皮肤癌管理中的 Keystone 重建技术地图

English | 31 December 2023 | ISBN-10: 3031408047 | 218 pages | PDF (True) | 34 MB

Worldwide, it is quoted that 85% of Melanoma cases are treated surgically. The reliability of the Keystone Perforator Island Flap (KPIF) as a reconstructive technique has wide applications. Its low complication rate is the key to its surgical success. The technique is clearly explained in this Atlas by the author, a renowned plastic and reconstructive surgeon, who established this reconstructive principle over 20 years. The illustrations range from simple to complex cases in an easy-to-follow format. Audio files, as a supplementary tool, amplify the technique to enhance the reader’s experience and foster clear understanding. Chapters focussing on anatomical regions contain carefully selected cases accompanied by images to demonstrate a step-by-step surgical technique. The basic design format for all Keystones are highlighted, all sitting within the dermatomal precincts. The KPIF must contain a fascial base for lining and the island outline is an essential pre-requisite. It is hypothesized that this islanding creates a sympathectomy effect resulting in hyperaemic blood flow which optimises healing. Undermining up to 2/3 is permissible as long as there is a deep attachment of 1/3 at the base of the flap to contain the random perforator vascular support. This design allows the rotation, advancement and transposition (ART) of the flap to facilitate the reconstructive closures. Presumably, there are somatic and autonomic neural support lines accompanying the vascular pathways of these random perforator flaps. The vascular perforator tree must not be skeletonised (as in propellor flaps) to allow preservation of such anatomical elements - somatic, autonomic and lymphatic pathways, all of which are an essential component in any surgical repair. This KPIF provides an alternative to microvascular procedures where the biggest drawback is tissue match. The KPIF addresses this problem admirably with a low pain component, an excellent aesthetic match with a low vascular complication rate and a performed in an expeditious manner – these all characterise the KPIF. Simple solutions solve problems and this KPIF Atlas for Melanoma becomes a welcome companion to any surgical speciality including plastic and reconstructive surgeons, surgical oncologists, general surgeons and dermatologists.

全球数据显示，95%的黑色素瘤病例都是通过手术治疗。 Keystone Perforator Island Flap (KPIF) 作为一种重建技术的应用范围广泛。其低并发症率是该手术成功的关键。作者解释了这一重建技术，并是一位享有盛誉的整形外科和重建外科医生，他在该原则上的应用已超过20年。插图从简单的病例到复杂的病例，都以易于跟随的方式呈现出来。辅助工具音频文件则扩大了这项技术的应用范围，从而增强读者的体验并促进清晰的理解。专注于解剖区域的章节包含了一组精心挑选的案例，并附有图像来演示手术步骤。所有Keystone的基本设计格式都得到突出展示，所有的设计都在皮神经区域内。KPIF必须具有筋膜基底进行内衬，并且岛状轮廓是必备条件之一。假设这种岛状操作可以创建一种交感神经切除术的效果，从而导致血液流量的增加，从而优化愈合过程。只要在边缘保留了三分之一的深层附着就可以允许二分之三的下挖。KPIF的设计使得能够旋转、推进和转换（ART）瓣体来促进重建缝合。假定这些随机穿支瓣体中伴随血管路径的是有感觉神经和支持路径。为了保持诸如有感觉神经、自主神经以及淋巴管等解剖学元素，无法像在扇形瓣体中那样对这些随机穿支瓣体进行“骨架化”。KPIF提供了一种替代微血管手术的方法，该方法的主要缺点在于组织匹配问题。KPIF以低疼痛、优秀的美学匹配和低血管并发症率很好地解决了这一问题，并且执行速度快——所有这些都是KPIF的特点。简单解决方案解决复杂问题，这款针对黑色素瘤的KPIF图谱成为了任何外科专长（包括整形与重建外科医生、肿瘤外科医生、普通外科医生以及皮肤科医生）的受欢迎伴侣。

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