bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘The hearths and altars for the vital fire’
Authors: Compston Alastair 
Published: September 2021

Abstract
Chapter 15, ‘The hearths and altars for the vital fire: medical chemistry and disease’ is based on a close reading of De fermentatione, De febribus, De urinis (1659), De scorbuto (1667), and De sanguinis accensione (1670) in explaining Willis’s concept of how living bodies function. His explanation that the nutritive products of digestion are distributed as chyle, interact with an unknown property of air leading to fermentation, with circulation of the heated blood to body parts where it is further altered, recirculation for refreshment in the lungs, and excretion of residues in several body fluids, is described. An account is given of Willis’s focus on the action of five principles (sulphur, spirit, salt, water, and earth), which heat the blood when inflamed. His description of disorders characterized by fever is described. The chapter ends with a summary of Willis’s treatise on the study of urine in detecting healthy and impaired fermentation. {149 words}
‘Neurologie: the doctrine of the nerves’
Authors: Compston Alastair 
Published: September 2021

Abstract
Chapter 16: ‘Neurologie: the doctrine of the nerves: the brain and nervous stock’ summarizes Willis’s treatises in Cerebri anatome, Nervorumque descriptio et usus (1664), De motu musculari (1670) and De anima brutorum (1672). Willis’s coinage of the term ‘neurologie’, intending this as the doctrine of the nerves based on the anatomy of the cranial nerves rather than the study of diseases affecting the brain and nervous stock, is described. The chapter explains why these treatises are additionally important for assigning function to the cerebrum and cerebellum rather than the ventricles; the concept of cerebral localization; the distinction between voluntary and involuntary, or reflex, movement; Willis’s account of the autonomic nervous system; and his ideas on muscular movement. Apart from these innovative contributions, Willis’s description of the arrangement of blood vessels supplying the brain and spinal cord, for which the book is celebrated, is described. The fifteen engraved plates are included. {148 words}
Vascular anatomy
Authors: Murphy Amanda , Morris Steven F. , Taylor G. Ian 
Published: September 2021

Abstract
Knowledge of cutaneous vascular anatomy has increased exponentially within the last four decades, coinciding with the early evolution of microsurgery. This chapter summarizes the progress in understanding the vascular basis of flap design and provides an introduction to the general vascular anatomy of the integument, muscle, and bone alongside a discussion of the angiosome concept and associated clinical applications.
Anaesthesia
Authors: Srinath Chetan , Yates Alan 
Published: September 2021

Abstract
The evolution of surgical anaesthesia began nearly 175 years ago with the first public demonstration in 1846 by William G. Morton. Modern anaesthetic techniques have developed in keeping with our understanding of human physiology and the demands of surgical innovation. Anaesthesia can be local, regional, or general and plastic surgery lends itself to local or regional techniques. Local anaesthesia infiltrates the active agent throughout the area in question, while regional anaesthesia uses discrete placement of the anaesthetic agent to block the conduction in nerves supplying sensibility to a wide predictable area. General anaesthesia involves complete loss of consciousness and awareness.
Skin grafts
Authors: O’Ceallaigh Siobhan , Shah Mamta 
Published: September 2021

Abstract
Skin grafts are an option for closing skin defects that cannot be closed primarily. A skin graft consists of epidermis and a portion of the underlying dermis that is detached from its blood supply and transferred to another location, usually on the same individual (an autograft). Skin grafts can also be used from cadaver donors (allografts) in extensive burn injuries, but as the recipient’s immune system will eventually reject this foreign tissue, this is only a temporary measure.
Skin flaps
Authors: Dewar Donald 
Published: September 2021

