50 Studies Every Plastic Surgeon Should Know 1st Edition by C Scott Hultman ISBN 1482240823 9781482240825

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ISBN 10: 1482240823 
ISBN 13: 9781482240825
Author: C Scott Hultman

50 Studies Every Plastic Surgeon Should Know identifies those influential contributors who have shaped the practice of modern plastic surgery. Presenting chief sections of 50 key scientific articles in the field, it demonstrates the vast depth and diversity of plastic surgery and highlights the importance of innovation as the field’s core competency. No single sub-specialty is neglected. The book presents studies on hand, craniofacial, aesthetic, and burn surgery as well as breast, trunk, and head and neck reconstruction. Studies on microsurgery, surgical foundations, and innovation are also included. The book also provides commentary from the studies’ original authors, supplemented by expert reflections and editorial perspectives. A short bibliography is added to each review, serving as a springboard for further inquiry. The book is an invaluable reference for residents and surgeons studying for boards or in-service exams, as well as for seasoned surgeons who want to stay current in the field.

50 Studies Every Plastic Surgeon Should Know 1st Table of contents:

Chapter 1 The Use and Uses of Large Split Skin Grafts of Intermediate Thickness
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 2 The Theory and Practical Use of the Z-incision for the Relief of Scar Contractures
Fig. 2-1 Z-plasty technique.
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 3 Surgical Replacement of the Breast
Fig. 3-1 A, Plan and incision. B, Pedicle tubed to midline. Donor area closed or grafted. Wait two weeks.
Fig. 3-2 Extension of tube leaving 2 inch base. Wait one week.
Fig. 3-3 A, Freeing of medial end of flap. Excision of scar. B, Implantation in mammary position. Wait three weeks.
Fig. 3-4 A, Division of pedicle. B, Skin and fat fitted in.
REFERENCES
EXPERT COMMENTARY
Chapter 4 Clinical Definition of Independent Myocutaneous Vascular Territories
Table 4-1 Myocutaneous Vascular Territories
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 5 Classification of the Vascular Anatomy of Muscles: Experimental and Clinical Correlation
Fig. 5-1 Patterns of vascular anatomy of muscle: type I, one vascular pedicle; type II, dominant pedicle(s) plus minor pedicles; type III, two dominant pedicles; type IV, segmental vascular pedicles; type V, dominant pedicle plus secondary segmental pedicles.
REFERENCES
STUDY AUTHOR REFLECTIONS
Section Two Hand Surgery
Chapter 6 The Carpal-Tunnel Syndrome. Seventeen Years’ Experience in Diagnosis and Treatment of Six Hundred Fifty-Four Hands
Fig. 6-1 The wrist-flexion test is positive when numbness and paresthesia in the median-nerve distribution in the hand are reproduced or exaggerated by holding the wrists in complete flexion from thirty to sixty seconds.
REFERENCES
EXPERT COMMENTARY
Chapter 7 Primary Repair of Lacerated Flexor Tendons in “No Man’s Land”
Table 7-1 Patient Outcomes as Previously Published
Fig. 7-1 The repaired digit is immobilized in a dorsal plaster splint to maintain the finger and wrist in moderate flexion. If there is no fracture, elastic dynamic traction is added. This permits some extension without stress on the site of repair and may prevent adhesions at the suture line.
REFERENCES
EXPERT COMMENTARY
Chapter 8 Reconstruction of the Thumb by Transposition of an Adjacent Digit
Fig. 8-1 Usual operative approach for mobilization of an index finger to replace the thumb. Following this step, the extensor tendons of the index finger are drawn under the skin flap and anchored with a removable wire suture. The second metacarpal, if not already fractured at the time of injury, is transected and the index finger moved into thumb position.
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 9 Immediate Thumb Extension Following Extensor Indicis Proprius-to-Extensor Pollicis Longus Tendon Transfer Using the Wide-Awake Approach
Fig. 9-1 The circled area was injected with 20 cc of 1 % lidocaine with 1:200,000 epinephrine 30 minutes before the operative procedure. Dashed lines indicate incisions. Black lines outline the extensor indicis proprius and extensor pollicis longus tendons. EIP, Extensor indicis proprius; EPL, extensor pollicis longus.
