bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanisms of burn injury
Authors: Sood Ravi F. , Gibran Nicole S. 
Published: September 2021

Abstract
Burns comprise a highly heterogeneous group of injuries resulting from a variety of mechanisms. In order to provide adequate care for the burned patient, providers must be familiar with mechanism-specific factors. This chapter reviews common types of burn injuries requiring burn-centre admission, including those resulting from heat, cold, electricity, chemicals, and radiation. Specifically, the chapter focuses on clinically relevant differences in epidemiology, injury patterns, and pathophysiology. These considerations directly inform management and prevention of burn injuries and provide an essential framework for modern burn care.
Functional anatomy of the abdominal wall
Authors: Echlin Kezia 
Published: September 2021

Abstract
This chapter describes the functional anatomy of the abdominal wall. The layers of the abdominal wall consist of skin, superficial fascia, deep investing fascia, muscles, and inner fascial layers: transversalis fascia, extraperitoneal fascia, and peritoneum. The layers are variable in different areas of the abdomen. Skeletal support for the abdomen is derived from the lumbar vertebrae, the superior parts of the pelvic bones, and the bony parts of the inferior thoracic skeleton: the lower ribs and their costal cartilages and the xiphoid process.
The principles of complex abdominal hernia repair
Authors: Echlin Kezia , Fleming Andrew 
Published: September 2021

Abstract
Large, complex abdominal hernias can be repaired with the component separation technique, which creates sliding bipedicled flaps of the rectus abdominis to allow autogenous repair of midline, ventral hernias. This technique involves longitudinal release of the external oblique aponeurosis just lateral to the linea semilunaris, and developing the plane between the external and internal oblique muscles to allow the rectus abdominis muscle and sheath to slide medially. Modifications of the original technique include the addition of mesh reinforcement, release of the deeper elements of the abdominal wall, and sparing of the peri-umbilical perforators to the skin from the deep inferior epigastric artery. Component separation technique is an effective technique to repair large ventral hernias but carries a significant risk of wound complications and a risk of cardiorespiratory compromise.
Functional anatomy of the pelvis and gluteal region
Authors: Hudson Donald , Moodley Sean 
Published: September 2021

Abstract
A thorough understanding and knowledge of the regional anatomy of the pelvis and gluteal regions is essential for the understanding of the pathology and the flaps required for the reconstruction of various defects. The bony and ligamentous structure of the pelvis and the muscular and vascular anatomy of the gluteal region are described.
Perineal reconstruction following anorectal excision
Authors: Crick Alexandra 
Published: September 2021

Abstract
Anorectal abdominoperineal excision, either as a primary procedure for rectal cancer or as a salvage procedure for residual or recurrent anal cancer following chemoradiotherapy, creates a defect of the pelvic floor, pelvic dead space, and a perineal skin defect and may include a defect of the posterior vaginal wall. The ideal reconstruction should address all components of this defect and aims to achieve primary uncomplicated healing while preserving and restoring function. Pedicled flaps from the abdomen, gluteal and thigh regions, and occasionally free flaps are available for this purpose. There is increasing evidence that flap reconstruction improves perineal healing especially where there is a history of radiotherapy.
Modification of the facial skeleton in aesthetic facial surgery
Authors: Johnson Paul , Tighe David 
Published: September 2021

Abstract
The facial bones form the foundation of the face and provide support for the overlying soft tissues. Changing their structure can have profound effects on facial appearance. Procedures may involve augmentation, bone reduction by contouring, or repositioning of bones by means of osteotomies. Each of these techniques can be used to improve facial appearance.
Treatment of small breasts and inverted nipples
Authors: Grob Marion , Smock Elliott 
Published: September 2021