Abstract
Flaps can reconstruct defects of the integument, resurface mucosal defects, as well as contribute to contour. They are used where grafting is not feasible because of the nature of the defect and/or where the aims of reconstruction would be better served by vascularized tissue with both cutaneous and subcutaneous components. A skin flap can also be combined with fascia, muscle, or bone to reconstruct a complex or composite defect, and to provide tissue to restore function. Flaps may be classified according to the origin of the flap: local skin flaps are raised from tissue adjacent to the defect (usually deriving their blood supply from the subcutaneous tissue and subdermal plexus), and distant flaps are raised on dedicated vascular pedicles from a non-contiguous region. A distant flap may be moved to the defect maintaining the continuity of the pedicle (a ‘regional’ or ‘pedicled’ flap) or as a free flap, where the flap is elevated from its remote donor site and the pedicle is divided to allow the flap to be transported ‘free’ to the defect and then the vascular continuity is re-established by anastomosis to a recipient vessel in the defect. This chapter focuses on local flaps.
Vascularized composite allotransplantation
Authors: Wilks Daniel , Kay Simon 
Published: September 2021

Abstract
Vascularized composite allotransplants contain the products of multiple cell lineages to reconstruct the form and function of complex, composite tissue defects. This chapter discusses the ethical principles and the immunology behind composite transplantation, including the selection of immunomodulatory agents and the immune basis and treatment of rejection. The principles of organ allocation and candidate preparation are presented prior to discussion of the clinical applications and outcomes of hand, face, abdominal wall, uterus, penis, and lower limb transplantation.
Hand therapy after peripheral nerve injury
Authors: Rosén Birgitta , Jerosch-Herold Christina 
Published: September 2021

Abstract
Injury to the peripheral nerve affects the whole length of the neuron and is not just localized to the site of injury, making a nerve injury different from other types of tissue injury in the body. Moreover, a nerve injury has immediate functional consequences for the brain in terms of rapid cortical functional reorganization. Lifelong limitations of hand function with loss of sensibility, muscle weakness, prehensile problems, pain, and cold sensitivity are common. Recovery can take years in adults, especially of tactile discrimination, but often remains incomplete and quality of life may be significantly affected. Numerous factors influence the outcome: age, type of injury, timing of surgery, and cognitive capacity. In addition, education, sex, and post-traumatic stress have proved to be prognostic factors. The timing of hand rehabilitation including sensory and motor re-education are also important contributors to the final outcome.
Physiological requirements for action potential conduction, sensory awareness, and motor control
Authors: Johansson Staffan 
Published: September 2021

Abstract
Nervous system function depends on electrical and chemical signals. The nervous impulse is a fluctuation in voltage across the neuronal cell membrane, generated by ion currents through ion-selective, voltage-sensitive membrane channels. Neuronal information is encoded in the temporal pattern of such impulses propagated along the nerve fibres at speeds that may reach about 100 m/s in fibres electrically isolated by myelin. Signal transmission to other cells via synaptic contacts occurs mainly via chemical transmitters that control membrane ion channels and give rise to electrical responses in receiving cells, with plasticity in the process making the system capable of learning and memory storage. Since impulse generation as well as synaptic transmission depends on ion flux across the membrane, energy-dependent ion pumps are critical for maintaining the ion concentration gradients necessary for the nervous signals. As a consequence, the nervous system consumes a lot of energy and is sensitive to any lack of energy.
Tactile sensory control of the human hand
Authors: Johansson Roland S. , Nordmark Per F. 
Published: September 2021

Abstract
This chapter details the sensory input from the hand that is mediated by a system of fast-adapting and slowly adapting nerve fibres with a specific anatomical distribution and associations with particular sensory end organs that allow multimodal sensory input and processing. This highly refined system interacts with the motor system to provide continuous feedback that allows the dexterous manipulation of the environment that distinguishes the human hand.
Tinel–Hoffman sign
Authors: Kay Simon 
Published: September 2021

Abstract
The Tinel–Hoffman sign is uniquely valuable to the peripheral nerve surgeon. Described by both Hoffman (1915) and Tinel (1915) on opposite sides of the First World War, its value lies in assessing nerve recovery after injury. Originally called ‘Le signe du fourmillement’ by Tinel, it relies upon the phenomenon that regenerating axon sprouts depolarize on mechanical stimulation so that percussion or pressure over the site of nerve regeneration causes the patient the sensation of tingling in the distribution of that nerve.
Nerve grafts and transfers
Authors: Bains Robert , Kay Simon 
Published: September 2021

