Venous Access: Saphenous Vein Cutdown The greater saphenous vein is an anatomically constant vein that is easily cannulated for emergency venous access. The saphenous vein at the ankle is constant,…

Ligation, Stripping, and Harvesting of the Saphenous Vein Amir F. Sleiman Jamal J. Hoballah This chapter first covers excision of the greater and lesser saphenous veins for management of varicosities,…

Above-Knee Amputation Above-knee amputation is performed when it is not possible to save the knee joint because of the extent of injury or ischemic damage. Generally, the longer the stump,…

Below-Knee Amputation Most amputations are performed for ischemia. The choice of the level of amputation requires mature judgment. Although it is important to salvage as much length as possible, a…

Transmetatarsal and Ray Amputations Transmetatarsal and ray amputations require meticulous patient selection and attention to surgical technique when performed in patients with peripheral vascular disease. Transmetatarsal amputation is performed for…

Debridement and Split-Thickness Skin Graft This chapter describes two strategies for debridement of burns or necrotizing soft tissue infections. It also details the technique of split-thickness skin graft. Skin grafting…

Proctoscopy This chapter deals with the performance of rigid proctoscopy (sometimes called rigid sigmoidoscopy). Flexible fiberoptic sigmoidoscopy is performed essentially as detailed in Chapter 96, except that the distance to…

Transsacral Approach to Rectal Lesions The transsacral approach is most commonly used for resection of benign retrorectal tumors or for removal of sessile polyps that cannot be reached by other…

Management of Perirectal Abscesses, Anal Fistulas, and Chronic Anal Fissure Andreas M. Kaiser Perirectal abscesses and anal fissures are among the most frequent causes of anorectal pain. Cryptoglandular abscesses characteristically…