2.2 CLASSIFICATION OF CONGENITAL LIMB MALFORMATIONS 37
2.3 ANATOMICAL CLASSIFICATION BY ZONE OF EXTENSOR TENDON INJURY (FIG. 2.2) 46
2.4 FLEXOR TENDON INJURY ZONES: VERDAN 48
2.6 CLOSED AVULSION OF FDP: LEDDY AND PACKER 49
2.7 DOYLE’S CLASSIFICATION OF MALLET FINGER INJURY 50
2.8 CLASSIFICATION OF AETIOLOGY OF A FLEXION CONTRACTURE (LIMITATION OF EXTENSION) 50
2.9 NERVE INJURY CLASSIFICATION SYSTEMS 51
2.10 ROLLING BELT INJURY 51
2.11 CLASSIFICATION OF VESSEL INJURY 52
2.12 RING AVULSION INJURY: URBANIAK’S CLASSIFICATION 52
2.13 CLASSIFICATION OF REPLANTATION 52
2.14 CLASSIFICATION OF THUMB AMPUTATION AND RECONSTRUCTIVE OPTIONS 52
2.15 EPIPHYSEAL FRACTURES: SALTER AND HARRIS CLASSIFICATION 54
2.16 CLASSIFICATION OF LONG BONE FRACTURE PATTERNS 54
2.17 SCAPHOID FRACTURE CLASSIFICATION—HERBERT CLASSIFICATION 55
2.18 STAGE OF KIENBOCK’S DISEASE (LICHTMAN) 56
2.19 SCAPHOLUNATE ADVANCED COLLAPSE (SLAC) WRIST 56
2.20 CLASSIFICATION OF TYPES OF ARTHRITIS 56
2.21 PSORIATIC ARTHRITIS CLINICAL CLASSIFICATION: WRIGHT AND MOLL 60
2.22 CLASSIC X-RAY CHANGES OF OSTEOARTHRITIS 61
2.23 CLASSIFICATION OF TRIGGER FINGER 62
2.24 GENERAL CLASSIFICATION OF TUMOURS 62
2.25 DIABETIC STIFF HAND 63
2.26 CLASSIFICATION OF BURN CONTRACTURES OF THE HAND (SEE CHAPTER 11) 63
2.27 CLASSIFICATION OF DUPUYTREN’S CONTRACTURE 63
2.28 CLASSIFICATION OF FIBROMATOSES 64
2.29 VOLKMANN ISCHAEMIC CONTRACTURE 64
2.30 CLASSIFICATION OF SPASTICITY IN CEREBRAL PALSY 64
2.31 CLASSIFICATION OF MECHANISMS OF NERVE COMPRESSION (FIG. 2.7) 65
2.32 CLASSIFICATION OF HAND INFECTIONS 68
2.33 COMPLEX REGIONAL PAIN SYNDROME CLASSIFICATION 69
2.34 CLASSIFICATION OF SPLINTS 69
Chapter 3 Skin and Vascular 70
3.1 FITZPATRICK SKIN TYPE CLASSIFICATION 70
3.2 WORLD CLASSIFICATION OF SKIN TYPE 70
3.3 CLASSIFICATION OF SKIN FUNCTIONS 70
3.4 CLASSIFICATION OF SKIN BLOOD SUPPLY 72
3.5 CLASSIFICATION OF ARTERIAL TERRITORIES 73
3.6 CLASSIFICATION OF SKIN LESIONS 74
3.7 GENERAL CLASSIFICATION OF BENIGN NON-PIGMENTED SKIN LESIONS ACCORDING TO TISSUE OF ORIGIN 74
3.8 CLASSIFICATION OF TYPES OF BENIGN PIGMENTED LESION 74
3.9 CLASSIFICATION OF BASAL CELL CARCINOMA (BCC) 75
3.10 CLASSIFICATION OF DIAGNOSTIC CRITERIA FOR GORLIN’S SYNDROME 75
3.11 CLASSIFICATION OF TREATMENT OPTIONS FOR NON-MELANOMA SKIN CANCER 75
3.12 MALIGNANT MELANOMA CLASSIFICATIONS 75
3.13 CLASSIFICATION OF MALIGNANT MELANOMA ACCORDING TO MORPHOLOGY 76
3.14 TNM STAGING OF MELANOMA 76
