Topic structure

Use the same structure across topics to make them more consistent.

Example

Figure 1 shows a screenshot of the Example topic, that follows the structure.

1. Overview

The procedure and cases are presented automatically with photos, names, and short descriptions.

2. Introduction

Structure of the introduction page:

• Authors
• Introduction: Introduce the topic/procedure/technique/diagnosis
• Definitions: List terms and their definitions
• Background: History and year of first time performed surgery with reference
• References

3. Anatomy

Structure of the anatomy page:

• Authors
• Standard anatomic composition: E.g. the breast or flap
• Blood supply
• Nerves that should be identified and spared during the operation 
• Muscles used for flap bulk 
• References

For anatomy pages use drawn illustrations.

4. Subtopics: The theoretical background and patophysiology for the diagnosis, grades of disease or calculation.

May be several menubars in larger chapters as burns, breast surgery, melanoma or facial flaps.

The subtopics are all the theoretical parts of the topic which are not surgical procedures or cases, which should also be organized and well structured in the menu to the left.

• Authors
• Theoretical description of the suptopic including patophysiology, grades of disease (eg burns degree 1-3) or calculation (eg burns calculation of burnt % of TBSA) with drawn illustrations. See examples below.
• In smaller topics the patophysiology of the disease is descriped.
• References

Examples for Subtopics

• The Topic Instruments
  • Forceps
    • The different kinds of forceps
    • How to hold a forceps
    • How to use a forceps
  • Needle holder (driver)
    • The different kinds of needle holders
    • How to hold a needle holder
    • How to use the the needle holder – the cremiere, placement of needle, etc (See also sutures)
  • Etc

• The topic Surgery Preparation
  • Surgical scrub
    • Short description of background and reason to perform surgical scrub
    • Description (numbered) how to perform scrub
    • Video
  • Sterile gloves
    • Short description of types, sizes, latex vs non-latex, double-layer
    • Short historic background
    • Description how to put on gloves
    • Video
  • Etc

• The topic Basic Surgical Technique
• Local anesthesia
  • Short description of historic background and types of local anesthesia
  • How to fill up the syringe
  • Description How to do local infiltration
  • Video
• Surgical incision
  • How to hold the knife
  • Video
• Etc

• The topic: Pre-OP Assesment
• Introduction
• Aim and Background
• Medical History (More illustrations!)
• Review of Organ Systems (hedder det det?)
• Patient Examination (God ide med illustrationer. Måske blot flere normal body illustrations?)
• Plan and conclusions

• The topic Skin Cancer the subtopics are:
  • Patophysiology of skin cancers
  • Patient history and presentation
  • Basal Cell Carcinoma
    • Patophysiology
    • Photo examples
    • Treatment and surgical margins
    • Link to Excision of facial tumors in the bottom
  • Squamous cell carcinoma
    • etc
  • Merkel Cell Carcinoma
    • etc
  • Malignant adnexal tumors
  • Pre-cancerous lesions

The Topic: Excision of Facial tumors

• Introduction, Background and definitions
• Anatomy
  • Resting Skin Tension Lines
  • Nerves
  • Arteria
• Patient presentation
• Pre-operative considerations and information
• Procedure
• Scalp
  • Pre-operative considerations
  • Illustrations
  • Excision on scalp (step-by-step procedure)
  • Cases with description of photos
• Front
  • etc
• Eyelid
• Nose
• Etc
• Post-operative care

• The topic: Burns (The design of the whole chapter) is:
  • Introduction with background, definitions
  • Anatomy
  • Patophysiology of burns
    • Local skin response
    • Systemic response
  • Assesment of Burn degrees
    • 1st degree (Epidermal)
    • 2nd degree (Dermal)
    • 3rd degree (Subdermal)
  • Calculating burn size
    • Rule of nines
    • Rule of hand
    • http://www.burn-app.com (Burn Calculator)
  • Indication for referral to burn unit
  • Calculating Fluid resucitation (www.burn-app.com)
  • Antibiotics administration
  • Procedure: Cleaning the burn (step-by-step)
  • Procedure: Applying bandages (step-by-step)
    • Face
    • Arm
    • Hands
    • Thorax
    • Leg
    • Foot
    • Using Aquacel burn
    • Using flamazine/silverderma and jelonet
  • Procedure: Surgical debridement (necrectomy)
  • Procedure: Skin grafting
  • Post-operative care
  • Follow-up treatment
    • Evaluating Burns
  • Procedure: Changing the bandage

• The topic: Facial flaps (the design of the chapter) is:

