The skin is the largest human organ system. Loss of skin integrity due to injury or illness results in a substantial physiologic imbalance and ultimately in severe disability or death. The most common cause of significant skin loss is thermal injury, followed by trauma and chronic ulcerations. Over the past decades extraordinary advances have been made in the understanding of cellular and molecular processes of wound healing and the pathobiology of chronic wounds. This knowledge has led to wound care innovations that facilitate more rapid closure of wounds with better functional and aesthetic outcome. A sensible and resource-saving utilization of these innovative technologies requires a broad knowledge of these processes and innovations. This book intends to give an overview about today's wound care developments in tissue engineering and skin replacement. It presents a variety of indications and diversities of clinical applications to help the surgeon select a specific procedure for each clinical situation.

Hair transplantation is in demand worldwide, but because Asian hair tends to be more sparse and coarse than Caucasian hair, transplantation procedures need to be adapted to Asian patients. This book, exclusively devoted to Asian hair, is a complete and comprehensive text written by a group of authors sharing their experience in their specialized fields of hair restoration. Included are many practical tips as well as chapters on regional transplantation such as eyebrows, eyelashes, sideburns, beards, and mustaches, in addition to the usual scalp hair restoration. With its many illustrations, the book gives readers a complete knowledge of hair restoration surgery and provides a quick, easy-to-use reference on Asian hair and the differences in patients' demands. With an influx of new physicians in this challenging field of medicine, further education and training are imperative and must be available to provide a high standard of medical practice. This compilation meets that objective and ultimately makes the valuable contribution of restoring patients' self-confidence.

Laryngotracheal Reconstruction: From Lab to Clinic lines for using the technique of tracheal autotra- presents the experimental and clinical aspects of plantation in conservation laryngectomy. The tissue reconstruction of the larynx and trachea. shortcomings and complications of tracheal auto- The book reflects the development and implemen- transplantation encountered in the initial patient tation of a research-based clinical program. The series led to a modification of the technique. The experimental work was started in 1989 with the modified autotransplantation technique proved to aim of improving the reconstructive possibilities be reliable from a reconstructive, functional and in the following two clinical situations: (1) extend- oncological viewpoint. ed hemilaryngectomy defects after tumour In a second part (Chap. VI), healing aspects after removal and (2) tracheal stenoses that are impos- repair of laryngotracheal defects are highlighted. sible to repair by segmental tracheal resection. The The healing mechanisms of the cartilage support, two problems differ in localization (larynx, tra- the mucosal lining and the blood supply were chea), etiology (oncology, traumatic), and treat- studied for each tissue component individually.

One of the most outstanding achievements in contemporary surgery has been the development ofmicrosurgery and its c1inical application. Early in 1960s, the Shanghai Sixth People's Hospital began to research and practise the replant- ation of severed limbs and has hence been acc1aimed as the cradle of replant- ation surgery in China. Succeeding Dr. Chen Zhong-wei, Dr. Yu Zhong-jia has led the Department of Orthopaedic Surgery to continue ploughing and weeding diligently in the field of microsurgery of the extremities and has made, in both reconstructive and reparative microsurgery, great advances that have attracted world attention. I used to be the scientific advisor of this hospital and have therefore followed c1ose1y what has been achieved there. A well-known orthopaedist and microsurgeon, Dr. Yu Zhong-jia is adept in using the present advanced techniques to solve difficult problems which re- mained unsettled in spite of predecessors' repeated earlier attempts, and his own scientific research is always directed by the imperative needs of his patients. The results of his research thus not only attain a high technical standard, but are also rich in practical value. Dr. Yu was the the first surgeon in the world to trans plan ted autogenous toes to the amputated forearm stump, with a metallic artificial metacarpus as the connection, reconstructing a new hand with sensibil- ity and movability afterwards eulogized by foreign friends as the "China Hand".

Much progress has been made in recent years and new techniques have been developed in the field of plastic surgery of the breast. Breast Surgery presents plastic surgeons with a comprehensive summary of current practice and the techniques available.
Clearly written in language accessible to both specialists and non-specialists, Breast Surgery presents a variety and range of techniques with which excellent results in both plastic and reconstructive breast surgery can be achieved. Over 600 drawings and photographs, both in black and white and in colour, accompany the text, providing the plastic surgeon with clearly-illustrated guidelines to follow.
Dr. Nathalie Bricout is a leading figure in the field of plastic surgery of the breast in France.

