By Ken K. Lee
This full-color atlas provides an in-depth pictorial show of cutaneous surgical procedure designed for all these drawn to enhancing their surgical abilities, from scholars and citizens to skilled surgeons throughout a variety of clinical specialties. It presents step by step directions via a chain of designated colour pictures and illustrations. The excisions and ensuing defects featured inside hide various destinations. The upkeep differ in style and dimension with a purpose to supply a number of ideas in reconstruction. The chapters are separated into anatomic areas to permit the reader easy accessibility to precise anatomic defects.
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Extra info for Color Atlas of Cutaneous Excisions and Repairs
In older individuals, the RSTL will be obvious as they coincide with wrinkles. However, in younger individuals these lines can be accentuated with exaggerated facial movements such as smiling, grimacing, and pursing the lips. This accentuates the RSTL of the face and helps one determine the direction of the fusiform ellipse. B, C. When performing surgery on the neck, trunk, and extremities, where lines and tension can change depending on the position, the RSTL is best determined by stretching the skin with the patient in a neutral position.
Further bisection of each half in sequential fashion results in an ‘‘S’’ shape. 10 M-plasty. An M-plasty is used to prevent the extension of an incision into signiﬁcant cosmetic areas such as the eyebrows. The M-plasty is used to wrap the incisions above and below the eyebrow. A. The design of the M-plasty involves creating two 30° angles at one end of the fusiform ellipse; this shortens the length of the scar by one-fourth to one-third. B. Three tips are excised. C. Immediate post-op. A three-point tip stitch is useful at the corner of the M-plasty.
The advancement ﬂap has many variations. ‘‘O to L’’ or ‘‘A to L’’ is a common variation. A single horizontal incision is made at the base of the defect, usually along a cosmetic border. B. A dog-ear is removed in a direction perpendicular to the original incision. C. The ﬂap is elevated and undermined in the shaded regions. D. Because the incisions are perpendicular, there is a wide vascular pedicle at the base of the ﬂap. An additional horizontal incision in the opposite direction would provide more movement and is called an ‘‘O to T’’ or ‘‘A to T’’ advancement ﬂap.