Microvascular Reconstruction: Anatomy, Applications And Surgical Technique

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Reconstructive microvascular surgery is now in its teens. At first many thought this new child was a whim and would fail to thrive. Some were un­ certain, others with vision either supported or became actively involved in this new area of surgical endeavour. Although initial interest was focused on the replantation of amputated parts, it has been the one stage free trans­ fer of living tissue to a distant site which has launched microsurgery into the surgical spotlight. From its humble beginnings we have witnessed a revolution in this branch of plastic surgery; many of the long established methods of recon­ struction have, like barricades, fallen before the advances made in this field. In its infancy there were relatively few procedures available. There was a tendency to make the patient's problem fit the operation, rather than the reverse, and this frequently led to an inferior result. The then known flaps, such as the groin flap and the deltopectoral flap, were employed. Unfortunately they were sites which posed many technical problems; namely those of vascular anomaly, a short pedicle and vessels of small cal­ ibre. Long operations were the norm, and vascular thrombosis was not un­ common. Hospital routine often was disrupted and there was a danger that these new techniques would fall into disrepute. Over the last decade this state of affairs has changed dramatically.


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Ralph T. Manktelow Microvascular Reconstruction Anatomy, Applications and Surgical Technique With Section on Paediatrics by Ronald M. Zuker Foreword by G. Ian Taylor Illustrated by Ken Finch With 288 Figures Springer-Verlag Berlin Heidelberg New York Tokyo Ralph T.Manktelow, M.D., F.R.C.S. (C) Associate Professor of Surgery, University of Toronto Faculty of Medicine; Head, Division of Plastic Surgery, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G2C4 ISBN -13 :978-3-642-70331-7 DOl: 10.1007/978-3-642-70329-4 e-ISBN-13:978-3-642-70329-4 Library of Congress Cataloging-in-Publication Data Manktelow, Ralph T. Microvascular reconstruction. Includes bibliographies and index. 1. Blood - vessels - - Surgery. 2. Microsurgery. 3. Flaps (Surgery) I. Title. [DNLM: 1. Microsurgery--methods. 2. Surgical Flaps. WO 512 M278m) 1986 617'.413 85-30323 RD594. 2. M36 ISBN -13:978-3-642-70331-7 (U.S.) This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machine or similar means, and storage in data banks. Under § 54 of the German Copyright Law where copies are made for other than private use, a fee is payable to "Verwertungsgesellschaft Wort," Munich. © by Springer-Verlag Berlin Heidelberg 1986 Softcover reprint of the hardcover 1st edition 1986 The use of general descriptive names, trade names, trade marks, etc. in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 2124/3145-543210 To Marg, Blair, Greg, Jennifer and Scott Foreword Reconstructive microvascular surgery is now in its teens. At first many thought this new child was a whim and would fail to thrive. Some were uncertain, others with vision either supported or became actively involved in this new area of surgical endeavour. Although initial interest was focused on the replantation of amputated parts, i