Abstract
Augmentation mammoplasty is one of the most popular aesthetic surgical procedures in the world and the number of cases performed continues to increase yearly. This chapter presents a comprehensive review of this topic which includes implant selection, surgical approaches, management of complications, and some of the pitfalls associated with this popular procedure. The chapter also covers the classification and treatment of inverted nipples.
Factitious injury and related conditions
Authors: Kay Simon , Bellew Maggie 
Published: September 2021

Abstract
Some patients consciously or unconsciously generate their own symptoms or physical injuries. Excluding deliberate self-harm (acknowledged by the patient), the remaining presentations can be categorized as somatoform disorders, factitious disorders (including Munchausen’s syndrome and Munchausen’s syndrome by proxy), and malingering. The distinction between these disorders is important for the plastic surgeon who may have the first opportunity to diagnose them.
Legal aspects of consent to treatment and the nature of malpractice claims in the United Kingdom
Authors: Ashley Mark 
Published: September 2021

Abstract
The UK law on consent to medical treatment is derived from statutes (acts of parliament and their subordinate statutory instruments) and case law which develops as individual cases are decided by the courts. Regard must also be had to guidance published by the General Medical Council, which all UK-registered medical practitioners are expected to follow. Further detailed guidance on consent is provided by the Royal College of Surgeons.
Soft tissue inflammatory disorders of the hand
Authors: Akhtar Sohail 
Published: September 2021

Abstract
Soft tissues are an important interface between the tendons and bones of the hand. This interface provides both physical and biological functions by facilitating smooth tendon excursion, tendon healing, and tendon and joint stability. Disease of these soft tissues results in pain, swelling, and loss of function, and can be due to systemic conditions or local factors. These conditions include disease of the tendon sheath, disease of the tendon synovium, and diseases of tendon attachments. Inflammation was considered a universal hallmark in these conditions but recent evidence suggests that this is not true for all such conditions, whose treatment has consequently been modified. This knowledge has also caused reflection on the nomenclature used to describe these conditions and has brought clarity to the traditionally used terminology such as tenosynovitis.
Tendon transfers in the hand and wrist
Authors: Hernon Cath 
Published: September 2021

Abstract
This chapter discusses the general principles and indications for tendon transfers in the hand and wrist. The main functional deficits requiring tendon transfers in the upper limb result from peripheral nerve injury. Clinical assessment for each specific nerve deficit and reconstructive options are discussed. The evolution of various reconstructive strategies is reviewed and the rationale for the commonly used techniques is described. Brief descriptions of some techniques are included.
Soft tissue swellings of the hand and upper limb
Authors: Devaraj Vikram 
Published: September 2021

Abstract
There is a broad range of soft tissue swellings in the hand, and most are benign lesions. Depending on their nature, they can be managed non-surgically or by excision. Malignant lesions are rare and careful assessment of the patient at presentation with appropriate investigation will distinguish these lesions which may require a multimodal approach to treatment.
Assessment of patients with craniosynostosis
Authors: White Nicholas 
Published: September 2021

Abstract
The term craniosynostosis denotes the pathological partial or complete absence of one or more cranial sutures which manifests as abnormal skull growth. Although it is often referred to as premature fusion this is misleading as only the metopic suture fuses in the normal physiological state. The remaining sutures change and mature in macroscopic and microscopic form during growth but remain present. This chapter discusses the assessment of patients with craniosynostosis.
Non-syndromic craniosynostosis
Authors: Duncan Christian , Nishikawa Hiroshi 
Published: September 2021

Abstract
Craniosynostosis is defined as the premature fusion of a skull suture and has an incidence of approximately 1:2000 live births. Historically, craniosynostosis was subdivided into primary and secondary synostosis. Further subclassifications included syndromic/non-syndromic and single/multisuture. Multisuture synostoses also give rise to characteristic head shapes, which, with experience, are readily identifiable by experienced clinicians using clinical examination alone. While in the past, single-suture craniosynostosis was classified as ‘non-syndromic’, advances in genetic analysis has shown that this may not be the case in a proportion of these cases, just as some multisuture presentations may also be non-syndromic. This particularly applies to unicoronal craniosynostosis along with some metopic and bicoronal synostosis. Given the higher rate of syndromic association in these patients, along with the tendency to require late surgery for facial scoliosis in unicoronal and unilambdoid patients, this cohort should be regarded as a more complex subset.
Orofacial clefts
Authors: FitzPatrick David R. 
Published: September 2021

