Practical Plastic Surgery For Nonsurgeons

[Pages:385]Practical Plastic Surgery For Nonsurgeons

Nadine B. Semer, M.D.

Practical Plastic Surgery for Nonsurgeons

NADINE B. SEMER, MD

Clinical Instructor Division of Plastic Surgery University of Southern California

School of Medicine Los Angeles, California

illustrations by

MARTHE ADLER-LAVAN, MD

Philadelphia, Pennsylvania

HANLEY & BELFUS, INC. Philadelphia

Publisher:

HANLEY & BELFUS, INC. Medical Publishers 210 S. 13th Street Philadelphia, PA 19107 (215) 546-4995 FAX (215) 790-9330

Library of Congress Cataloging-in-Publication Data

Practical plastic surgery for nonsurgeons / by Nadine B. Semer. p. ; cm.

Includes bibliographical references and index. ISBN 1-56053-478-8 (alk. paper) 1. Surgery, Plastic. 2. Rural health services. I. Semer, Nadine B, 1960? [DNLM: 1. Reconstructive Surgical Procedures. WO 600 P895 2001] RD118.P73 2001 617.9'5--dc21

00-054179

PRACTICAL PLASTIC SURGERY FOR NONSURGEONS

ISBN 1-56053-478-8

? 2001 by Hanley & Belfus, Inc. All rights reserved. No part of this book may be reproduced, reused, republished, or transmitted in any form or by any means without written permission of the publisher.

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Dedication

To Chris and Jenny McConnachie, Cosimo Storniolo and Meredith Weir, and all health care providers worldwide who are working to bring quality medical care to people living in rural areas And to David, who helped me to see that anything is possible

International Medical Missions

The following is a short list of organizations that sponsor international medical missions. There are many more. The World Wide Web and local medical/professional societies are other sources of information. The minimum time commitment ranges from a few days to several months to years. Some are religious-based organizations. Listing here does not imply recommendation or endorsement of any of these organizations. If you are interested in international work, research the organization well.

The best advice I can offer to health professionals going to work in any rural area is to be open to anything, be as flexible as possible, and above all respect the people you are working with and the people you are serving.

Nadine B. Semer, MD nadine@

Organization American Medical Student Association Catholic Medical Mission Board CB International Doctors of the World-USA Doctors Without Borders, USA

M?decins San Fronti?res The Flying Hospital, Inc. Global Volunteers Health Volunteers Overseas Himalayan HealthCare, Inc. International Medical Corps

International Rescue Committee Interplast, Inc. Mercy Ships Operation Smile Physicians for Peace Presbyterian Church (USA), Worldwide

Ministries Division, Mission Service Recruitment Office Project Hope

U.S. Contact Information and Internet Address

1902 Association Drive, Reston, VA 20191 (703) 620-6600;

10 West 17th Street, New York, NY 10011 (800) 678-5659;

1501 West Mineral Avenue, Littleton, CO 80120 (800) 487-4224;

375 West Broadway, 4th Floor, New York, NY 10012 (888) 817-HELP;

6 East 39th Street, 8th Floor, New York, NY 10016 (212) 679-6800;

11836 Fishing Pointe Drive, Newport News, VA 23606 (757) 873-6794;

375 East Little Canada Road, St. Paul, MN 55117 (800) 487-1074;

P.O. Box 65157, Washington, DC 20035 (202) 296-0928;

P.O. Box 737, Planetarium Station, New York, NY 10024 (212) 829-8691; himalayan-

11500 West Olympic Blvd., Suite 506, Los Angeles, CA 90064 (310) 826-7800; imc-

122 East 42nd Street, New York, NY 10168 (212) 551-3000;

300-B Pioneer Way, Mountain View, CA 94041 (650) 962-0123;

P.O. Box 2020, Garden Valley, TX 75771 (800) 424-7447;

6435 Tidewater Drive, Norfolk, VA 23509 (757) 321-7645;

229 West Bute Street, Suite 900, Norfolk, VA 23510 (757) 625-7569; physicians-for-

100 Witherspoon Street, Louisville, KY 40202 (800) 779-6779; msr

255 Carter Hall Lane, Millwood, VA 22646 (800) 544-4673;

Table of Contents

Chapter 1 Suturing: The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Chapter 2 Basic Surgical Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Chapter 3 Local Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Chapter 4 Protecting Yourself from Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . 45

Chapter 5 Evaluation of the Acutely Injured Patient . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Chapter 6 Evaluation of an Acute Wound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Chapter 7 Gunshot Wounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Chapter 8 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Chapter 9 Taking Care of Wounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Chapter 10 Secondary Wound Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Chapter 11 Primary Wound Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Chapter 12 Skin Grafts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Chapter 13 Local Flaps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Chapter 14 Distant Flaps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Chapter 15 Scar Formation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137

v

vi Contents

Chapter 16 Facial Lacerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

Chapter 17 Pressure Sores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

Chapter 18 Chronic Wounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

Chapter 19 Soft Tissue Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183

Chapter 20 Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191

Chapter 21 Fractures of the Tibia and Fibula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

Chapter 22 Skin Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221

Chapter 23 Cleft Lip/Palate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235

Chapter 24 Breast Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244

Chapter 25 Facial Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251

Chapter 26 The Normal Hand Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257

Chapter 27 Evaluating the Injured Hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267

Chapter 28 Hand Splinting and General Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275

Chapter 29 Fingertip and Nail Bed Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283

Chapter 30 Finger Fractures and Dislocations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293

Chapter 31 Traumatic Hand and Finger Amputations . . . . . . . . . . . . . . . . . . . . . . . . . 303

Chapter 32 Tendon Injuries of the Hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307

Contents vii

Chapter 33 Nerve and Vascular Injuries of the Hand . . . . . . . . . . . . . . . . . . . . . . . . . . 313

Chapter 34 Hand Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321

Chapter 35 Hand Crush Injury and Compartment Syndrome . . . . . . . . . . . . . . . . . . . 329

Chapter 36 Hand Infections: General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339

Chapter 37 Specific Types of Hand Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347

Chapter 38 Chronic Hand Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355

Chapter 39 Exploration of an Injured Hand or Forearm . . . . . . . . . . . . . . . . . . . . . . . . 367

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375

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In order to avoid copyright disputes, this page is only a partial summary.

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