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.

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.