Treatment of articular cartilage pathology in the knees of young and active patients is a challenging and controversial issue. Biologic Knee Reconstruction: A Surgeon's Guide is a how-to, step-by-step guide that addresses the evaluation and management of this unique patient population.   Internationally renowned cartilage experts Dr. Brian J. Cole and Dr. Joshua D. Harris, along with their contributors, present information on normal and abnormal history and physical examination. The reader will learn proper decision-making using a patient-centered approach of treatment, increasing the likelihood of a successful outcome. In addition to radiographic assessment of articular cartilage, Biologic Knee Reconstruction discusses the use of biomarkers, defect classification, and patient-reported and surgeon-measured outcomes. Aggressive nonsurgical medical management, including medications, injections, physiotherapy, and rehabilitation, is also presented.   Biologic Knee Reconstruction also discusses the management of concomitant pathologies such as malalignment, meniscal deficiency, and ligamentous instability. Selection of surgical cartilage restorative treatment options is multifactorial, requiring consideration of several patient-, knee-, and defect-specific issues. All contemporary open and arthroscopic cartilage techniques are presented in detail with high resolution figures. A unique feature of Biologic Knee Reconstruction is the presentation of several chapters discussing non-medical issues highly pertinent to the advancement and future of this field: funding of research and cost of new advanced technologies, regulation of advanced cellular, tissue, and genetic technologies, evidence-based medicine and clinical trial design and conduct, and the ethics of allograft tissues and stem cell use.   Features: Technique preference cards from the experts performing cartilage surgery Patient education information The most up-to-date descriptions of advanced cartilage techniques Unique chapters not covered in books elsewhere, including: Biomarkers Patient-reported outcomes assessment Newer injection techniques (PRP, stem cells) One- and two-stage open and arthroscopic techniques using chondrocyte- and stem cell based cell therapies Costs and public and private funding of research Barriers to high-quality randomized trials Governmental regulation and availability/accessibility to patients Gene therapy and tissue engineering Ethics of articular cartilage surgery with stem cells, ex-vivo cell manipulation, and juvenile tissue sources   With the most up-to-date content and step-by-step methods for surgical procedures, Biologic Knee Reconstruction: A Surgeon's Guide is the perfect addition to the bookshelf of the orthopedic surgeon, cartilage researcher, sports physical therapist, or athletic trainer who evaluates and manages this unique patient population.

Biomaterials are used in many areas of medicine, particularly in surgery and d- tistry. In orthopedic surgery, total hip arthroplasty has been extremely successful, and has been called 'the operation of the 20th century'. Total hip arthroplasty is r- tinely performed every day in most orthopedic departments. Over the last decades, many efforts have been made to better integrate the components within the recipient bones, to decrease the friction at the prosthetic interface, and to minimize wear. Minimally invasive procedures have been developed, and various designs are inte- ed to preserve as much as possible of the bone stock of young patients. By contrast, the clinical results have been less favorable after various hand and wrist joint replacements. Many early designs have failed, the clinical data of the current pr- theses are frequently quite limited, and there is often insufficient biomechanical information available, although trapezio-metacarpal arthroplasty in particular has become quite popular in recent years. In order to promote progress in hand and wrist arthroplasty, Antonio Merolli and Thomas J. Joyce have edited this lovely book, whose chapters discuss current research and recent advances in hand and wrist arthroplasty. The problems of metacarpophalangeal joint prostheses are particularly developed.

Under the Auspices of the Alfredo and Amalia Lacroze de Fortabat Foundation

In the last decade there has been no major clinical mono- graph on this increasingly common and difficult malignancy which is a killer of young people. The gap in the literature is now filled by this authoritative volumewhich will be essential reading for any body involved in the study or management of melanoma.

Strong body odor is a condition for which, until now, there have been few treatment methods. The Japanese authors, encouraged by the willingness of Oriental patients to undergo radical treatment, have developed the subcutaneous tissue shaving method, which eliminates the condition in a very short period of time without ugly scarring. The book Human Body Odor not only introduces the completely new subcutaneous tissue shaving method, it also questions conventional theories on the hair cycle itself and throws a new hypothesis about the process of hair generation and regeneration into the scientific arena. This could even lead in the future to a formula for retarding hair loss! Developed over the past twenty years, the authors' new surgical method for the radical treatment of bromidrosis represents a landmark in cosmetic surgery and dermatology!