Table 9-1 Reported Outcomes for the First Five Patients Who Underwent Wide-Awake EIP-to-EPL Tendon Transfer
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 10 Nerve Transfers for the Restoration of Hand Function After Spinal Cord Injury
Table 10-1 Medical Research Council Motor Function of Bilateral Upper Extremities Before Operative Intervention
Fig. 10-1 Musculocutaneous and median nerve anatomy relevant to the brachialis nerve to AIN transfer in C-7 SCI. A, The donor brachialis branch divides from the musculocutaneous nerve on its medial aspect. After this branch point, the musculocutaneous nerve becomes the lateral antebrachial cutaneous nerve. B, The recipient AIN branches from the median nerve in the forearm on its lateral aspect, but courses proximally into the arm on its posterior/medial aspect. The donor brachialis nerve is transferred into the anterior interosseous fascicle in the arm. C, The AIN fascicle in the arm is located on the posterior/medial aspect of the median nerve, between the palmaris longus/flexor digitorum superficialis/flexor carpi radialis fascicle and the sensory component of the median nerve. The fascicular group to the pronator teres is located in the anterior portion of the median nerve, while the sensory fibers are lateral and the motor fibers medial. A, Anterior; L, lateral; M, medial; N, nerve; P, posterior; R, radial; U, ulnar.
REFERENCES
STUDY AUTHOR REFLECTIONS
Section Three Craniofacial Surgery
Chapter 11 Refinements in Rotation-Advancement Cleft Lip Technique
REFERENCES
EXPERT COMMENTARY
Chapter 12 Cleft Palate Repair by Double Opposing Z-plasty
Table 12-1 Degree of Velopharyngeal Insufficiency in Treatment of Cleft Patients
REFERENCES
STUDY AUTHOR REFLECTIONS
Table 12-2 Private Practice Experience With Double Opposing Z-Plasty for Cleft Palate Repair
EDITORIAL PERSPECTIVE
Chapter 13 Lengthening the Human Mandible by Gradual Distraction
REFERENCES
STUDY AUTHOR REFLECTIONS
EDITORIAL PERSPECTIVE
Chapter 14 Technical Advances in Ear Reconstruction With Autogenous Rib Cartilage Grafts: Personal Experience With 1200 Cases
Fig. 14-1 Ear framework fabrication with integral tragal strut. A, Construction of the frame. The floating cartilage creates a helix, and second strut is arched around to form the antitragus, intertragal notch, and tragus. This arch is completed when the tip of the strut is affixed to the crus helix of the main frame with horizontal mattress suture of clear nylon. B and C, Actual framework fabrication with the patient’s rib cartilage.
REFERENCES
STUDY AUTHOR REFLECTIONS
EDITORIAL PERSPECTIVE
Chapter 15 The Definitive Plastic Surgical Treatment of the Severe Facial Deformities of Craniofacial Dysostosis. Crouzon’s and Apert’s Diseases
Fig. 15-1 Total osteotomy of the middle third of the face, with a step cut in the malar bone, and with sagittal splitting of the lateral orbital walls. A, The facial retrusion and exorbitism are noted, the keel-shaped osteotomy is outlined, and the step cut osteotomies in the zygomas are shown. B, Outline of the orbital osteotomies, through which one does a sagittal splitting of the lateral orbital walls with a chisel. C, The osteotomy between the maxilla and the pterygoid process is done bilaterally. D, The main basal osteotomy is done, either a straight horizontal one or a keel-shaped one. E, The oblique sectioning of the vomer. F, Bringing the facial mass forward, exposing the extent of the diastasis between the cranium and the face. Bone grafts are inserted into the step cuts in the zygomas.
Fig. 15-2 Variation. A–B, Total osteotomy of the mid-face without the step cut in the malar and without sagittal splitting of the lateral orbital walls. Deep orbital osteotomies, plus a cut across the frontal process near the frontomalar surture, plus a cut across the junction of the zygomatic arch with the zygoma. The posterior face of the main cuts, and the cranial base. C, Bringing the facial mass forward. Inserting bone grafts into the main gaps.
REFERENCES
EDITORIAL PERSPECTIVE
Section Four Head and Neck Reconstruction
Chapter 16 A Two-Stage Method for Pharyngoesophageal Reconstruction With a Primary Pectoral Skin Flap
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 17 The Pectoralis Major Myocutaneous Flap. A Versatile Flap for Reconstruction in the Head and Neck
REFERENCES
STUDY AUTHOR REFLECTIONS
EDITORIAL PERSPECTIVE
Chapter 18 A 10-Year Experience in Nasal Reconstruction With the Three-Stage Forehead Flap
REFERENCES
STUDY AUTHOR REFLECTIONS
EDITORIAL PERSPECTIVE
Chapter 19 A Review of 60 Consecutive Fibula Free Flap Mandible Reconstructions
Fig. 19-1 Algorithm for mandible reconstruction with osseous free flaps. Donor-site selection is based primarily on the location and extent of the bony defect and the associated soft-tissue requirements.
