tailieunhanh - Ebook Principles and practice of surgery(6th edition): Part 2

(BQ) Part 2 book "Principles and practice of surgery" presents the following contents: Surgical specialties (Plastic and reconstructive surgery, the breast, endocrine surgery, vascular and endovascular surgery, orthopaedic surgery, transplantation surgery,.). | SECTIONS Surgical specialties Plastic and reconstructive surgery 281 The breast 302 Endocrine surgery 325 Vascular and endovascular surgery 345 Cardiothoracic surgery 379 Urological surgery 399 Neurosurgery 424 Transplantation surgery 444 Ear nose and throat surgery 459 Orthopaedic surgery 476 279 Intentionally left as blank . Watson 18 Plastic and reconstructive surgery CHAPTER CONTENTS Introduction 281 Structure and functions of skin 281 Wounds 281 Burns 289 Prognosis 291 Skin and soft tissue lesions 294 INTRODUCTION Plastic and reconstructive surgery is concerned with the restitution of form and function after trauma and ablative surgery. The techniques by which this is achieved are applicable to virtually every surgical subspecialty and are not limited to any single anatomical region or system. The reconstructive ladder is broad simple and widely applicable at its base but narrow technically demanding and complex at its top Fig. . It is important to distinguish plastic and reconstructive surgery from cosmetic or aesthetic surgery. In the latter the techniques of the former are applied to improve appearance but not physical function although there may be considerable psychological benefit. STRUCTURE AND FUNCTIONS OF SKIN Skin consists of epidermis and dermis. The epidermis is a layer of keratinized stratified squamous epithelium Fig. that sends three appendages hair follicles sweat glands and sebaceous glands into the underlying dermis. Because of their deep location the appendages escape destruction in partial-thickness burns and are a source of new cells for reconstitution of the epidermis. The basal germinal layer of the epidermis generates keratin-producing cells keratino-cytes which become increasingly keratinized and flattened as they migrate to the surface where they are shed. The basal layer also contains pigment cells melanocytes that produce melanin which is passed to the keratinocytes and protects the basal layer from ultraviolet light. .