Reconstructive Surgery of the Chest, Abdomen, and Pelvis

491 Pages·2004·41.47 MB·English

by  Gregory R.D. Evans

Reconstructive Surgery of the
Chest, Abdomen, and Pelvis
edited by
Gregory R. D. Evans
UniversityofCalifornia atIrvine
Irvine, California, U5.A.
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Preface
The art ofplastic surgery is the restoration ofform and function. We have become
proficient in the transfer of flaps for these functional restorations, but recent tech
niques have focused on these restorations with a more aesthetic approach and im
provementin thequalityoflife.Itiswiththesenewfounddirectionsthatreconstructive
surgery can expand beyond "just coverage of the wounds" and focus more on the
aesthetic restoration ofsoft and bony defects. In our search for these more focused
operations, reconstructionofthechest,abdomen, and pelvisarecritical for maintain
ingambulation, pulmonary function, and a sense ofappearance. This book attempts
to expand upon these time-honored and new aesthetic techniques to the trunk. The
most common operative procedures likely to be encountered by the plastic surgeon
have been identified within this book. In each chapter, the authors attempt to
synthesizethemyriad ofhistoricaldata and techniquesalongwith theirown personal
experiencetoobtainthoseresultstoimprovethequalityoflifeand restoreanaesthetic
appearance to the surgical area.
Theapproach to each chapterfollows ourapproach to individual patients. This
includesanassessmentofthedefect,indicationsfortheoperation,pathophysiologyof
thechanges, operative techniques, and postoperativecare. It is our hope that this ap
proach will mimic the approach we take daily in the preparation ofour patients.
FinallyIwould like to thankmyassociates, MarkKobayashi, Michael Sundine,
andJayCalvert,who havebeenan inspirationinmysurgicalskills. Iwouldalsoliketo
thank the endless numberofstudentsand residents who continue to push our knowl
edge and continue to drive us to perfection. I would be remiss ifI did not especially
thank my lovingfamily, who haveprovided me withendlesssupport and understand
ing in my professional life and mycommitment to patients and resident education.
I trust that you willfind this workexcitingand will spureachofyou tostrivefor
those more aestheticand quality-of-life issues we face daily.
Gregory R. D. Evans
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Contents
Preface iii
Contributors IX
CHEST
1. Anatomy of the Chest Wall
William P. Adams, Jr. andJeffrey E. Janis
2. Preoperative Evaluation ofPatients Undergoing Chest Wall
Reconstruction 17
Melissa A. Ka::.anolvski and GeofFey C Gurtner
3. Introduction to Surgical Infections of the Chest: Empyema
and Mediastinitis 29
Blanding U Jones, Jeffrey Jim. and Jeffrey C Milliken
4. Treatment ofSternal Clefts 43
Michael 1. Sundine
5. Poland's Syndrome 63
Yvonne L. Karanas and James Chang
6. Pleural Defects 73
Jay W. Calvert
7. Alloplastic Reconstruction ofChest Wall Deformities 87
David1. Rowe awl Arun K Gosain
8. Reconstruction ofPectus Excavatum and Pectus Carinatum 99
Theodore S. Wright, Seema Kumbhat, and Michael L. Bent:!
9. Chest Wall Tumors 113
Mary Maish and Garrett Walsh
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vi Contents
10. Effects ofRadiation and Chemotherapy on the Reconstruction
ofthe Chest, Abdomen, and Pelvis 139
Michael E. Budd and Gregory R. D. Evans
II. Local Flaps and Skin Grafts for Chest Reconstruction 153
David W. Chang
12. Rectus Abdominis for Chest Reconstruction 165
Andrew 1. L. Gear, Mark R. Migliori, and Warren Schubert
13. Latissimus Dorsi and Serratus Anterior for Chest WalJ Reconstruction 183
Michael P. McConnell and Gregory R. D. Evans
14. Pectoralis Muscle for Chest Reconstruction 195
Claire L. F. Temple and Charles E. Butler
15. Chest Wall Reconstruction with Omentum 215
Juan Carlos Jimenez and Gregory R. D. Evans
l6. Chest Wall Reconstruction with Scapula and Parascapula Flaps 223
Paul M. Gardner
17. Trapezius Flap for Chest Reconstruction 233
Maurice Nahabedian
18. Extended Flaps for Chest Wall Reconstruction 251
Peirong Yu and Geoffrey L. Robb
19. External Oblique Myocutaneous Flap 263
William A. Zamboni, Lee M. Reese, and Allison K. Reese
20. Free Flaps for Chest Wall Reconstruction 269
Vivian Ting and Julian 1. Priba::.
21. Outcomes in Chest Wall Reconstruction 303
Elisabeth K. Beahm. Roman 1. Skoracki, and David H. Song
ABDOMEN AND PELVIS
22. Anatomy and Physiology of the Abdominal Wall and Pelvis 325
Kenton D. Fong, HanJoon M. Song, Tony D. Fang.
Stephen M. Warren, and H. Peter Loren:
23. Tumors ofthe Pelvis 339
Alan W. Yasko
24. DirectClosure, Tissue Expansion, and Graftingofthe Abdominal Wall 361
Dimitris P. Mastorakos andJoseph J. Disa
25. Vastus Lateralis Muscle Flap 377
Jason Ganz and Christopher E. Allinger
26. Reconstructionofthe Abdomen and Pelvis with theTensorFasciaLata 391
Gregory R. D. Evans and Mark Kobayashi
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Contents vii
27. Gluteus Maximus 397
Jason Rosenberg and Bruce A. Mast
28. Rectus Femoris Flap 407
Peter C. Ne/igan
29. Rectus Abdominus Muscle in Reconstruction ofAbdominal
and Pelvic Defects 415
Mohamed S. A. Elfar and Gregory R. D. Evans
30. Filet Flap Reconstruction ofAbdominal and Pelvic Defect
from External Hemipelvectomy 429
Nho V. Tran
31. Free Flaps for Abdominal and Perineal Reconstruction 435
Joseph M. Ser/etti
32. Outcomes ofPerineal Reconstruction 449
Scott D. Oates
Index 457
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Contributors
William P. Adams, Jr. University ofTexas Southwestern Medical Center, Dallas,
Texas, U.S.A.
ChristopherE. Attinger The Limb Center, Georgetown University Hospital, Wash
ington, DC, U.S.A.
Elisabeth Beahm Department ofPlasticSurgery, University ofTexas M. D. Ander
son Cancer Center, Houston, Texas, U.S.A.
Michael L. Bentz Department ofSurgery, University ofWisconsin Medical School,
Madison, Wisconsin, U.S.A.
Michael E. Budd Division of Plastic Surgery, University of California at Irvine,
Irvine, California, U.S.A
Charles E. Butler Department of Plastic Surgery, University of Texas M. D.
Anderson Cancer Center, Houston, Texas, U.S.A
JayW.Calvert DivisionofPlasticSurgery,UniversityofCaliforniaatIrvine, Irvine,
California, U.S.A.
David W. Chang Department of Plastic Surgery, University of Texas M. D.
Anderson Cancer Center, Houston, Texas, U.S.A.
James Chang Division of Plastic Surgery, Stanford University Medical Center,
Stanford, California, U.S.A.
Joseph J. Disa Memorial Sloan-Kettering Cancer Center, New York, New York,
U.S.A.
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