Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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Reconstructive Surgery in the Tropics Figure 64. After Estlander-Abbe flap from right upper lip for commisure. Later lower lip cheek flaps have been turned in. Figure 65. Estlander-Abbe flap. Lateral view of turned in cheek skin flaps. Figure 66. Frontal view of patient one year after surgery—commisure adjusted. 273 26
26 274 Surgery and Healing in the Developing World Figure 67. Z-plasty. Severe scar contracture of perineum approximating both medial thighs. Figure 68. Multiple Z-plasties used in surgical treatment of this patient. Z-Plasty (Figs. 67, 68) Figure 67 shows a woman who has a scar contracture, which has pulled her two legs together. She is completely unable to walk because of this. The scar was the result of a severe burn of the perineum and upper medial thighs. A spinal anesthetic is used. The patient can be operated on in the supine position. The skin of the contracture is cut in a zig-zag fashion with the angles being at forty-five degrees for both the anterior and posterior scar. The inverted ‘V’ of the lower skin in then sutured into the ‘V’ of the upper scar as pictured. Both deep and superficial skin sutures are used. Advancement Rotation Flap Figure 69 shows a woman with a lesion on her left cheek after it has been made dark with various herbs. The pathology report showed that this was a neglected basal cell skin cancer. After a wide excision, the skin and superficial subcutaneous tissues are raised laterally all the way to the tragus of the ear and inferiorly well down on the neck. The dissection is kept superficial in a plane previously infiltrated with 20 cc of 0.25% xylocaine to which one drop of epinephrine has been added. The facial nerves will thus be protected. The blunt nose scissors dissector is used with its tip toward the skin. The skin is then incised lateral to the defect and high on the left cheek. It
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Surgery and Healing in the Developi
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Contents Foreword .................
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25. Dentistry .....................
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Editor Contributors Harold P. Adolp
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Foreword Surgery and Healing in the
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“poor, but modern”, as for exam
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There may be at least one considera
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It is that higher accountability th
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1 2 Surgery and Healing in the Deve
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CHAPTER 2 Surgery in Developing Cou
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2 10 Surgery and Healing in the Dev
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CHAPTER 4 International Surgical Ed
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CHAPTER 9 Lab-in-a-Suitcase: Saving
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10 72 Surgery and Healing in the De
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CHAPTER 12 Communication in the Thi
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CHAPTER 13 Anesthesia in the Third
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13 100 Surgery and Healing in the D
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CHAPTER 15 Basic Obstetrics and Obs
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CHAPTER 16 Pointers for American Su
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CHAPTER 20 Chronic Pyogenic Osteomy
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CHAPTER 23 Cleft Lip and Palate Sur
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CHAPTER 24 Outreach Dentistry: A Wo
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Page 336 and 337: CHAPTER 1 CHAPTER 30 Nutrition and
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Nutrition and Development in Africa
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CHAPTER 1 CHAPTER 31 Uterine Ruptur
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Uterine Ruptures in Rural Zaire Tab
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Uterine Ruptures in Rural Zaire 329
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CHAPTER 1 CHAPTER 32 Vesicovaginal
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Vesicovaginal Fistula in Democratic
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CHAPTER 1 CHAPTER 33 Ophthalmology
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Ophthalmology Figure 2. Refractive
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Ophthalmology Figure 4. A tonometer
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Ophthalmology 341 ml of 40 mg/ml IV
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Ophthalmology Figure 6. Axis determ
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Ophthalmology 345 thalmic set prepa
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Ophthalmology 347 Procedures Region
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Accommodating Deficits in Material
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Abscesses and Other Infections Trea
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CHAPTER 1 CHAPTER 36 Surgical Train
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Surgical Training of Nurses for Rur
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Training of Medical Assitants in Mo
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CHAPTER 1 CHAPTER 38 Training Surge
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Training Surgeons in the Developing
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Mobile Surgery Figure 1. 405 of tec
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Mobile Surgery Figure 3. 407 Childr
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Mobile Surgery 409 We have realized
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CHAPTER 1 CHAPTER 40 Public Health
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Public Health Problems on Burma Fro
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Medical Adventures in the Nigerian
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CHAPTER 1 CHAPTER 42 Wanted Glenn G
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Wanted 431 Studies Center (//www.am
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Wanted 433 MacArthur (The John D. a
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Wanted 435 most pathologic presenta
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Wanted 437 “outliers” in the he
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World Health 439 challenge: name fo
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CHAPTER 1 CHAPTER 44 Treating Other
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Treating Others: Human Sciences in
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Treating Others: Human Sciences in
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CHAPTER 1 CHAPTER 45 The Impact of
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The Impact of a Volunteer Medical M
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CHAPTER 1 CHAPTER 46 Field Notes on
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Field Notes on a Typical Day in a H
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Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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