Abstract
Orofacial clefting is an umbrella term for common human malformations. The most common of these malformations result from failure of tissue fusion events during formation of the embryonic face. Single-gene causes of orofacial clefting are rare and often associated with other clinical features in the form of a recognizable syndromal diagnosis. Isolated orofacial clefting is most likely caused by gene–environment interactions but the exact nature of these interactions is not yet known
Outcome assessment in cleft lip and palate surgery
Authors: Swan Marc C. , Harrison Conrad J. , Goodacre Tim E.E. 
Published: September 2021

Abstract
Outcome assessment for cleft management is complex due to the diverse elements of function affected by the condition, and the variation in effect on patients over time. Methods of assessment are broadly separated into objectively measurable variables that can be independently validated, and patient-reported measures that are necessarily more subjective. Validated tools to evaluate outcomes are now widely adopted for speech and facial growth, with other areas of outcome presenting greater problems in development of suitable measures. In recent years, the emphasis of outcome evaluation has turned towards greater reliance on patient-reported measures that require extensive preliminary research to develop if a high degree of validity is to be ensured. Existing outcome measures that are widely used are described in this chapter, along with a perspective for future trends and a forthcoming internationally applicable tool for comparative studies (ICHOM).
Secondary surgery in cleft lip and palate
Authors: Hodgkinson Peter D. 
Published: September 2021

Abstract
Secondary surgery in patients with cleft lip and palate should be undertaken within a cleft multidisciplinary team where such expertise is available. A clinical psychologist can identify issues related (or unrelated) to the cleft and aid in establishing appropriate patient expectations if surgery is contemplated. The requirements of patients considering secondary cleft surgery are more similar to the needs of patients undergoing primary surgery than they are to other non-cleft facial surgery patients. Secondary surgical procedures appropriate to cleft lip and palate patients include revisional lip surgery, adjunctive alveolar or maxillary surgery, orthognathic surgery, revisional nasal surgery, and adjunctive facial procedures. These procedures tend to be performed once facial growth is complete and may need to be coordinated with other interventions, including orthodontics and speech assessment. Surgical procedures should be correctly sequenced and a long-term plan made in conjunction with the patient.
The head and neck multidisciplinary team
Authors: Sørensen Kristian 
Published: September 2021

Abstract
The head and neck multidisciplinary team (MDT) is a multiprofessional group that provides comprehensive care for patients with head and neck cancers. The MDTs were created to standardize care given to head and neck patients. Local, regional, and national guidelines are followed by the MDTs to ensure optimum care throughout the whole disease process. Outcome measures are recorded and serve as benchmarks to compare care delivered to patients. MDTs contribute to clinical research and to national audits, as well as serving as the interface between specialist clinical services and primary care. A lead clinician is responsible for each MDT’s performance and compliance with established standards.
Assessment and management of metastatic neck disease
Authors: Paleri Vinidh , Ragbir Maniram 
Published: September 2021

Abstract
Tumour spread to the neck can occur from any primary sites that can harbour squamous cell carcinoma (SCC) in the upper aerodigestive tract (UADT) mucosa. This can also happen with other histological subtypes and from primary sites in the parotid and thyroid gland. Thus, the assessment of the neck should form an integral part of the clinical examination, imaging, and decision-making process prior to deciding treatment of the primary tumour. Given the propensity of these tumours to spread to the lymph nodes and given that the treatment algorithms used to manage lymph nodes in the neck are similar to those options available for the primary site, neck status often influences the choice of treatment. This chapter outlines the assessment and management of the metastatic neck node from an SCC of the UADT. To ensure uniformity in describing and communicating information about neck disease, the neck is divided into six levels, as recommended by the American Head and Neck Society and the American Academy of Otolaryngology–Head and Neck Surgery.
Nasal reconstruction
Authors: Kernohan Michael D. , Thornbury Kelly 
Published: September 2021

