This new second edition of the best-selling Atlas of Microvascular Surgery is updated with the latest information on harvesting, fabricating, and dissecting vessels in all areas of the body. It features coverage of 45 donor sites with thorough review of anatomy and potential anatomic variations; step-by-step instructions for 110 techniques for flap harvesting and fabrication, including many of the perforator flap harvesting details; and descriptions for 39 procedures for exposure of recipient site vessels. Highlights of the second edition: More than 650 color illustrations, including 115 new drawings, provide a visual guide to anatomy and possible variations Clear descriptions of 110 different flap-harvesting techniques, from planning and designing to harvesting surgical free flaps Discussion of perforator flaps based on the deep inferior epigastric artery, superior and inferior gluteal arteries, thoracodorsal artery, and lateral circumflex femoral artery Insightful review of the clinical indications for, as well as the advantages and disadvantages of, using specific donor sites helps the surgeon to approach each dissection with confidence Easy-to-reference organization according to upper extremity, lower extremity, trunk, and head and neck All plastic and reconstructive surgeons, orthopedic surgeons, hand surgeons, neurosurgeons, and residents in these specialties will benefit from the wealth of information in this landmark book.

For many years, the operative manipulation of the most minute struc tures was frustrated by the limitations of the human eye. With the introduction of the operating microscope by Nylen (1921), fine detailed anatomy was made visible, so that structures could be prepared, pre sented and manipulated. Nylen used the microscope for treating dis eases of the middle ear. In 1946 Perrit in the U.S.A. introduced the operating microscope into the field of ophthalmic surgery. In 1964, Smith, Kunze and Mitchen published reports on their clinical experi ence using the operating microscope in nerve surgery. Using this tech nique, it was possible to divide a peripheral nerve into individual fascicle bundles and reapir each bundle precisely. Following on from these developments, the term" microsurgery" was introduced to cover that branch of surgery which was carried out using the" equiped" eye - either by using 10upe spectacle magnifica tion or, more commonly, the operating microscope. The term "micro vascular surgery" developed for the operative treatment of small ves sels below 2 mm in diameter. Experimental studies for the use of microsurgery in the clinical situation developed alongside its use on small research animals for transplantation models in immunological study. Microsurgical techniques were used in the transplantation of rat liver, kidneys, pancreas, heart and other organs. The clinical appli cation of these microsurgical techniques is nowadays called "recon structive microvascular surgery."

Reconstructive microvascular surgery is now in its teens. At first many thought this new child was a whim and would fail to thrive. Some were un certain, others with vision either supported or became actively involved in this new area of surgical endeavour. Although initial interest was focused on the replantation of amputated parts, it has been the one stage free trans fer of living tissue to a distant site which has launched microsurgery into the surgical spotlight. From its humble beginnings we have witnessed a revolution in this branch of plastic surgery; many of the long established methods of recon struction have, like barricades, fallen before the advances made in this field. In its infancy there were relatively few procedures available. There was a tendency to make the patient's problem fit the operation, rather than the reverse, and this frequently led to an inferior result. The then known flaps, such as the groin flap and the deltopectoral flap, were employed. Unfortunately they were sites which posed many technical problems; namely those of vascular anomaly, a short pedicle and vessels of small cal ibre. Long operations were the norm, and vascular thrombosis was not un common. Hospital routine often was disrupted and there was a danger that these new techniques would fall into disrepute. Over the last decade this state of affairs has changed dramatically.