3.15 CLASSIFICATION OF SUNBLOCKS 77
3.16 WHO CLASSIFICATION OF SOFT TISSUE TUMOURS 2002 77
3.17 SARCOMA CLASSIFICATION SYSTEMS 77
3.18 ENNEKING CLASSIFICATION OF SARCOMA 78
3.19 SARCOMA CLASSIFICATION BY TISSUE OF ORIGIN 78
3.20 SARCOMA CLASSIFICATION BY “TNMG” (TUMOUR, NODE, METASTASIS, GRADE) 78
3.21 STAGING OF SARCOMA 78
3.22 GRADE OF SOFT TISSUE TUMOUR: TROJANI SCORES FROM 2 TO 8 79
3.23 CLASSIFICATION OF FEATURES OF A SOFT TISSUE LUMP SUGGESTIVE OF MALIGNANCY 79
3.24 CLASSIFICATION OF VASCULAR ANOMALIES 79
3.25 INTERNATIONAL SOCIETY FOR THE STUDY OF VASCULAR ANOMALIES (ISSAV): CLASSIFICATION OF VASCULAR ANOMALIES 80
3.26 CLASSIFICATION OF CONGENITAL HAEMANGIOMA 80
3.27 CLASSIFICATION OF LYMPHATIC MALFORMATIONS 81
3.28 CLASSIFICATION OF HAEMANGIOMA RESOLUTION 81
3.29 SCHOBINGER ARTERIOVENOUS MALFORMATION STAGING CLASSIFICATION 81
3.30 WANER GRADING FOR CAPILLARY MALFORMATION 81
33.31 CLASSIFICATION OF VASCULAR MALFORMATIONS ASSOCIATED WITH OVERGROWTH SYNDROMES 81
Chapter 4 Craniofacial, Cleft Lip and Palate 83
4.1 CRANIOFACIAL ABNORMALITY CLASSIFICATION 83
4.2 FACIAL CLEFTS 84
4.3 CRANIOSYNOSTOSIS 87
4.4 HYPOPLASTIC CONDITIONS 90
4.5 HYPERPLASTIC CONDITIONS 92
4.6 OTHER CRANIOFACIAL SYNDROMES 93
4.7 CLEFTS OF THE LIP AND PALATE 94
Chapter 5 Head and Neck 99
5.1 CLASSIFICATION OF NECK DISSECTION 99
5.2 GENERAL SCHEME FOR CLASSIFICATION OF TUMOURS OF THE HEAD AND NECK IN ADULTS 102
5.3 CLASSIFICATION OF HEAD AND NECK TUMOURS IN CHILDREN 103
5.4 TUMOUR, NODE, METASTASIS (TNM) CLASSIFICATION OF HEAD AND NECK CANCER 103
5.5 STAGING OF HEAD AND NECK CANCER 104
5.6 “S” CLASSIFICATION ORAL CANCER AETIOLOGY 104
5.7 CLASSIFICATION OF ORAL CAVITY TUMOUR APPROACHES 104
5.8 CLASSIFICATION OF RELATIVE INCIDENCE OF SALIVARY GLAND TUMOURS 104
5.9 HISTOLOGICAL CLASSIFICATION OF SALIVARY GLAND TUMOURS 105
5.10 FACIAL PALSY 105
5.12 EAR ABNORMALITIES 107
5.13 OCULOPLASTICS (FIG. 5.4) 109
5.14 NASAL RECONSTRUCTION 117
5.15 LIP RECONSTRUCTION (FIGS. 5.6 AND 5.7) 118
5.16 CHEEK RECONSTRUCTION 120
5.17 MANDIBULAR DEFECT CLASSIFICATION 121
Chapter 6 Facial Fractures 123
6.1 CLASSIFICATION OF FACIAL FRACTURES 123
6.2 LE FORT CLASSIFICATION OF MAXILLARY FRACTURES (FIG. 6.1) 123
6.3 STRANC CLASSIFICATION OF NASAL FRACTURES 125
6.4 ORBITAL FRACTURES (ALSO SEE OCULOPLASTICS SECTION IN CHAPTER 5) 125
6.5 MANDIBULAR FRACTURES 126
6.6 CLASSIFICATION OF PALATAL FRACTURES 127
6.7 ANGLES CLASSIFICATION OF MALOCCLUSION 128