Abstract
Reconstruction of nasal skin is one of the earliest recorded procedures of what is now referred to as the discipline of reconstructive plastic surgery. In the ancient Hindu Sanskrit text, ‘Sushruta Samhita’ (600–700 bc) the forehead rhinoplasty is described and later the Italian surgeon Tagliacozzi (1597) performed nasal reconstruction with skin pedicled from the upper arm. These early procedures treated the defects left by the ancient punishment of nasal amputation. Sir Harold Gillies and colleagues reinvigorated the art of plastic surgery after the First World War and provided the sound principles of reconstruction that are followed to this day. In more modern times, the refinement of this surgical technique has advanced considerably due to the work and publications of Dr Gary Burget and Dr Frederick Menick. They have greatly flattened the learning curve and finesse of the paramedian forehead flap and associated procedures.
Reconstruction of the pharynx
Authors: Pollock Jonathan , Ragbir Maniram 
Published: September 2021

Abstract
Reconstruction of the pharynx and cervical oesophagus represents a significant challenge for the plastic surgeon due to the complex functions and anatomical structures to be restored. Malignancy is the most common cause of pharyngeal defects, and this patient cohort has a generally poor prognosis due to the tendency to present late with advanced disease. While tumours of the hypopharynx make up only 5% of all head and neck cancers, the surgical management of laryngeal and upper oesophageal malignancy frequently involves the need to reconstruct or reinforce the pharynx. Reconstruction for these patients is further complicated by medical comorbidity, synchronous malignancy, and the patients’ poor nutritional state. With the move in recent years to chemoradiotherapy protocols for advanced disease, surgery is performed less frequently. Nevertheless, there is still a need for surgical management in both primary treatment and salvage cases following chemoradiotherapy. As survival is poor in this group, it is important that quality of life after reconstruction is considered, and hospital stay minimized. The restoration of an oral diet and intelligible speech is the priority, but there are a multitude of factors which must be considered when selecting the best reconstruction. This chapter outlines some historical methods of pharyngeal reconstruction, followed by the indications, advantages, and disadvantages of the methods in current use.
Reconstruction of the mandible and maxilla
Authors: Bryant Colonel Douglas G. , Jones Alex P. , Ragbir Maniram 
Published: September 2021

Abstract
Mandibular and maxillary reconstruction is commonly required in clinical practice following major trauma or tumour resection. General principles of reconstruction should be followed: replace like with like and address functional and cosmetic deficiencies. Many reconstructive approaches are applicable to both mandibular and maxillary reconstruction and free vascularized tissue transfer is the accepted standard for both these anatomical sites with flaps such as the fibula or iliac crest. Advances in microsurgery allow high-quality, reproducible reconstructions to be performed by specialist teams. Reconstruction modality will be influenced by a range of factors such as defect site, size, and soft tissue involvement, as well as patient factors such as general health, dentition, age, and further planned treatment. Key factors to consider when reconstructing the midface and jaw include the airway, swallowing, speech, nutrition, and dental rehabilitation. These are also considered in this chapter. Computer modelling and surgical planning based on preoperative computed tomography scanning is now commonly used by many teams and this is also discussed.
Adjuvant therapy for head and neck cancers
Authors: Kelly Charles 
Published: September 2021