Offering authoritative guidance and a multitude of high-quality images, Facial Trauma Surgery: From Primary Repair to Reconstruction is the first comprehensive textbook of its kind on treating primary facial trauma and delayed reconstruction of both the soft tissues and craniofacial bony skeleton. This unique volume is a practical, complete reference for clinical presentation, fracture pattern, classification, and management of patients with traumatic facial injury, helping you provide the best possible outcomes for patients' successful reintegration into work and society. Explains the basic principles and concepts of primary traumatic facial injury repair and secondary facial reconstruction. Offers expert, up-to-date guidance from global leaders in plastic and reconstructive surgery, otolaryngology and facial plastic surgery, oral maxillofacial surgery, neurosurgery, and oculoplastic surgery. Covers innovative topics such as virtual surgical planning, 3D printing, intraoperative surgical navigation, post-traumatic injury, treatment of facial pain, and the roles of microsurgery and facial transplantation in the treatment facial traumatic injuries. Includes an end commentary in every chapter provided by Dr. Paul Manson, former Chief of Plastic Surgery at Johns Hopkins Hospital and a pioneer in the field of acute treatment of traumatic facial injuries. Offers videos that clarify surgical technique, including intraoperative guidance and imaging; transconjunctival approach to the orbit and reconstruction of a zygomaticomaxillary complex fracture; calvarial bone autograft splitting; dental splinting; a systematic method for reading a craniofacial CT scan; and more. Features superb photographs and illustrations throughout, as well as evidence-based summaries in current areas of controversy. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

This advanced book of rigid fixation describes the scientific principles and applied techniques primarily for the AO/ASIF hardware system.

This book will enable the reader, regardless of their experience, to master the best rhinoplasty practice. It includes all contemporary techniques such as preservation, structural, and atraumatic rhinoplasty concepts, and makes them very practical to apply. Rhinoplasty in Practice not only explains the anatomy, historical evaluations, philosophy, descriptions, indications, limitations, and complications of rhinoplasty but also reports many innovative and unpublished data, tips, and tricks for success. The text is enhanced by: Algorithms and tables for a clear understanding of the deformity and treatment techniques Almost 100 full HD surgical and 3D animation videos (available via a Companion Website) to make the techniques clear, practical, and applicable Over 500 superb illustrations to make the anatomy and surgical techniques more easily comprehensible, allowing the reader to follow each step and including cadaver, histological, ultrasonography, computed tomography, and clinical studies

Liposuction began as a contouring procedure but has evolved into the treatment of obese patients, gynecomastia, ptosis, macromastia, and even patients who have complications from heart disease or diabetes. Other disorders such as axillary sweat hypersecretion, lipomas, and angiomas are also potential disorders that may be treated with liposuction.

Physicians performing liposuction must be adequately trained and experienced in the potential and actual complications before attempting to perform liposuction. Patient safety is the most important aspect of all surgeries, but especially of cosmetic surgery, which is an elective procedure.

New technology helps improve results but experience, care, and skill of the cosmetic surgeon is necessary to obtain optimal results that satisfy the patient.

The contributors to this book have spent time and effort presenting the cosmetic and plastic surgeon as much information as possible on the techniques and uses of liposuction for cosmetic and non-cosmetic surgery purposes.

This method of local anaethesia, developed by a dermatologist and a pharmacologist, is presented to demonstrate its use in cosmetic liposuction and other procedures. Richly illustrated to show details of the technique and with serialphotographs of many clinical cases, the book explains the advantages of this new technique and provides practical instruction in how to perform it.

