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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.
Sommario
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.
Info autore
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.
Riassunto
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.
