Microsurgical Reconstruction Of The Extremities

On April 23, 1906, Alexis Carrel presented his manuscript entitled "The Surgery of Blood Vessels" to the Johns Hopkins Medical Society. His work on the tech nique of small vessel anastomosis and the transplantation of visceral organs earned him the Nobel Prize in 1912. The use of magnification in operative surgery began in 1921 with the work of Nylen, who first employed the microscope for reconstructive procedures in the middle ear. Jacobson and Suarez published their initial observa tions on the use of microsurgery for the anastomosis of small vessels in 1960, and two years later, Malt reported the historic replantation of an upper extremity. To surgeons involved in reconstruction of the extremities, the evolution of micro surgery has provided the most significant advances of the past three decades. The dramatic clinical successes of replantation surgery and free tissue transfer have substantially improved functional and cosmetic results in addition to decreas ing morbidity in patients who present with complex reconstructive problems. Mi crosurgical Reconstruction of the Extremities crosses the traditional surgical discip lines and will be invaluable to orthopaedic surgeons, plastic surgeons, hand sur geons, and general surgeons, as well as to residents and fellows.

This issue of Clinics in Plastic Surgery, guest edited by Drs. Jin Bo Tang and Michel Saint-Cyr, is devoted to Microsurgery: Global Perspectives, An Update. This issue will include updates on topics such as: A Global View of Digital Replantation and Revascularization; Severe Crush Injury to the Forearm and Hand; Medial Femoral Trochlea Osteochondral Flap; Vascularized Small-Bone Transfers for Fracture Nonunion and Bony Defects; Microvascular Tissue Transfers for Severe Upper Extremity Trauma; Compound or Specially Designed Flaps in the Lower Extremities; Complex Microsurgical Reconstruction After Tumor Resection in the Trunk and Extremities; Pediatric Microsurgery; Innovations and Future Directions in Head and Neck Microsurgical Reconstruction; Microsurgical Tissue Transfer in Breast Reconstruction; Maximizing the Utility of the Pedicled Anterolateral Thigh Flap for Locoregional Reconstruction; Keystone and Pedicle Perforator Flaps in Reconstructive Surgery; Unique Techniques or Approaches in Microvascular and Microlymphatic Surgery; and Microsurgical Reconstruction of Neck, Trunk, and Extremities.

This issue of Clinics in Plastic Surgery, guest edited by Drs. Jin Bo Tang and Michel Saint-Cyr, is devoted to Microsurgery: Global Perspectives. Articles in this issue include: Digital Replantation: Current Status in the World; Exploring New Frontiers of Microsurgery: From Anatomy to Clinical Methods; Free Flaps, Toe Transfers and Microsurgery for Crush Injury in the Hand; Vascularised Bone Grafting for Scaphoid and Lunate Diseases; Vascularised Small Bone Grafting to Treat Scaphoid Non-Union: Outcomes; Compound or Specially Designed Flaps and Other Tissue Transfers in Upper and Lower Extremities; Special Considerations in Upper and Lower Extremity Pediatric Microsurgical Reconstruction; Microsurgical Tissue Transfer in Breast Reconstruction; Non-abdominal Based Free and Pedicle Flaps in Autologous Breast Reconstruction; Complex Microsurgical Reconstruction after Tumor Resection in the Trunk and Extremities; Keystone and Pedicle Perforator flaps in Sarcoma Reconstruction: New Modifications and Applications; Innovations and Future Directions in Head and Neck Microsurgical Reconstruction; New Frontiers in Robotic Assisted Microsurgical Reconstruction; and Current Methods to Deal with Vascular Crisis After Microsurgery: A Global View.

Advances made in microsurgical techniques during the last three decades have dramatically improved the treatment of complex limb injuries, such as a closed fracture covered by healthy tissue and a complex open fracture of the tibia. Microvascular transfers from the foot have revolutionized the treatment of digital amputations, and vascularized bone transfers are used in various indications.The microvascular techniques are still evolving. Many imaginative new flaps are being proposed to meet precisely the functional requirements of the various defects. Alternative anastomotic techniques are being investigated and the no-flow phenomenon has been extensively studied. Allotransplantation may be feasible in the future.This unique book is a result of the exchange of ideas among clinicians of various specialties noted for their innovations and basic researchers involved with the problems of microvascular reconstruction of upper and lower extremities. While most of the chapters are invited contributions, some are based on presentations made during an international symposium held in Brussels, Belgium, in 1997.

