Tumescent Local Anesthesia

ISBN-13: 9783540665441 / Angielski / Twarda / 2000 / 212 str.

C. W. Hanke; B. Sommer; G. Sattler

Opis

It is safe to say that without Jeffrey Klein, who first described tumes- cent local anesthesia, this book would never have been written. This technique of local anesthesia, originally designed for use in outpatient liposuction procedures in the United States of America, was intro- duced into clinical practice in Darmstadt in 1990 and is now employed in a growing number of areas of surgical dermatology. Eight years of experience have shown it to be a particularly elegant and safe method of local anesthesia, especially in the treatment of large areas of skin. A large number of scientific studies have improved our under- standing of tumescent local anesthesia. The administration of large quantities of a dilute local anesthetic into lipophilic tissue is no longer seen as a risk to the patient, although further discussion at the inter- national level will be required over the next few years in order to standardize the tumescent solution. Until then, the widely varying dosages reported around the world should be regarded with caution. The progress made and experience gained in recent years make it likely that tumescent local anesthesia will become firmly established in all branches of surgery. One important factor is the economy of the tumescent technique, the material costs of which are very low. In comparison to general anesthesia, enormous savings can be made in the costs of postopera- tive care, owing to reduced staff requirements and fewer complications of wound healing.

Spis treści

A Theory.- 1 Introduction and Definition.- 2 Historical Background.- 3 Composition of the Solution for Tumescent Anesthesia.- 4 Pharmacology.- 5 Toxicology.- 6 Sedation and Analgesia.- 7 Prevention of Infection and Thrombosis.- 8 Advantages and Disadvantages of TLA.- B Practical Application.- 9 Infiltration Technique.- 10 Technique of Subcutaneous Infusion Anesthesia.- 11 Patient Selection and Preoperative Preparation.- C Indications.- 12 Liposuction.- 13 Lipomas.- 14 Large Excisions.- 15 Abdominoplasty.- 16 Medial Thigh Lift.- 17 Tumescent Facelift.- 18 Skin Flaps.- 19 Split-Thickness Grafts.- 20 Dermabrasion.- 21 Laser Skin Resurfacing.- 22 Axillary Hyperhidrosis.- 23 Acne Inversa.- 24 Hair Transplantation.- 25 Breast Surgery.- 26 Arthroscopy.- 27 Sentinel Node Biopsy.- 28 High Ligation and Stripping of the Long Saphenous Vein.- 29 High Ligation and Stripping of the Small Saphenous Vein.- 30 Phlebectomy.- 31 Endoscopic Dissection of Perforator Veins.- 32 Fasciotomy.- 33 Debridement of Venous Ulcers.- 34 Shave Therapy for Crural Ulcers.- 35 Local Anesthesia in Children.- A: Toxicity of Lidocaine in Correlation to the Plasma Level.- B: Possible Toxic side Effects of TLA and their Therapy.- C: List of Suppliers.

O autorze

Dr. med. Gerhard Sattler, Humanmediziner, Facharzt für Dermatologie, Gründer und Leiter der Rosenparkklinik in Darmstadt. Dr. Sattler gehört zu den international führenden Experten seines Fachs und teilt seine Erfahrungen mit Spezialisten auf allen Kontinenten. Dr. med Boris Sommer ist Präsident der Deutschen Gesellschaft für Ästhetische Botulinumtoxin-Therapie e. V. (DGBT). Er ist in privatärztlicher Praxis mit dem Schwerpunkt ästhetische Dermatologie tätig.

Blurb

Since the introduction of Tumescent Local Anesthesia by Dermatologist and Pharmacologist J.A. Klein, this method of subcutaneous infiltration of large volumes of diluted anesthetic has been more rapidly adopted by doctors all over the world than any other anesthetic method before. Initially invented for cosmetic liposuction, the unsurpassed safety of the procedure has led to many new indications. Today, the advantages are used by dermatologists, general surgeons and plastic surgeons, gynecologists, phlebologists, and ENT specialists. The book contains a wealth of original work and for the first time gives detailed information, clinical examples and tips & tricks on: Medical issues such as liposuction, extirpation of lipomas, wide excision, dermabrasion, flaps and grafts, split skin grafting, hyperhidrosis, acne inversa, breast surgery, sentinel lymph node biopsy. Cosmetic surgery is also covered: abdominoplasty, medial thigh lift, face lift, laser skin resurfacing, hair restoration surgery. Special emphasis was laid on all aspects of phlebologic surgery in tumescent local anesthesia. All contributions were made by internationally renowned experts in their field, such as dermatoloogy, anesthesiology,plastic surgery, general surgery, phlebology, gynecology. The brief but thorough theoretical introduction covers up-to-date background information on pharmacology and technique and makes this book an ideal companion for all courses on the subject.