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Soft Tissue Coverage
Foot Ankle Clin N Am 6 (2001) xi – xii
Preface
Soft Tissue Coverage
Christopher E. Attinger, MD Guest Editor
This edition of the Foot and Ankle Clinics focuses on the soft tissue aspects of foot and ankle surgery. Soft tissue problems are rarely addressed in the literature but are frequently encountered when dealing with traumatic or limb sparing surgery. Applying the principles of plastic surgery to soft tissue helps minimize peri-operative complications and maximize limb salvage. This volume starts with a discussion of proper debridement techniques to establish a clean base for potential healing. The next chapter covers modern wound healing techniques and their role in converting a chronic wound to an acute wound. The strategies of when to use hyperbaric oxygen, growth factor, skin graft substitutes and negative pressure dressings are then reviewed. The critical role of adequate blood supply and how to achieve it using modern vascular surgical techniques is then discussed. The topic of how to address the vexing problem of vasculitis in the foot and ankle is then superbly reviewed. The role of orthopedic surgery is often the key to limb salvage but poses challenges to soft tissue reconstruction when external hardware is used. This topic is thoroughly covered by an expert in the use of the Ilizarov technique. The choice of safe surgical incisions based on vascular principles is then discussed. Extensive discussions on how to accurately assess the vascular supply of a given patient using the Doppler allows the reader to plan the surgery in the context of the patient’s actual blood supply. The next section covers specific reconstructive techniques for each region of the foot and ankle. Options for reconstruction of the plantar surface of the foot are reviewed with detailed discussions of what option best fits each clinical situation. This is followed by the very intriguing option of using thick plantar glabrous skin 1083-7515/01/$ – see front matter D 2002, Elsevier Science (USA). All rights reserved. PII: S 1 0 8 3 - 7 5 1 5 ( 0 2 ) 0 0 0 1 8 - 9
xii
Preface / Foot Ankle Clin N Am 6 (2001) xi–xii
grafts on defects of the sole. Option for reconstruction of the dorsum of the foot and how to pick the best solution for a given clinical situation is then covered. Finally, an analysis of strategies for coverage in the area that has the least amount of redundant tissue, ie, the ankle, is then discussed. The volume then closes with a superb review of how to apply the above plastic surgical techniques to the traumatized foot. Christopher E. Attinger, MD Georgetown Limb Center Georgetown University Medical Center Washington, DC 20007, USA
Preface
Soft Tissue Coverage
Christopher E. Attinger, MD Guest Editor
This edition of the Foot and Ankle Clinics focuses on the soft tissue aspects of foot and ankle surgery. Soft tissue problems are rarely addressed in the literature but are frequently encountered when dealing with traumatic or limb sparing surgery. Applying the principles of plastic surgery to soft tissue helps minimize peri-operative complications and maximize limb salvage. This volume starts with a discussion of proper debridement techniques to establish a clean base for potential healing. The next chapter covers modern wound healing techniques and their role in converting a chronic wound to an acute wound. The strategies of when to use hyperbaric oxygen, growth factor, skin graft substitutes and negative pressure dressings are then reviewed. The critical role of adequate blood supply and how to achieve it using modern vascular surgical techniques is then discussed. The topic of how to address the vexing problem of vasculitis in the foot and ankle is then superbly reviewed. The role of orthopedic surgery is often the key to limb salvage but poses challenges to soft tissue reconstruction when external hardware is used. This topic is thoroughly covered by an expert in the use of the Ilizarov technique. The choice of safe surgical incisions based on vascular principles is then discussed. Extensive discussions on how to accurately assess the vascular supply of a given patient using the Doppler allows the reader to plan the surgery in the context of the patient’s actual blood supply. The next section covers specific reconstructive techniques for each region of the foot and ankle. Options for reconstruction of the plantar surface of the foot are reviewed with detailed discussions of what option best fits each clinical situation. This is followed by the very intriguing option of using thick plantar glabrous skin 1083-7515/01/$ – see front matter D 2002, Elsevier Science (USA). All rights reserved. PII: S 1 0 8 3 - 7 5 1 5 ( 0 2 ) 0 0 0 1 8 - 9
xii
Preface / Foot Ankle Clin N Am 6 (2001) xi–xii
grafts on defects of the sole. Option for reconstruction of the dorsum of the foot and how to pick the best solution for a given clinical situation is then covered. Finally, an analysis of strategies for coverage in the area that has the least amount of redundant tissue, ie, the ankle, is then discussed. The volume then closes with a superb review of how to apply the above plastic surgical techniques to the traumatized foot. Christopher E. Attinger, MD Georgetown Limb Center Georgetown University Medical Center Washington, DC 20007, USA