...fungar vice cotis, acutum reddere quae ferrum valet exsors ipsa secandi (HORACE, .Ars poetical Era da prevedere che dopo parentesi assai lunga di silenziosa elaborazione, al grande sviluppo della chirurgia plastica ed al suo affermarsi come "specialita) generalmente riconosciuta, seguisse la fioritura di testi vari di mole e di intenzione a quella dedicati. Lodevoli opere quasi tutte ma per la maggior parte riflettenti massima la preoccupazione degli autori di esibire i piu brillanti risultati raggiunti anzicM indicare con sufficiente chiarezza e dettaglio i mezzi piu idonei a conseguirli. Ma ecco finalmente uscire per Ie stampe questi volumi splendidi di veste dove gli Autori, pur valentissimi chirurghi, quasi dappertutto rinunciano a far bella mostra di se col fotografico sciorinamento di quanto pur sanno fare ed invece con modestia pari a quella dell'antico Poeta esporre ogni piu riposto dettaglio di interventi fondamentali 0 menD comuni valendosi del sussidio di figure di rigorosa rispondenza e di insuperata artistica efficacia. Opera questa destinata ad imporsi ed a rimanere proprio percM di essa puo farsi il raro elogio d'essere veramente strumento di lavoro cui tanti chirurghi non mancheranno di fare frequente ricorso onde affinare la propria esperienza proprio come Orazio pensava dovesse essere dell'opera sua.

In recent years wrist problems have increasingly attracted the attention of orthopaedic and hand surgeons. Numerous advances have been achieved in functional anatomy, biomechanics, diagnosis, and treatment. There are, however, many controversial aspects to these problems. Many clinical and associated investigators from around the world have attempted to increase our knowledge of the wrist with enthusiastic and devoted studies. An international symposium was held at the Nagoya Castle Hotel, Nagoya, Japan from March 6th through March 8th, 1991 to further understanding and promote discussion of wrist problems among a representive international group. Approximately 300 participants from 16 different countries assembled for these discussions. This monograph consists of 40 selected papers based on presentations given at the international symposium. The topics are divided into six chapters: Functional Anatomy, Diagnosis and Basic Studies; Kienbock's Disease; Scaphoid Fracture, Distal Radius Fracture; Carpal Instability and Wrist Pain; and Wrist Arthroplasty. A number of unique observations as well as detailed surgical techniques were presented. These include topics such as the vascularity of the triangular fibrocartilage, radial wedge osteotomy and vascular bundle implantation into the lunate for Kienbock's disease, Herbert screw insertion though a minimal exposure for acute scaphoid fracture, and closing wedge oseotomy of the radial styloid for the early stage of the SLAC wrist. It is hoped that this monograph will be of benefit to surgeons interested in not only achieving more satisfactory clinical outcomes, but also in stimulating further contemplation and research about these difficult wrist problems.

The advent in the 1960s of the unique and exciting new form of energy called laser brought to medicine a marvelous tool that could accomplish new treatments of previously untreatable disorders as well as improved treat ment of mundane problems. This brilliant form of light energy is many times more powerful than the energy of the sun yet can be focused microscopically to spot sizes as small as 30 microns. Lasers can be directed into seemingly inaccessible areas by mirrors or fiberoptic cables or can be directly applied into sensitive areas such as the retina without damage to intervening structures. There has been a rapid proliferation in the use of lasers in all surgical specialties. Starting with bold ideas and experiments of "thought leaders" in each specialty, the application of lasers has evolved into commonplace usage. Beginning with the era when laser presentations and publications were an oddity, now nearly all specialty areas have whole sections of meetings or journals devoted exclusively to laser usage. Laser specialty societies within a specialty have developed and residency training programs routinely instruct trainees in laser techniques. Basic science and clinical experimentation has supported laser knowledge. Laser usage has also become international. Newer wavelengths and accessories have added to the armamentarium of laser usage. Despite the rapid growth in laser interest, no single source exists to instruct the many new laser users in proper, safe, and effective use of this new modality."

Until now, the general belief has been that premature baldness (male pattern bald- ness: M.P.B., or androgenetie alopeeia) is a hereditary eondition that progresses with age and for which there is no eure. If the father is bald, it is assumed that the ehild may also be destined to be bald sometime in the future. The existing theory throughout the world is that the eentral portion of the hair follicle is the hair root, and hair ean never regrow if the hair root has been removed. Dr. Inaba has introdueed a new theory that the eentral portion of the hair folliele is not only the hair root but the upper isthmal portion elose to the duet opening of the sebaeeous gland. This is a totaUy new understanding of the hair growth mechanism and the hair eyele. In his experienee in the surgieal removal of the sweat glands, whieh also removes the hair root, Dr. Inaba has found inereasing evidenee that hair regrows if the sebaeeous gland is left intaet.