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 20 Comprehensive Management of Pan-facial Fractures
Fig. 20-1 In the repair of the pan-facial fractures it is essential to correct the displaced projection, facial height, and facial width.
Fig. 20-2 A, Fixation of the face fractures with plates and screws to achieve stability of the face. B, Biodegradable plates on the right of the skull and miniplates on the left.
Fig. 20-3 Fracture of the zygoma results in a flat cheek bone and excess prominence of the zygomatic arch. This must be corrected with adequate and appropriate reduction and plate and screw fixation.
REFERENCES
STUDY AUTHOR REFLECTIONS
EDITORIAL PERSPECTIVE
Section Five Breast Reconstruction
Chapter 21 Comparison of Radical Mastectomy With Alternative Treatments for Primary Breast Cancer. A First Report of Results From a Prospective Randomized Clinical Trial
Fig. 21-1 The incidence of lung carcinoma after surgery for breast carcinoma with and without postoperative radiotherapy.
Fig. 21-2 A, Probability (%) of survival without disease. MX, Mastectomy; NSABP, National Surgical Adjuvant Breast Project; RAD, radiation. B, NSABP Protocol No. 4: site of first reported treatment failure (% of patients). A, Eligible for protocol; B, patients per protocol, including radiation variations; C, patients per protocol with follow-up.
Fig. 21-3 A, Probability (%) of survival. MX, Mastectomy; NSABP, National Surgical Adjuvant Breast Project; RAD, radiation. B, NSABP Protocol No. 4: percent of deaths and average monthly death rate. A, Eligible for protocol; B, patients per protocol, including radiation variations; C, patients per protocol with follow-up.
REFERENCES
EXPERT COMMENTARY
Chapter 22 Breast Reconstruction After Mastectomy Using the Temporary Expander
REFERENCES
EXPERT COMMENTARY
Chapter 23 Meta-analyses of the Relation Between Silicone Breast Implants and the Risk of Connective-Tissue Diseases
Table 23-1 Estimates of the Summary Adjusted Relative Risks of an Association Between Breast Implants and Connective-Tissue Diseases
REFERENCES
EXPERT COMMENTARY
Chapter 24 Breast Reconstruction With a Transverse Abdominal Island Flap
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 25 Vertical Mammaplasty and Liposuction of the Breast
Fig. 25-1 Schematic representation of the operation. A, Markings of the skin excision and of the lateral skin undermining (gray areas) and incision for liposuction above the lower marking. B, Deepithelialization and incision of the gland from the upper parts of the vertical markings diverging to the lower breast. C, Excision of the excess tissue below and, if necessary in large breasts, behind the areola. D, Final resection of glandular tissue. E, Plication of the pedicle to the areola and fixation of the gland to the pectoralis muscle. F, Suture of the areola in its new site and suture of the lateral pillars of breast tissue. G, Gathering of the skin interiorly, from the nipple to the inframammary fold. H, Final inverted appearance immediately after surgery.
Table 25-1 Complications After Vertical Mammaplasty in 100 Patients (192 Breasts)
Table 25-2 Healing Complications (192 Breasts)
REFERENCES
EDITORIAL PERSPECTIVE
Section Six Microsurgery
Chapter 26 Thumb Replacement: Great Toe Transplantation by Microvascular Anastomosis
Fig. 26-1 Successful great toe-to-thumb transfer after right thumb was amputated by a power tool.
REFERENCES
EXPERT COMMENTARY
Chapter 27 Early Microsurgical Reconstruction of Complex Trauma of the Extremities
Table 27-1 Results
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 28 The Radial Forearm Flap: A Versatile Method for Intra-oral Reconstruction
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 29 Conventional TRAM Flap Versus Free Microsurgical TRAM Flap for Immediate Breast Reconstruction
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 30 Have We Found an Ideal Soft-Tissue Flap? An Experience With 672 Anterolateral Thigh Flaps
REFERENCES
EDITORIAL PERSPECTIVE
Section Seven Trunk Reconstruction
Chapter 31 “Components Separation” Method for Closure of Abdominal-Wall Defects: An Anatomic and Clinical Study
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 32 Multivariate Predictors of Failure After Flap Coverage of Pressure Ulcers
REFERENCES
STUDY AUTHOR REFLECTIONS
EDITORIAL PERSPECTIVE
Chapter 33 High-Lateral-Tension Abdominoplasty With Superficial Fascial System Suspension
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 34 Utility of the Omentum in the Reconstruction of Complex Extraperitoneal Wounds and Defects: Donor-Site Complications in 135 Patients From 1975 to 2000
Fig. 34-1 Transposition of the omentum to the thorax. The arc of rotation permits coverage of the mediastinum, subclavian region, neck, and chest wall, via defects in the diaphragm (A) and the abdominal wall (B).
