Front cover -- Preface -- Contents -- Contributors -- 1 Properties of the Skin -- I. INTRODUCTION -- A. Anatomy -- REFERENCES -- 2 Wound Healing -- I. INTRODUCTION -- II. PATHOPHYSIOLOGY OF THE BURN WOUND -- III. REPARATIVE PROCESS OF WOUNDS -- A. Inflammatory Phase -- B. Proliferative Phase -- C. Maturational and Remodeling Phase -- D. Factors Affecting Wound Healing -- ACKNOWLEDGMENTS -- REFERENCES -- 3 Principles in Management of Acute Burns -- I. INTRODUCTION -- II. BURN MORTALITY -- III. RESUSCITATION AND INITIAL ASSESSMENT -- A. Initial Wound Care -- B. Resuscitation -- C. Escharotomies -- D. Initial Wound Assessment -- E. Burn Size -- IV. INITIAL WOUND MANAGEMENT AND OPERATIVE PLANNING -- V. SPECIAL AREAS -- VI. DERMAL EQUIVALENTS IN PRIMARY CLOSURE -- A. Integra -- B. Alloderm -- VII. METABOLISM AND WOUND HEALING ADJUNCTS -- VIII. CULTURED EPITHELIAL AUTOGRAFTS -- IX. CONCLUSIONS -- REFERENCES -- 4 Management of Electrical Injuries -- I. INTRODUCTION -- II. PATHOPHYSIOLOGY OF ELECTRICAL INJURY -- III. ACUTE CARE -- IV. GENERAL MANAGEMENT A. Ocular Injuries -- B. Renal Complications -- C. Cardiac Arrhythmias -- V. WOUND CARE -- A. Injuries to the Scalp and Skull -- B. Oral Commissure Burns -- C. Injuries to the Torso -- D. Genital Injuries -- VI. LIGHTNING INJURIES -- VII. PREGNANT PATIENTS -- REFERENCES -- 5 Chemical Burns: Small Burns with Severe Consequences -- I. INTRODUCTION -- II. CASE 1: CHEMICAL BURN BY CONTACT -- III. CASE 2: HYDROFLUORIC ACID BURN TO THE FINGERS -- IV. CASE 3: ASSAULT TO THE PENIS BY ACID -- V. CASE 4: ASSAULT TO THE FACE WITH AN UNKNOWN CHEMICAL -- REFERENCES -- 6 Reconstructive Needs of the Burn Patient -- I. INTRODUCTION -- II. OPERATIVE INTERVENTION FOR RECONSTRUCTION -- III. RECONSTRUCTION OF FACIAL BURNS -- IV. RECONSTRUCTION OF BREAST BURNS -- V. RECONSTRUCTION OF EXTREMITY BURNS -- VI. OTHER ISSUES.

VII. SUMMARY -- REFERENCES -- 7 Anesthesia for Reconstructive Burn Surgery -- I. INTRODUCTION -- II. PREOPERATIVE EVALUATION -- A. Airway Evaluation -- B. Pulmonary Evaluation -- C. Preoperative Diagnostic Tests -- III. MANAGEMENT OF ANESTHESIA -- A. Preoperative Preparation -- B. Airway Management -- C. Regional Techniques -- D. Pharmacologic Considerations in Patients Undergoing Burn Reconstruction -- E. Postoperative Nausea and Vomiting After Burn Reconstructive Surgery -- F. The Biology of Nausea and Vomiting -- G. Antiemetic Agents -- H. Treatment of Patients at High Risk for PONV -- I. Postoperative Analgesia -- IV. SUMMARY -- REFERENCES -- 8 Skin Grafts -- I. HISTORY A. Autografts -- B. Allografts and Xenografts -- C. Skin Grafts -- II. HARVESTING A. Free-Hand Harvesting -- B. Power Dermatome -- C. Hand-Driven Dermatomes -- III. GRAFT SURVIVAL -- A. Revascularization -- IV. GRAFT FAILURE -- REFERENCES -- 9 Skin Substitutes: Theoretical and Developmental Considerations -- I. OBJECTIVES OF SKIN SUBSTITUTES -- II. REQUIREMENTS A. Anatomic and Physiologic -- B. Surgical -- III. PRINCIPLES OF TISSUE ENGINEERING OF HUMAN SKIN -- A. Components -- B. Process -- IV. CLINICAL CONSIDERATIONS -- A. Surgical Considerations -- B. Nursing Considerations -- C. Assessment -- D. Cost -- V. REGULATORY ISSUES -- VI. CLINICAL EXPERIENCE: BURNS -- VII. FUTURE DIRECTIONS -- A. Regulation of Pigmentation -- B. In Vitro Angiogenesis -- C. Cutaneous Gene Therapy -- VIII. CONCLUSIONS -- ACKNOWLEDGMENTS -- REFERENCES -- 10 Microsurgical Free Tissue Transfer in Burn Reconstruction: Overview -- I. INTRODUCTION -- II. PATHOLOGY OF BURN WOUNDS -- III. PREOPERATIVE EVALUATION -- IV. LIMITATIONS OF TRADITIONAL MANAGEMENT -- V. INDICATIONS FOR MICROSURGICAL RECONSTRUCTION -- A. Functional Considerations -- B. Aesthetic Considerations.