In this issue of Hand Clinics, guest editors Drs. Harvey Chim and Kevin Chung bring their considerable expertise to the topic of Advances in Microsurgical Reconstruction in the Upper Extremity. Top experts in the field discuss techniques, outcomes, and new developments such as perforator mapping, thin flaps, and functional muscle transfers, providing surgeons with expert guidance and resources in order to maximize function. Contains 14 relevant, practice-oriented topics including recent advances in upper extremity microsurgery: from traditional to perforator flaps; evolution and application of ultrasound for flap planning in upper extremity reconstruction; functional free muscle transfers for reconstruction of the paralytic limb; functional free muscle transfers for reconstruction of brachial plexus injuries; and more. Provides in-depth clinical reviews on advances in microsurgical reconstruction in the upper extremity, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Microsurgical techniques are widely used in the field of orthopaedics. This book addresses all aspects of orthopaedic microsurgery, from development of the principles to their applications. Replantation of fingers, hands and extremity parts are well summarized by highly experienced microsurgical surgeons. The methods for tissue transplantation and microsurgical reconstruction of tissue defects, which have been proved to be successful tools for saving severely injured extremities, were developed by experienced orthopaedic surgeons in cooperation with plastic surgeons. Injuries to peripheral nerves and the brachial plexus are also discussed extensively in this monograph. All illustrations and tables were meticulously selected and are easy to understand. The book was written for all microsurgeons who work in the fields of orthopaedics, plastic and hand surgery. Guoxian Pei is a professor at the Department of Orthopaedics, Xijing Hospital, the Fourth Military Medical University, Xi An, China.​

This issue of Clinics in Plastic Surgery, guest edited by Drs. Jin Bo Tang and Michel Saint-Cyr, is devoted to Microsurgery: Global Perspectives, An Update. This issue will include updates on topics such as: A Global View of Digital Replantation and Revascularization; Severe Crush Injury to the Forearm and Hand; Medial Femoral Trochlea Osteochondral Flap; Vascularized Small-Bone Transfers for Fracture Nonunion and Bony Defects; Microvascular Tissue Transfers for Severe Upper Extremity Trauma; Compound or Specially Designed Flaps in the Lower Extremities; Complex Microsurgical Reconstruction After Tumor Resection in the Trunk and Extremities; Pediatric Microsurgery; Innovations and Future Directions in Head and Neck Microsurgical Reconstruction; Microsurgical Tissue Transfer in Breast Reconstruction; Maximizing the Utility of the Pedicled Anterolateral Thigh Flap for Locoregional Reconstruction; Keystone and Pedicle Perforator Flaps in Reconstructive Surgery; Unique Techniques or Approaches in Microvascular and Microlymphatic Surgery; and Microsurgical Reconstruction of Neck, Trunk, and Extremities.

This practical and generously illustrated text presents the current concepts regarding the management of the mangled extremity, including microsurgery, vascular surgery, free tissue, nerve, hand, and replantation surgery. Since the advent of microsurgical reconstruction, significant progress has been made in the areas of replantation, free tissue transfer, as well as the refinement of skeletal fixation techniques. The scope will encompass the initial triage of a patient with a mangled upper or lower extremity, the initial and subsequent reconstructive efforts, to include skeletal fixation, vascular and soft tissue reconstruction, muscle and tendon transfers, psychological impact, therapy requirements, amputation considerations, and current data on salvage versus amputation in these scenarios. Case examples will be included to add further depth and context to the techniques and recommendations provided. Presenting these surgical challenges in detail, The Mangled Extremity will be an ideal resource for orthopedic and trauma surgeons, residents and fellows, as well as emergency surgeons facing these intense, traumatic injuries.