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 35 Body Contouring by Lipolysis: A 5-Year Experience With Over 3000 Cases
REFERENCES
STUDY AUTHOR REFLECTIONS
Section Eight Burn Surgery
Chapter 36 The Treatment of the Surface Burns
Fig. 36-1 Treatment protocol. ED, Emergency department; NS, normal saline.
REFERENCES
EXPERT COMMENTARY
Chapter 37 The Use of a Topical Sulfonamide in the Control of Burn Wound Sepsis
Fig. 37-1 Treatment protocol.
Table 37-1 Total Body Surface Area Versus Mortality in the Pre–Sulfamylon-Treated (1960 to 1963) and Sulfamylon-Treated (1964 to 1965) Groups
REFERENCES
STUDY AUTHOR REFLECTIONS
EXPERT COMMENTARY
Chapter 38 Early Excision and Grafting vs. Nonoperative Treatment of Burns of Indeterminant Depth: A Randomized Prospective Study
Fig. 38-1 Overview of the study method. TBSA, Total body surface area.
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 39 Improved Net Protein Balance, Lean Mass, and Gene Expression Changes With Oxandrolone Treatment in the Severely Burned
Fig. 39-1 Overview of design. TBSA, Total body surface area.
Fig. 39-2 Oxandrolone improved net muscle protein synthesis. Net balance of d5-phenylalanine across the leg with and without therapy. There was a significant improvement in net balance in the oxandrolone-treated group (p <0.05). There was no difference in the placebo group. Significance denoted by * and accepted as p <0.05.
Table 39-1 Changes in Gene Expression From Before and After 1 Week of Oxandrolone Treatment
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 40 Pulsed Dye Laser Therapy and Z-plasty for Facial Burn Scars: The Alternative to Excision
Fig. 40-1 Treatment with PDL therapy in three different groups. PDL, Pulsed dye laser.
REFERENCES
STUDY AUTHOR REFLECTIONS
Section Nine Aesthetic Surgery
Chapter 41 The Superficial Musculo-aponeurotic System (SMAS) in the Parotid and Cheek Area
Fig. 41-1 Schema of the SMAS. The arrow goes deep to the SMAS, which extends from the frontalis to the platysma muscle.
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 42 Spreader Graft: A Method of Reconstructing the Roof of the Middle Nasal Vault Following Rhinoplasty
Fig. 42-1 A, A donor site at the vomer ensures the integrity of the graft pocket. B, The graft extends under the bony arch to the caudal border of the upper lateral cartilage. The graft’s anterior edge is flush with the septum.
REFERENCE
STUDY AUTHOR REFLECTIONS
Chapter 43 A Placebo-Controlled Surgical Trial of the Treatment of Migraine Headaches
Table 43-1 Patient Results Comparing Actual Surgery to Sham Surgery
Table 43-2 Overall Change From Baseline to 12 Months By Location and Type of Surgery
REFERENCE
STUDY AUTHOR REFLECTIONS
Chapter 44 Subfascial Endoscopic Transaxillary Augmentation Mammaplasty
REFERENCE
STUDY AUTHOR REFLECTIONS
Chapter 45 Treatment of Glabellar Frown Lines With C. Botulinum-A Exotoxin
Table 45-1 Number of Patients Having Single or Multiple Injection Sessions
Table 45-2 Time Between Injection Sessions in Patients Who Have Undergone Six or More Sessions
Table 45-3 Subjective Patient Response to C. Botulinum Toxin Injection for Brow Furrows*
Table 45-4 Complications of C. Botulinum Toxin Injection Treatment of Glabellar Frown Lines
REFERENCES
EDITORIAL PERSPECTIVE
Section Ten Innovations
Chapter 46 The Vascular Territories (Angiosomes) of the Body: Experimental Study and Clinical Applications
REFERENCES
EDITORIAL PERSPECTIVE
Chapter 47 Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Clinical Experience
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 48 Facial Augmentation With Structural Fat Grafting
REFERENCES
EXPERT COMMENTARY
Chapter 49 A Prospective Analysis of 100 Consecutive Lymphovenous Bypass Cases for Treatment of Extremity Lymphedema
REFERENCES
STUDY AUTHOR REFLECTIONS
Chapter 50 Near-Total Human Face Transplantation for a Severely Disfigured Patient in the USA
REFERENCES
STUDY AUTHOR REFLECTIONS

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