6.8 THE “P SYSTEM” FOR EXAMINATION OF THE HEAD AND NECK 128
6.9 GLASGOW COMA SCALE 129
Chapter 7 Breast 130
7.1 CLASSIFICATION OF CAPSULAR CONTRACTURE FOLLOWING BREAST AUGMENTATION 130
7.2 MODIFIED BAKER CLASSIFICATION IN POST BREAST RECONSTRUCTION PATIENTS 130
7.3 CLASSIFICATION OF APPROACH TO TREATMENT OF CAPSULAR CONTRACTURE 130
7.4 CLASSIFICATION OF BREAST PTOSIS 131
7.5 CLASSIFICATION OF BREAST REDUCTION TECHNIQUES 133
7.6 SIMON’S CLASSIFICATION OF GYNAECOMASTIA BASED ON SURGICAL REQUIREMENT 133
7.7 WEBSTER’S CLASSIFICATION OF GYNAECOMASTIA 133
7.8 HISTOLOGICAL CLASSIFICATION OF GYNAECOMASTIA 134
7.9 LETTERMAN SCHUSTER CLASSIFICATION OF GYNAECOMASTIA 134
7.10 ROHRICH CLASSIFICATION OF GYNAECOMASTIA 134
7.11 CLASSIFICATION OF AETIOLOGY OF GYNAECOMASTIA: 3 “PS” 134
7.12 TUBEROUS BREAST DEFORMITY (ALSO KNOWN AS TUBULAR/CONSTRICTED BREAST DEFORMITY) 134
7.13 BREAST CARCINOMA: WORLD HEALTH ORGANIZATION (WHO) CLASSIFICATION 135
7.14 VAN NUYS PROGNOSTIC INDEX FOR DCIS 136
7.15 CLASSIFICATION OF RELATIVE RISK FACTORS FOR BREAST CANCER IN WOMEN 136
7.16 AMERICAN JOINT COMMITTEE ON CANCER (AJCC) STAGING SYSTEM INCORPORATES CLINICAL AND PATHOLOGICAL FACTORS INTO TUMOUR CLASSIFICATION 136
7.17 AMERICAN COLLEGE OF RADIOLOGY BREAST IMAGING REPORTING AND DATA SYSTEM 137
7.18 STAGING OF BREAST CANCER 137
7.19 CLASSIFICATION OF TYPES OF BREAST SURGERY FOR BREAST CANCER 138
7.20 CLASSIFICATION OF RECONSTRUCTIVE OPTIONS FOLLOWING MASTECTOMY 139
7.21 CLASSIFICATION OF RESPONSE TO NEOADJUVANT CHEMOTHERAPY 140
7.22 CLASSIFICATION OF TYPE OF DEFORMITY FOLLOWING ONCOPLASTIC TREATMENT FOR BREAST CANCER 140
7.23 CLASSIFICATION OF GOALS OF NIPPLE RECONSTRUCTION 141
7.24 CLASSIFICATION OF TECHNIQUES OF NIPPLE–AREOLAR COMPLEX RECONSTRUCTION 141
Chapter 8 Trunk 142
8.1 CLASSIFICATION OF CONDITIONS THAT MAY PRESENT FOR CHEST WALL RECONSTRUCTION 142
8.2 Classification of Posterior Chest Wall Muscle Flap Reconstructive Options 145
8.3 PRESSURE SORES 148
Chapter 9 Lower Limb 153
9.1 CLASSIFICATION OF OPEN TIBIAL FRACTURES (GUSTILLO ET AL.) 153
9.2 CLASSIFICATION OF OPEN TIBIAL FRACTURES (BYRD AND SPICER) 153
9.3 MANGLED EXTREMITY SEVERITY SCORE – “MESS” 154
9.4 HIDALGO AND SHAW CLASSIFICATION OF FOOT TRAUMA 154
9.5 ORTHOPAEDIC TRAUMA ASSOCIATION CLASSIFICATION OF LONG BONE FRACTURES 155
9.6 SOFT TISSUE INJURY CLASSIFICATION OVER CLOSED FRACTURES 155
9.7 CLASSIFICATION OF OPTIONS FOR MANAGING BONY DEFECTS ACCORDING TO SIZE 155