VI. CONTRAINDICATIONS TO MICROSURGICAL RECONSTRUCTION -- VII. TIMING OF MICROSURGICAL RECONSTRUCTION -- VIII. SELECTION OF FREE FLAPS -- IX. COMPLICATIONS AND LIMITATIONS -- X. INTRAOPERATIVE CONSIDERATIONS IN FREE-FLAP RECONSTRUCTION -- XI. POSTOPERATIVE CARE AND REHABILITATION -- XII. ADVANTAGES AND DISADVANTAGES OF MICROSURGICAL TISSUE TRANSFER -- XIII. CONCLUSION -- REFERENCES -- 11 Principles of Tissue Expansion -- I. INTRODUCTION -- II. HISTOMORPHOLOGY OF TISSUE EXPANSION -- A. Epidermis -- B. Dermis -- C. Skeletal Muscle -- D. Adipose Tissue -- E. Blood Vessels -- F. Molecular Basis for Tissue Expansion -- III. PRINCIPLES OF TISSUE EXPANSION -- A. Incisions: Paralesional or Remote -- B. Implant Type and Size -- C. Internal vs. External Ports -- D. Rate of Expansion -- E. Techniques in Tissue Expansion -- IV. BURN RECONSTRUCTION: THE ROLE OF TISSUE EXPANSION -- A. Burn Alopecia -- B. Face and Neck -- C. Breasts -- D. Chest/Abdomen -- E. Upper Extremities -- F. Lower Extremities -- V. COMPLICATIONS OF TISSUE EXPANSION -- VI. CONCLUSIONS -- REFERENCES -- 12 Management of Pigmentation Changes in Burn Patients -- I. INTRODUCTION -- II. PATHOPHYSIOLOGY -- III. HISTOLOGY -- IV. TREATMENT A. Hyperpigmentation Following Superficial Burns -- B. Nonsurgical Methods -- V. SURGICAL THERAPY A. Primary Excision -- B. Treatment of Hyperpigmentation of Skin Grafts -- C. Treatment of Hypopigmentation Changes -- VI. SURGICAL TREATMENT -- A. Grafts -- VII. TREATMENT OF IMMATURE HYPERTROPHIC RED SCARS -- VIII. CONCLUSION -- REFERENCES -- 13 The Etiology and Management of Hypertrophic Scars and Keloids Following Thermal Injury -- I. INTRODUCTION -- II. PATHOGENESIS OF HYPERTROPHIC SCAR, KELOIDS, AND CONTRACTURES A. Histopathology and Ultrastructure -- B. Macromolecular Composition of the Extracellular Matrix.

