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.

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.