• Flap classifications
  • Vascular supply
  • Tissue to be transferred
  • Geometrical design
• Designing af local skin flap
• Biomechanics of local skin flaps
• Patient history and presentation
• Pre-operative work-up
• Procedures:
• Rotation flap
  • Introduction
  • Definitions
  • Design
  • Flap proportions
  • Cases
• Interpolated flap
  • etc
• Etc
• Post-operative care

The topic: MM

• Background and Definitions
• Patophysiology (Skin anatomy)
• Diagnosis
  • Prognostic factors
  • ABCDE rule
  • Patient history and presentation
• Types of Melanoma
  • SSMM with photo
  • Nodular MM with photo
  • etc
• TNM staging
• Prognosis
• Pre-operative work-up
• Procedure
  • Excision of MM step-by-step
  • Re-exc of MM step-by-step
    • Indication
    • Pre-operative considerations
    • step-by-step photos
    • post-operative care
    • Pearls and Pitfalls
  • Sentinel node
    • etc
  • Axillary lymph node dissection
  • Groin lymph node dissection
  • Neck lymph node dissection
• Histopathologic description of MM
• Follow-up regimen in Denmark
  • Follow-up algorithm
  • Indication for PET-CT
  • Follow-up consultation
• Adjuvant therapy

The Topic: Massive Weightloss

• Introduction with background and definitions
• Anatomy
• Patophysiology of massive weightloss (Following gastric bypass or change in dietary and physical activity)
• The referral
• Indications and Contraindications
• Brachioplasty
  • Introduction
  • Patient history and presentation
  • Preoperative considerations
  • Procedure (step-by-step)
  • Post-operative
  • Cases 1-2-3-4
• Abdominoplasty
  • etc
• Fleur de lis (vertical abdominoplasty)
• 360 Belt lipoectomy
• Thigh plasty
• Mastopexia (LOPOSAM – Lower pole subglandular advancement mastoplasty)

5. Indications and Contraindications 

Structure of the indication and contraindication page:

• Authors
• Indications for surgery in the specific diagnosis/topic/procedure. 
• Who and when to operate?
• Contraindication including comorbidities or other factors that makes patients unsuitable for this procedure. 
• References

Examples

• Indication for treatment of gynocomastia, SCC etc.
• Indication for a bilobar nasal flap instead of a nasolabial flap. 
• Indication for a TAP flap instead of a DIEP flap in breast reconstruction.

6. Drop-down menu with procedure and cases

Procedure and cases must be placed in a drop-down menu, where the menu item has the name of the procedure and the procedure page is titled “Procedure”, see the Example. How cases are named is described in the section below called “Cases”.

Structure of procedure and case pages:

• Authors
• Introduction to the step-by-step case
  • Short and precise patient history
    • Age
    • Sex
    • Reason for admission
    • Location of tumor/reconstruction/etc
    • E.g: “51-year old female admitted to Odense University Hospital for delayed breast reconstruction with a Thoracodorsal Artery Perforator flap (TAP flap).”
  • Patient Examination
    • Inspection
    • Palpation
    • Function of relevant body parts, arteria, nerves
    • E.g: “Inspection: Right breast with horizontal mastectomy scar. Palpation: Tight scaring with skin adhesion to the thoracic wall. Function: Normal function of arm. No lymphedema. Appropriate amount of excess skin to raise a TAP flap. Sufficient perforators found on ultrasound.”
• Pre-operative considerations
  • Anatomy, dissection plane, nerve, and arterial supply, etc.
  • Flap design, dimensions, and thoughts on e.g. pedicle
  • Useful tips for young doctors to prepare 
  • Pre-operative information to the patient on e.g. damage to the facial nerve
• Before and after photo
• Step-by-step procedure photos
  • With number, description, and photos.
  • Should be descriptive enough to be reproducible 
• Post-operative care
• Pearls
  • What are the advantages of this procedure/technique? 
• Pitfalls
  • What is the most complicated part of the surgery?
• Video
  • If we have any of this procedure
• References used in this procedure
  • Are numbered in the text: “(1)”, “(2)”, etc
  • Book chapters and articles from peer-reviewed journals.
  • Links to articles
  • Links to web-sites

Examples of procedures

• The Orlando Technique
• Bilobar flap for nasal reconstruction
• Excision of MM
• Sentinel node procedure
• Excision of tumor on the lip
• DIEP flap
• Primary assessment of burns patients
• Primary treatment of burns patients
• Breast reduction

Cases

Cases are created and placed under the same menu item as the procedure. Then they will automatically be displayed at the bottom of the procedure or case.

Cases should have a title in the following format: “Case [number]: [description]” e.g. “Case 1: Hypertrophic breast”. It is important to use a colon “:”.

An example of a case could be breast lift using the Orlando Technique (including use of wise pattern and supero-medial stilk). In the future we will have several cases of the same procedure.