Abstract
Following Cruickshank’s (1795) ingenious (and at first disbelieved) demonstration of the regenerative capacity of mammalian nerves, the eighteenth and nineteenth centuries saw a pan-European enthusiasm to redress the nihilism surrounding nerve injury. The first recorded experimental nerve grafts were performed by Philipeaux and Vulpian who attempted both nerve autografting as well as allografting in dogs. At that time, and for many years, allografts were thought to behave similarly to autografts, a belief that persisted well into the twentieth century in some clinics and laboratories. These early attempts at nerve grafting yielded poor results and most surgeons aimed for primary nerve repair despite nerve gaps. Other techniques to allow direct repair involved alteration of position, transposition of the nerve, and even sometimes bone shortening. Although primary repair was frequently possible, after these measures the repair was under tension and mechanical failure was common. Spurling (1945), Whitcomb (1946), and Woodall (1956) showed failure rates of 4%, 7.5%, and 22.4% respectively. Some recovery of function following nerve grafting was documented by Sanders (1942), Seddon (1954), and Brooks (1955). Millesi subsequently published his results for nerve grafting for injuries to the upper limb in 1984. These papers demonstrated more significant recovery of function and highlighted the detriment of delay in treatment to final outcome. Microsurgical advances were central to Millesi’s results, and he emphasized atraumatic dissection and the deleterious effect of tension at the repair site resulting in fibrosis preventing axonal regrowth. Nerve autograft is now the standard for orthotopic nerve reconstruction when primary repair cannot be achieved.
Compression neuropathies
Authors: Dahlin Lars B. , Thomsen Niels 
Published: September 2021

Abstract
Nerve compression disorders affect nerve trunks, particularly in the upper extremity where carpal tunnel syndrome (median nerve compression at the wrist) is the most common and ulnar nerve compression the second most common disorder. Compression affects the various components of the nerve trunk, including the intraneural blood vessels, the Schwann cells, the axons, and the connective tissue components. It results in sensory and motor dysfunction, and sometimes pain. Risk factors for nerve compression disorders are known and may predict surgical outcome. A careful clinical examination should always be done, sometimes complemented with appropriate electrophysiology and magnetic resonance imaging for diagnosis. If conservative treatment is not appropriate, or fails, simple decompression is generally the primary treatment, but problems may persist. The presence of other neuropathies should be considered.
Lower limb replantation
Authors: Tarar Moazzam N. , Ul Haq Ata 
Published: September 2021

Abstract
Advances in microsurgery have made possible replantation of severed body parts. Lower limb replantation has been successfully attempted and reported in the literature. Despite many similarities with replantation of the upper limb, the same degree of outcome has not been attained in lower limb replantation. This is due to the strong forces required to result in lower limb amputation and relatively less potential of recovery. In selected cases when distal amputations were caused by sharp injuries, favourable outcomes were reported. Similarities and differences between upper and lower limb replantations are outlined in this chapter with special reference to indications, assessment, operative management, and results.
Amputations in the lower limb
Authors: Khan Umraz , Gordon Alan 
Published: September 2021

Abstract
Amputation surgery of the lower extremity is frequently an end point of many differing disease processes. Often the most difficult decisions relate to the timing and the level of amputation. Both of these are dictated by the disease. Amputation for trauma is often more difficult both to undertake and to accept when compared to amputation for dysvascular disease or diabetes. This decision must be made by experienced surgeons in coordination with the patient, the patient’s family, and the limb-fitting professionals. This chapter outlines the principles of surgery from minor to major amputations, tries to simplify the surgical steps, and emphasizes the importance of exemplary rehabilitation after a major amputation.
Deformities of the chest
Authors: Stern Harvey 
Published: September 2021

