FINGERTIP AND NAILBED INJURIES I. OVERVIEW A. The part of the digit distal to distal interphalangeal (DIP) joint is considered the fingertip (Fig. 41-1). B. The glabrous skin on the fingertip is specialized…
THORACIC RECONSTRUCTION I. FORM AND FUNCTION A. Protection: Vital organs of the chest B. Flexibility: The thorax is not a static structure C. Stability: Necessary for pulmonary function D. Physiology—inspiration/expiration 1. Thoracic expansion = negative intrathoracic…
I. MEETING THE PATIENT A. ABCs (airway, breathing, circulation) of trauma for all injured patients B. AMPLE (allergies, medications, past medical history, time of last meal, and events leading to injury) history, and…
I. HISTORICAL ORIGINS A. References of total nasal reconstruction date as far back as 3000 BC India. B. Local cheek flaps published in “Sushruta Samhita” by Sushruta (India, 700 BC). C. Adjacent tissue rearrangements…
I. HISTORY 1896 Tansini Latissimus dorsi flap for post-mastectomy coverage 1964 Cronin and Gerow Introduction of silicone implant 1982 Hartrampf TRAM flap 1983 Taylor DIEP flap 1989 Grotting Routine use of…
I. EMERGENCY DEPARTMENT (ED) EVALUATION A. History 1. Mechanism of injury determines the degree of force a. Interpersonal violence (usually low energy) b. Motor vehicle accident (usually higher energy) 2. History, prior facial trauma 3. Time…
I. GENERAL PRINCIPLES A. Function and goals of reconstruction 1. Function a. *Thumb contributes 40% of the hand function. b. Essential for prehensile hand function c. Requires contact between the index and the thumb pulp to…
I. PROBLEMS A. Burn contractures 1. Tight, shortened scars from tissue deficit 2. Can form across joint creating limitation of movement 3. Can involve more than skin: Causes shortening and fibrosis of underlying muscle, fascia,…
BASICS I. STRUCTURE A. Tendons are strong, dense, uniform connective tissue structures that attach muscles to bones. B. Consist of long collagen fibrils produced by specialized fibroblasts called tenocytes that are embedded in…
BLEPHAROPLASTY I. ANATOMY A. General anatomy 1. Levator palpebrae a. Origin: Lesser wing of sphenoid b. Insertion: Dermis and superior edge of tarsus c. Innervation: CN III d. Action: 10 to 15 mm upper lid excursion e. Whitnall…
