Ebook Surgical tips and skills (1st edition): Part 1

‘The reward of a thing well done is to have done it.’ RALPH WALDO EMERSON ‘Today`s heresy is tomorrow`s orthodoxy.’ HELEN KELLER This image shows the 20 triangulate faces of this polyhedron which are a reflection of the versatility of this design concept, more variations of which are illustrated in this text, which is really a second volume of the KPIF principle. Felix C Behan FRCS, FRACS Associate Professor of Surgery University of Melbourne Plastic and Reconstructive Surgeon Department of Surgical Oncology Peter MacCallum Cancer Centre Melbourne, & Western Health surgical and skills Sydney Edinburgh London New York Philadelphia St Louis Toronto Churchill Livingstone is an imprint of Elsevier Elsevier Australia. ACN 001 002 357 (a division of Reed International Books Australia Pty Ltd) Tower 1, 475 Victoria Avenue, Chatswood, NSW 2067 This edition © 2014 Elsevier Australia This publication is copyright. Except as expressly provided in the Copyright Act 1968 and the Copyright Amendment (Digital Agenda) Act 2000, no part of this publication may be reproduced, stored in any retrieval system or transmitted by any means (including electronic, mechanical, microcopying, photocopying, recording or otherwise) without prior written permission from the publisher. Every attempt has been made to trace and acknowledge copyright, but in some cases this may not have been possible. The publisher apologises for any accidental infringement and would welcome any information to redress the situation. This publication has been carefully reviewed and checked to ensure that the content is as accurate and current as possible at time of publication. We would recommend, however, that the reader verify any procedures, treatments, drug dosages or legal content described in this book. Neither the author, the contributors, nor the publisher assume any liability for injury and/or damage to persons or property arising from any error in or omission from this publication. National Library of Australia Cataloguing-in-Publication entry ___________________________________________________________________ Author: Behan, Felix C., author. Title: Surgical tips and skills / Felix Behan. ISBN: 9780729540995 (paperback) Notes: Includes index. Subjects: Surgery–Textbooks. Surgery–Technique. Dewey Number: 617.9 ___________________________________________________________________ Content Strategist: Larissa Norrie Senior Content Development Specialist: Neli Bryant Project Managers: Karthikeyan Murthy and Rochelle Deighton Edited by Linda Littlemore Proofread by Tim Learner Cover and internal design by Stan Lamond Index by Robert Swanson Typeset by Toppan Best-set Premedia Limited Printed in China by China Translation & Printing Services Limited Foreword The skills of a plastic surgeon are acquired in many ways. Most surgeons learn their craft from an experienced surgeon and then modify their practice in the light of their own experiences. It is not surprising that changes in operative technique usually occur slowly, only changing rapidly when a new technology is introduced. This has been most obvious in plastic surgery in the emergence of microsurgery, which has provided a method for the reconstruction of many major defects. Unfortunately, simpler, more traditional classical methods of tissue transfer involving less operating time and hospitalisation are sometimes forgotten. Almost 100 years ago, a Melbourne plastic surgeon, Jerry Moore, wrote a seminal book entitled Plastic Surgery based purely on his own personal experience and innovation. It is pleasing to be asked to write a foreword to an equally important book, Surgical Tips and Skills by Felix Behan, which may also change the face of plastic surgery. Like Moore, Professor Behan is an original thinker, and some 40 years ago he realised it is possible to raise composite flaps using embryological dermatomes, as these include skin, neurovascular tissue, lymphatics and fascia. He gradually developed his own ideas of local tissue rearrangement based on this principle, enabling him to close defects that were previously irreparable. My late brother Robert Marshall, surgeon and anatomist, grasped this principle of the vertical orientation of the circulation of the skin and underlying tissue, and was sufficiently impressed to include it in his book, Living Anatomy, Structure as a Mirror of Function, in 2001. Mr Marshall observed to the author that the improved vascularity in these island flaps may be a local sympathectomy effect. Professor Behan has continued his innovative approach for more than 40 years, and shares with us in his new book numerous examples of remarkable reconstructions using local fascio-cutaneous keystone flaps together with many relatively simple but neat surgical tips to improve surgical outcomes. This book is divided into three sections, Basic, Intermediate and Advanced, and there is something in it for aspiring surgeons as well as for the most experienced. The Basic and Intermediate sections contain many surgical tips, including suturing techniques, harvesting of skin grafts and their applications, simple means of immobilisation and innovative methods of establishing drainage to improve the results of many plastic surgery procedures. The Advanced section has beautifully illustrated examples of keystone fascio-cutaneous flap reconstructions, which many experienced surgeons would be pleased to claim as their own. Plastic surgery has changed over the past 50 years, becoming dominated by cosmetic surgery and microsurgery with a decline in the art of local tissue repair, which is the fundamental basis of plastic surgery. It is to be hoped this book may stimulate a resurgence of the more classical aspects of the specialty. With the passage of time and tightening of resources, there will inevitably be more scrutiny by health administrators of the cost of plastic surgery procedures. It will become increasingly difficult to justify operations that require expensive resources, multiple surgeons and prolonged operating times, when there are simple, less expensive alternatives readily available that produce results often superior in terms of function and appearance. Professor Behan has shown the way – plastic surgeons need to sit up, take notice and embrace local fascio-cutaneous island reconstruction as an alternative to microsurgery or risk losing a large part of our specialty. Donald R. Marshall AM MB MS FRACS FACS v ... - tailieumienphi.vn