Abstract
Analysis and surgical management of chest wall deformities involves understanding complex congenital and acquired conditions and well as the full spectrum of reconstructive techniques. Congenital chest wall deformity includes pectus excavatum, pectus carinatum, and Poland syndrome. In surgical correction of these conditions, timing and the understanding of the growing child is important. Traumatic chest wall deformities present a different set of challenges, especially as the context is often a very unwell patient. As cardiothoracic surgeons push the boundaries of what is possible in patients with ischaemic heart disease, iatrogenic defects are not uncommon, and repair of such defects is described. Lastly, this chapter covers surgery for the coverage of major tumour resection defects in oncological surgery.
Surgical anatomy of the breast
Authors: Jeeves Amy E. 
Published: September 2021

Abstract
The anatomy of the breast is integral knowledge for the surgeon undertaking oncoplastic, aesthetic, or reconstructive breast surgery. This chapter reviews the current literature on applied breast anatomy. Arterial and nerve supply, venous and lymphatic drainage, and ligamentous framework as well as the nipple–areolar complex are discussed. Relevant gross anatomy and histology are covered along with current concepts of breast aesthetics. This chapter emphasizes surgical anatomy with both historical and practical references for the plastic surgeon
Congenital deformities of the breast
Authors: Lodge Michelle L. 
Published: September 2021

Abstract
Congenital breast anomalies include supernumerary nipples (polythelia) and supernumerary breasts (polymastia) which can be generally found on the embryonic mammary ridge. Absence of the breast occurs less frequently and varying presentations of absence of nipples only (athelia), absence of mammary gland tissue (amazia), or absence of the entire breast (amastia). Tuberous breast deformity is a common congenital anomaly with varying degrees of constriction, hypoplasia, areolar herniation, skin deficiency, and asymmetry. Treatment consists of breast augmentation, either primarily or after tissue expansion, in combination with mastopexy. Gynaecomastia is the development of breast tissue in males. The aetiology is diverse and includes physiological, pathological, acquired, drug-related, and idiopathic causes. Poland syndrome is discussed elsewhere (Chapter 9.2).
The tissue-engineered breast
Authors: Morrison Wayne 
Published: September 2021

Abstract
The adipose tissue engineering paradigm of in vitro cell-seeded scaffolds subsequently implanted in vivo failed because of inadequate vascularization. Consequently, entirely in vivo models of tissue engineering are being trialled where angiogenic growth is stimulated in unison with expansion of implanted cells and matrices. In animals, impressive amounts of fat and fibroblastic tissue have been grown by matrix induction of preadipocytes or by redirecting a vascular pedicle with fat into a sealed chamber space and proof of principle shown in a human trial. The models are cumbersome limiting clinical translation and currently direct fat transfer by injection is simpler. Unlike true tissue engineering there is, however, no net gain of tissue and even when ‘successful’ it is debated whether the graft survives or is replaced by newly regenerated adipocytes. Research focuses on stem cell differentiation, cell survival, and matrix and biomechanical manipulations.
Anaesthesia and analgesia considerations in breast surgery
Authors: Rudkin Glenda , Gardiner Sarah 
Published: September 2021

Abstract
Breast surgery is most commonly conducted for a suspected diagnosis or treatment of cancer. Additionally, cosmetic breast surgery is an increasingly common field particularly in the day-case setting. Both oncological and plastic surgery of the breast varies in site, extent of dissection, surgical technique, and duration of procedure in the context of diverse patient factors (premorbid psychosocial profile, physical habitus, tissue quality, comorbidities). These elements all require careful consideration for the attending anaesthetist and surgical team in order to optimize the patient journey through their recovery in both the acute and long-term periods. In addition to systemic administration, improved postoperative analgesia and subsequent recovery in breast surgery incorporates regional and local anaesthetic techniques. Integral to any surgical setting is a patient-specific pain management plan. This should commence at the time of anaesthesia and continue into the postoperative period. Any risk factors for chronic pain need to be identified and managed early.
Measuring outcomes in plastic surgery of the breast
Authors: Dean Nicola R. , Cooter Rod , Pusic Andrea L. 
Published: September 2021