Abstract
The non-surgical management of head and neck cancer has changed over the last two decades with more emphasis given now to organ preservation and post-treatment organ function. These two concepts do not necessarily go hand in hand but preserving an organ without preserving its function is pointless. In this period, for some head and neck cancers subsites, for example, oropharynx, the treatment model has moved away from primary surgery followed by planned, adjuvant radiotherapy, to one of primary chemoradiotherapy with the objective of greater organ and function preservation. This change in management strategy may be coming under further review now, with the introduction of transoral robotic surgery (TORS), where the treatment model may revert back to primary surgery with the question raised, whether highly selective TORS followed by highly selective adjuvant radiotherapy using the newer radiation technologies and techniques with intensity-modulated radiotherapy or tomotherapy, with or without chemotherapy might optimize tumour control with minimal long-term morbidity.
Thigh lift
Authors: Barabás Anthony , Soldin Mark 
Published: September 2021

Abstract
The skin of the medial thigh is thin and inelastic, and laxity here is often the earliest sign of ageing in the thighs. The medial thigh skin is also one of the areas most affected following weight loss. The majority of skin laxity occurs at the junction of the anterior and medial thigh, where the skin tends to hang in a dependent, pleated fashion. This can interfere with walking, toileting, and various other day-to-day activities, resulting in irritation due to chaffing between the thighs. Body contouring techniques are routinely combined in stages to achieve a more harmonious result. Medial thigh lift is frequently combined with upper body lift or breast surgery, or both, whereas brachioplasty is usually combined with abdominoplasty/lower body lift. Opposing vectors of pull and excessive damage to local vascularity are thereby avoided. However, staging surgical procedures has the potential to reveal additional areas of dissatisfaction to the patient. Abdominoplasty patients often report increased dissatisfaction with the medial thighs as a consequence of this previously hidden deformity becoming visible to them postoperatively. In fact, massive weight-loss patients’ dissatisfaction with their thighs is almost as great as with the changes to their breasts in terms of their severely decreased self-esteem, sexuality, and quality of life.
The ageing breast
Authors: Hudson Donald 
Published: September 2021

Abstract
The breast is a subcutaneous structure which changes with age. The supporting structures of the breast include the parenchyma, fat, skin, and, most importantly, the fascial system which connects the skin to the underlying muscles via Cooper’s ligaments. Each of these components changes throughout life, changing the breast appearance as the body ages. Many factors influence the effect of ageing (genetics, smoking, weight fluctuation, pregnancy, hormone replacement therapy, etc.). The firm, full, youthful breast slowly becomes a softer and more hanging structure. The weakening of the supporting structures of the breast commonly leads to ptosis. In some patients, atrophy of the breast occurs with ageing, whereas with others, hypertrophy occurs.
Asymmetry of the breast
Authors: Ali Farida 
Published: September 2021

Abstract
Developmental breast asymmetry is common in women and may be associated with significant psychological distress. It may be due to deformity of the breast itself (true) or secondary to abnormalities of the underlying torso (apparent). True breast asymmetry may be congenital or acquired. This chapter gives an overview of the aetiology and classification of developmental breast asymmetry and discusses the clinical evaluation of women presenting with breast asymmetry. Congenital breast asymmetry, subdivided into hypoplastic, hyperplastic, and deformational, is discussed. The abnormalities and challenges specific to Poland syndrome and tuberous breast deformity are described. For each subdivision, the surgical techniques available to correct the deformity are reviewed. The limitations of surgery and potential outcomes are discussed.
The burnt child
Authors: Rea Suzanne , Falder Sian 
Published: September 2021

Abstract
Burns are a common form of trauma in children. Common mechanisms of injury include scalds from hot beverages and contact burns from household items. The physical and psychological trauma may have long-lasting effects for both child and family. Children are not just small adults; there are important anatomical and physiological differences. Paediatric burn patients have specific treatment needs that must be accounted for. Estimation of burn size, threshold for commencement of intravenous fluid resuscitation and enteral feeding, in addition to wound assessment, wound care, and treatment are all different to a similar size injury in an adult. These paediatric-specific issues are discussed in more detail. The investigation and interpretation of suspected non-accidental burn presenting to a burns unit is also outlined.