III. ETIOLOGY OF DERMAL FIBROSIS FOLLOWING THERMAL INJURY A. Hypertrophic Scar Fibroblasts -- B. Fibroblast Proliferation and the Possible Failure of Apoptosis -- C. Circulating Peripheral Blood Fibrocytes -- IV. WOUND CONTRACTION FOLLOWING THERMAL INJURY -- V. FIBROGENIC CYTOKINES -- A. Transforming Growth Factor-beta 1 -- B. Connective Tissue Growth Factor -- C. Insulin-Like Growth Factor-1 -- D. Interactions of IGF-1 and TGF-beta 1 -- E. The Role of the Th1/Th2 Paradigm After Burn Injury -- VI. TREATMENT OF HYPERTROPHIC SCAR, KELOIDS, AND CONTRACTURES -- A. Prevention of Dermal Fibroproliferative Disorders -- B. Conservative Therapy for Keloids, Hypertrophic Scar, and Contractures -- C. Intralesional Corticosteriods -- D. Surgical Therapy -- E. Surgical Therapy of Contractures -- F. Laser Therapy of HSc and Keloids -- VII. NEW PHARMACOTHERAPIES FOR HYPERTROPHIC SCARRING A. Antifibrotic Factors: IFN-alpha2b and IFN-gamma -- B. Other Antagonists of TGF-beta -- C. Modulators of Fibroblast-Mediated ECM Metabolism -- VIII. SUMMARY -- REFERENCES -- 14 Lasers in the Treatment of Postburn Scars -- I. INTRODUCTION -- II. SCAR FORMATION IN BURNS -- III. LASER TYPES AND MECHANICS -- A. Argon Laser -- B. Nd:YAG Laser -- C. Copper Vapor and Copper Bromide Lasers -- D. Flashlamp-Pumped PDL -- E. Tuneable Dye Laser -- F. V-Beam PDL System -- IV. SUMMARY -- REFERENCES -- 15 Evaluation of the Burned Face -- I. INTRODUCTION -- II. ACUTE TRAUMA: OPERATIVE VS. CONSERVATIVE THERAPY AND PREVENTION OF SECONDARY DEFORMITIES A. Principles and Other Considerations -- B. Scalp -- C. Face -- D. Ears -- E. Eyelids and Eyebrows -- F. Nose -- G. Lips and Mouth -- H. Neck -- I. Prevention of Secondary Problems -- III. RECONSTRUCTIVE CONSIDERATIONS AND PLANNING A. Functional Deficits -- B. Aesthetic Reconstruction -- C. Decision Making -- D. Skin Match -- E. Compression Therapy.

F. Artificial Skin Coverage -- IV. FUTURE PERSPECTIVES -- REFERENCES -- 16 Reconstruction of the Burned Scalp -- I. INTRODUCTION -- II. ACUTE BURN CARE A. Soft Tissue Injuries Only -- B. Calvarial Involvement -- III. RECONSTRUCTION -- A. Scalp Burns without Bony Involvement -- B. Scalp Burns with Involvement of the Skull -- IV. CONCLUSION -- REFERENCES -- 17 Burns of the Skull and Scalp and Their Clinical Management -- I. INTRODUCTION -- II. HISTORICAL PERSPECTIVE -- III. ANATOMICAL PERSPECTIVES -- A. Pathophysiology of the Burned Skull -- B. Types of Skull Wounds -- C. Diagnostics -- D. Treatment Modalities -- IV. CONCLUSION -- REFERENCES -- 18 Role of Micrografts and Minigrafts in Burn Reconstruction -- I. ROLE OF MICROGRAFTS AND MINIGRAFTS IN BURN RECONSTRUCTION -- A. Technique -- II. CASE 1 -- III. CASE 2 -- IV. CASE 3 -- REFERENCES -- 19 Reconstruction of Burned Eyelids -- I. INTRODUCTION -- II. ANATOMY -- A. Eyelid Margin -- B. Special Considerations in Eyelid Burn Management -- C. Acute Management and Early Reconstruction -- III. CONCLUSION -- REFERENCES -- 20 Reconstruction of Cheek Deformities -- I. INTRODUCTION -- II. ANATOMY -- III. DEFORMITIES OF THE CHEEK -- IV. RECONSTRUCTION A. Skin Grafts -- B. Flaps -- C. Tissue Expansion -- D. Free-Tissue Transfer -- REFERENCES -- 21 Reconstruction of the Burned Nose -- I. INTRODUCTION A. Historical Perspective -- II. ANATOMY -- III. CURRENT CONCEPTS IN THE ACUTE CARE OF THE BURNED NOSE -- IV. GENERAL CONCEPTS OF NASAL RECONSTRUCTION -- V. CLASSIFICATION OF POSTBURN NASAL DEFORMITY -- VI. RECONSTRUCTIVE OPTIONS -- A. Nasal Prosthesis -- VII. POSTBURN NASAL RECONSTRUCTION IN THE PEDIATRIC PATIENT -- VIII. CONCLUSION -- REFERENCES -- 22 Reconstruction of the Burned Ear -- I. INTRODUCTION -- A. Ears -- B. Facial Burns -- II. ACUTE CARE OF EAR BURNS A. Partial-Thickness Injuries.