Abstract
A surgical outcome can be sensibly defined as a measurable end point relating to the goal of surgical treatments. Historically, complication rates have been used as surrogates for outcome, but now high-quality outcome measures such as the BREAST-Q are available; these should be a major focus for analysis of results in plastic surgical procedures of the breast. It is also important to collect high-quality data on complications and to document outcomes with methodologies such as standardized photography and three-dimensional laser scanning. Proper evaluation of outcomes is a potent driver of practice improvement in breast reconstruction and practical approaches to outcomes measurement in routine practice is discussed in this chapter. The history of device registries for breast devices is explained and the current and future roles for device registries are discussed.
Pressure ulcers
Authors: Hudson Donald , Moodley Sean 
Published: September 2021

Abstract
Pressure ulcers are a problem worldwide with social and cost implications. Patients at special risk are paraplegics, those in intensive care units who are critically sick, and older patients having prolonged bed rest for whatever reason. The important extrinsic factors are pressure, shear, and friction. There are a number of charts, which endeavour to identify patients at risk, and institute appropriate preventative measures thereby avoiding the long-term sequelae and burden of pressure ulcers. In patients with established pressure ulcers, an accurate patient and wound evaluation is vitally important. The long-term success of management of these ulcers is dependent on good patient rehabilitation and optimization of the wound. Reconstructive success is improved by following surgical guidelines. Use of fasciocutaneous flaps, designed in a V–Y configuration, is the preferred method of reconstruction with muscle flaps reserved as a back-up option. Conscientious postoperative care is equally important at ensuring a successful surgical outcome and minimizing complications
Bladder exstrophy and epispadias
Authors: Wilby Dan , Wood Dan 
Published: September 2021

Abstract
Bladder exstrophy and epispadias are congenital anomalies of the urogenital tract with deformity of the genitals as well as the pelvis, abdominal wall, and bladder in exstrophy. Reconstruction of the anomalies is a complex process with the aims of restoring function and appearance. Fertility and management of pregnancy in the exstrophy patient are also discussed in this chapter.
Periorbital, lower face, and neck
Authors: Waterhouse Norman , Noshi Naresh , Kirkpatrick Niall , Brendling Lisa 
Published: September 2021

Abstract
Facial ageing occurs as a consequence of multifactorial changes in both the external skin and underlying tissues. The ageing process may vary dramatically between individual patients and is thus influenced by genetic factors. When assessing the ageing face it is important to consider the skeletal architecture, the soft tissue layers including the anterior fat pads, the osseocutaneous ligament anchors, and finally the overlying skin. Assessment of the external skin incorporates factors such as dermal thinning, solar damage, lifestyle effects such as smoking, and Fitzpatrick skin type. Surgical correction of facial ageing attempts to reverse both gravitational change of soft tissues and also to restore volume loss. There are a variety of methods used to divide the face into regions, but for the purpose of this chapter, the surgical management of facial ageing will be separated into three anatomical areas: (1) upper face, including the upper eyelids, eyebrows, and forehead; (2) midface, including the lower eyelid/anterior cheek continuum; and (3) lower and lateral cheek, neck, and perioral region
The ethics of gender reassignment surgery
Authors: Fenton Oliver 
Published: September 2021

Abstract
Transgender issues are very much in the news at present. There has been discussion about both gender dysphoria in general but, more specifically, the practical, psychological, and financial implications of carrying out gender reassignment surgery. In the United Kingdom, this extends to a debate on whether it is justifiable to carry out these procedures within an already hard-pressed National Health Service. This chapter discusses the nature, history, and background of both gender dysphoria and gender reassignment surgery and whether such procedures are justifiable in terms of outcomes and patient satisfaction; and also whether these are legitimate procedures to carry out within the National Health Service.
Consulting with children
Authors: Kay Simon , Bellew Maggie 
Published: September 2021

Abstract
Plastic surgery deals with appearance and function, and a significant proportion of its work is in children with birth or developmental defects who require care throughout childhood and sometimes as an adult. For some plastic surgeons, children form a major part of their work whereas for others, their skills set may only occasionally be relevant to childhood conditions. Consulting with children and their families requires special circumstances and techniques for success. In this chapter (which should be read in conjunction with Chapter 13.2), the theoretical aspects of consulting with children is first examined, before considering the practical consequences for clinic arrangements.