Discussing the most current and pioneering techniques in breast reconstruction without the use of implants, this is the volume every breast surgeon has been waiting for. Focusing not only on how to reconstruct breasts following mastectomy but also on how to achieve the highest degree of aesthetic success possible, Dr. Kroll describes in detail his techniques in using autologous tissue. Over 500 photographs and custom illustrations demonstrate and compare the different techniques used in breast reconstruction with autologous tissue such as conventional TRAM flaps, free TRAM flaps, the extended latissimus dorsi myocutaneous flap, and the Rubens fat pad free flap. Also include are chapters on immediate and delayed reconstructions, shaping the breast mound, nipple and areolar reconstruction and choice of technique, follow-up and patient selection.

In spite of great advance made by ENT and maxillofacial surgeons as well as radiotherapists to improve therapy of cancer of the oral cavity and oropharynx, it has not been possible in the past 4 decades to raise the chances of patient survival above 40%-45%. However, recent studies with different combination therapies indicate that better results can be expected in the future. In this volume, the current status and results of therapeutic studies are presented by distinguished clinicians in the three disciplines. The book provides up-to-date information and encourages interdisciplinary cooperation.

Posttraumatic stump formation and replantation of the severed limb are both reconstructive plastic operations which may lead to the improvement or destruction of a patient's lifestyle. For the primary attending surgeon, the decision whether to undertake such an operation depends on the patient's clinical condition, the operational circumstances, the psychological and social aspects and, last but not least, on the surgeon's own abilities. This monograph is designed as a synopsis of the great number of patho-physiological parameters and surgical and rehabilitational aspects which must be considered in the analysis of complications in major limb replantation. In addition, basic information about the key role of ischemic myopathy and microangiopathy is supplied to encourage further experimental investigations.

Fang Zhi-yang 1. 1 History of Traditional Treatment of Burns in China China is a country of ancient culture. The treatment of burn injury was documented more than 1500 years ago. As early as the Eastern Jin Dynasty, the Handbook of Prescriptions for Emergencies written by Ge Hong (281-341 A. D. ) and in the Southern Qi Dynasty (479-502 A. D. ) Liu J uan-Zi's Remedies Left Over by Ghosts, a book dealing mainly with diagnosis and treatment of traumatic wounds, are the earliest known monographs on "external diseases" in China. They record the treatment of burns with topical agents such as the preparation of a lard ointment of the liquid extract of Angelica anomalea Lallem, Gardenia jasminoides Ellis, Glycyrrhiza uralensis Fisch, Radia salviae miltiorrhizae, and the white cortex of willow. These herbs are found to be astringents and antibiotics. During the Sui Dynasty, a doctor of the Imperial Medical Academy (550- 630 A. D. ), Chao Yuan-fang, was authorized by imperial decree to compile the book General Treatise on the Etiology and Symptomatology of Diseases (610 A. D. ), the first book on etiology and symptomatology in China. This book with its valuable descriptions has been an authoritative and important reference for medical students for more than 1000 years.

This monograph presents a comprehensive review of the clinical experience in surgical repair of cranial defects which the author has gained during a period of over ten years. Particular problems of patients undergoing cranioplasty, such as neurological impairments, EEG changes, variations of intracranial pressure, and sinking skin flap syndrome are described and discussed. The author presents convincing evidence of the importance of cranioplasty in improving the quality of life of patients with large and disfiguring cranial defects. Unfortunately, cranioplasty still ameliorates only to a minimal extent the general condition in patients suffering of major cerebral lesions. I am convinced that this volume will serve the purpose it was designed for : that it will be a most helpful introduction into the problems related to reconstructive surgery. Basel, August 1984 Otmar Gratzl Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 A. History of Cranioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 B. Clinical Aspects of Cranial Bone Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 I. Origin of Cranial Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1. Acquired Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2. Congenital Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3. Demographic and Other Characteristics of Patients . . . . . . . . . . . . . . . . . 9 II. Neurological and Psychic Changes Before and After Cranioplasty . . . . . . . 11 1. Classification of Neurological Deficits and of the Skin Flap Types . . . . . 13 2. The "Sinking Skin Flap Syndrome" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 3. The Influence of Cranioplasty Upon Neurological and Psychic Changes 17 III. Electroencephalographic (EEG) Changes in Patients with Cranial Defects 21 1. EEG Recordings and Casuistic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2. Evaluation of EEG Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 IV. Scintigraphy Findings in Patients with Cranial Bone Defects . . . . . . . . . . . . 26 1. Casuistic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 2. Results and Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .