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Anaesthesia for plastic and reconstructive surgery 

Anaesthesia for plastic and reconstructive surgery
Anaesthesia for plastic and reconstructive surgery

Jeremy Prout

, Tanya Jones

, and Daniel Martin

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date: 15 April 2021

This chapter describes the anaesthetic considerations for major plastic surgery and in particular free flap surgery including the physiology of the microcirculation. Laminar flow characteristics of the microcirculation allow the anaesthetist to manipulate the perfusion pressure, extent of vasodilation and viscosity to improve flow dynamics for improved flap outcome. The pathophysiology of a burn injury is described; the burn wound and systemic response including shock and inhalational injuries. The initial assessment of the burn follows an ABCDE approach with details of assessing burn area and depth. Initial management guides fluid resuscitation demonstrating the Parkland formula and assessing response to resuscitation. Special considerations for Intensive Care are described.

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