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CHAPTER 1 ANATOMY AND PHYSIOLOGY OF THE SKIN&Gregory H.Branham 1

Histology of the Skin 1

Vascular Anatomy 2

Neural Anatomy 2

Pilosebaceous Units 3

Random Pattern Flaps 3

Axial Pattern Flaps 5

Factors Affecting Flap Survival 6

Tissue Injury Response 6

Inflammatory Phase 6

Proliferative Phase 9

Comorbid Disease and Other Factors 9

Suggested References 11

CHAPTER 2 BASIC WOUND HEALING&Arash Moradzadeh and Jill L.Hessler 13

Introduction 13

Phases of Wound Healing 13

Wound Tensile Strength 17

Factors Affecting Wound Healing 17

Local Factors Affecting Wound Healing 17

Systemic Factors Affecting Wound Healing 18

Aberrant Wound Healing:Keloids and Hypertrophic Scars 18

Suggested References 19

CHAPTER 3 SOFT TISSUE TECHNIQUES&Gregory H.Branham 21

Instrumentation 21

Local Anesthesia 24

Topical Anesthetics 25

Tumescent Anesthesia 25

Incision Planning 26

Undermining 26

Wound Closure Techniques 27

Suture Selection 29

Cutaneous Tissue Adhesives 31

Suggested References 32

CHAPTER 4 PRINCIPLES OF FLAP DESIGN AND PREOPERATIVE ANALYSIS&Gregory H.Branharn 33

Introduction 33

Vascular Supply 33

Facial Esthetic Units 34

Relaxed Skin Tension Lines 35

Other Factors 36

Local Flaps 36

Types of Local Flaps 37

Advancement Flaps 38

Rotation Flap 43

Transposition Flaps 44

Suggested References 51

CHAPTER 5 SKIN GRAFTS&Gregory H.Branham 53

Introduction 53

Planning and Preoperative Analysis 53

Recipient Site 54

Donor Sites for Split Thickness Grafts 54

Harvesting Split Thickness Grafts 54

Placement of the Skin Graft 56

Donor Sites for Full Thickness Grafts 56

Healing of Skin Grafts 56

Postoperative Care 57

Suggested References 58

CHAPTER 6 NASAL RECONSTRUCTION&Gregory H.Branham and Arash Moradzadeh 59

Introduction 59

Nasal Anatomy 59

Nasal Defect Analysis 61

Nasal Defect Preparation 62

Choice of Reconstructive Technique 62

Alternatives to Local Flaps 62

Total Nasal Defects 63

Nasal Dorsum Reconstruction 66

Subtotal Dorsal Defects 66

Nasal Sidewall 67

Nasal Tip 70

Nasal Ala 71

Columella 71

Nasal Lining Restoration 72

Auricular Composite Grafts 72

Bipedicle Vestibular Skin Advancement Flap 73

Septal Mucoperichondrial Hinge Flaps:Ipsilateral and Contralateral 73

Inferior Turbinate Flap 76

Septal Composite Chondromucosal Pivotal Flap 76

Forehead Flap 76

Epithelial Turn-in Flap 77

Summary 77

Suggested References 78

CHAPTER 7 LIP AND PERIORAL RECONSTRUCTION&Christina Kenney Magill and Jill L.Hessler 79

Introduction 79

Facial Analysis 79

Special Preoperative Considerations 80

Oral/Perioral Defect Analysis 81

Choice of Reconstructive Technique 81

Defect considerations 81

Postoperative Care 87

Complications 87

Suggested Readings 87

CHAPTER 8 FOREHEAD AND BROW RECONSTRUCTION&Gregory H.Branham 89

Introduction 89

Anatomy 89

Vascular Supply 91

Neural Anatomy 91

Defect Analysis 93

Defect Preparation 93

Choice of Reconstructive Technique 94

Alternatives to Local Flaps 94

Glabella 94

Forehead 95

Brow 95

Temporal Region 96

Suggested References 96

CHAPTER 9 CHEEK RECONSTRUCTION&Gregory H.Branham 97

Introduction 97

Anatomy 98

Vascular Supply 98

Neural Anatomy 98

Defect Analysis 99

Defect Preparation 100

Choice of Reconstructive Technique 100

Alternatives to Local Flaps 101

Posterior Cheek 101

Anterior Cheek 101

Central/Inferior Cheek 102

Superior Cheek 103

CHAPTER 10 EYELID AND PERIOCULAR RECONSTRUCTION&Jasmine Mohadjer and John B.Holds 105

Introduction 105

Regional Anatomic Considerations 105

Eyelid Reconstruction 108

Postoperative Care 112

Eyelid Malpositions 113

Conclusion 115

Suggested References 115

CHAPTER 11 SCALP RECONSTRUCTION&Michael J.Brenner 117

Scalp Reconstruction 117

Introduction 117

Facial Analysis 117

Preoperative Considerations 122

Techniques 122

Postoperative Care 135

Complications 135

Suggested References 135

CHAPTER 12 POSTOPERATIVE CARE，COMPLICATIONS，AND ADJUNCTIVE SCAR CAMOUFLAGE&Gregory H.Branham 137

Postoperative Dressings 137

Tissue Adhesives 138

Technique for Application of Tissue Adhesive 138

Long-Term Scar Care 139

Scar Camouflage 139

Scar Revision Techniques 140

Suggested References 140

CHAPTER 13 COMPLICATIONS OF LOCAL FLAPS:PREVENTION AND MANAGEMENT&Michael J.Brenner and Chadd J.Sukut 141

Introduction 141

Patient Factors 141

Surgical Technique 142

Flap Design 145

Conclusion 149

Suggested References 149

INDEX 151