9.8 BOYD CLASSIFICATION OF CONGENITAL PSEUDOARTHROSIS 156
9.9 CLASSIFICATION OF LEG ULCER AETIOLOGY 156
9.10 CLASSIFICATION OF THE MECHANISMS INVOLVED IN VENOUS ULCER PRODUCTION 156
9.11 OSTEOMYELITIS CLASSIFICATION 157
9.12 “P” CLASSIFICATION OF COMPARTMENT SYNDROME DIAGNOSTIC FEATURES 157
9.13 CLASSIFICATION OF TYPES OF LYMPHOEDEMA 158
9.14 COMPRESSION BANDAGES 159
9.15 BRITISH STANDARDS INSTITUTE: THREE CLASSES OF COMPRESSION STOCKINGS 159
9.16 SANTANELLI DESCRIPTIVE CLASSIFICATION OF FOOT DEFECTS 159
9.17 DIABETIC FOOT ULCER: WAGNER SCALE 1981 160
Chapter 10 Urogenital Tract 161
10.1 CLASSIFICATION OF HYPOSPADIAS ACCORDING TO POSITION OF THE MEATUS (AFTER CORRECTION OF THE ASSOCIATED CHORDEE) 161
10.2 CLASSIFICATION OF SYNDROMES CAUSING AMBIGUOUS GENITALIA AND ASSOCIATED CHROMOSOMAL ABNORMALITY 163
10.3 CLASSIFICATION OF VAGINAL RECONSTRUCTIVE OPTIONS FOR CONGENITAL DEFECTS 163
10.4 ANATOMICAL CLASSIFICATION OF ACQUIRED VAGINAL DEFECTS 163
Chapter 11 Burns 165
11.1 CLASSIFICATION OF BURN DEPTH 165
11.2 CLASSIFICATION OF BURN TYPE 166
11.3 CLASSIFICATION OF INHALATIONAL INJURY 166
11.4 PARKLAND FORMULA FOR BURNS RESUSCITATION 166
11.5 URINE OUTPUT INDICATING ADEQUATE FLUID RESUSCITATION 167
11.6 CURRERI FORMULA FOR DAILY CALORIFIC REQUIREMENT IN BURNS PATIENTS 167
11.7 CLASSIFICATION OF ZONES OF INJURY (JACKSON’S MODEL 1947) (FIG. 11.1) 167
11.8 CLASSIFICATION OF PATHOPHYSIOLOGY 168
11.9 CLASSIFICATION OF THE IMMUNE SYSTEM 168
11.10 NATIONAL BURN CARE REVIEW BURN CLASSIFICATION 170
11.11 CLASSIFICATION OF BURNS UNIT REFERRAL CRITERIA 170
11.12 CLASSIFICATION OF BURN SURFACE AREA ESTIMATION METHODS 170
11.13 CLASSIFICATION OF BODY FLUID COMPARTMENTS 170
11.14 CLASSIFICATION OF AIMS OF BURN CARE 170
11.15 CLASSIFICATION OF TIMING OF BURNS SURGERY 171
11.16 CLASSIFICATION OF BURN DISASTER TRIAGE 171
11.17 CLASSIFICATION OF DRESSINGS FOR BURNS 171
11.18 CLASSIFICATION OF POST BURN CONTRACTURES OF THE IPJ OF THE HAND 172
11.19 CLASSIFICATION OF NATURE OF SUBSTANCES WHICH CAN EXTRAVASATE 172
11.20 EXTRAVASATION INJURY CLASSIFICATION OF MECHANISMS OF TISSUE INJURY 172
11.21 CLASSIFICATION OF COLD INJURY 173
Chapter 12 Cosmetic Surgery 175
12.1 THE FACE (FIG. 12.1) 175
12.2 THE NECK 181
12.3 THE BROW 181
12.4 BLEPHAROPLASTY 182
12.5 RHINOPLASTY 184
12.6 ABDOMINOPLASTY 188
12.7 LIPOSUCTION 191
12.8 UPPER EXTREMITY BODY CONTOURING 192
12.9 THE BREAST 192
Abbreviations 193
Index 196