Axial pattern flaps

Question 1

Axial pattern flaps are cutaneous flaps based on a named nutrient vessel

Answer 1

T

Question 2

Axial pattern flaps have a pedicle containing a named cutaneous artery

Answer 2

T Vs random pattern flaps whose blood supply is based on the subdermal plexus

Question 3

The paramedian forehead flap has a pedicle most commonly based on the supratrochlear artery

Answer 3

T

Question 4

The abbe flap has a pedicle based on either the superior or inferior labial artery

Answer 4

T

Question 5

The dorsal nasal rotation flap has a pedicle based on the dorsal nasal artery

Answer 5

T

Question 6

Axial pattern flaps are usually staged surgical procedures.

Answer 6

T

Question 7

Convex areas generally heal better with second intention than concave areas.

Answer 7

F Other way round.

Question 8

Grafts rarely match the aesthetic results seen with flap reconstructive procedures.

Answer 8

T

Question 9

The reduction of blood flow from the proximal to distal portion of the flap results in relative tissue hypoxia and challenges flap survival.

Answer 9

T

Question 10

Flaps that have excessive width:length ratios may undergo distal necrosis.

Answer 10

F Excessive length:width.

Question 11

Flaps inset under heightened tension show reduced perfusion.

Answer 11

T

Question 12

Most flaps utilised in derm surgery are random pattern flaps.

Answer 12

T

Question 13

Axial pattern flaps commonly used in facial reconstruction include the median and paramedian forehead flaps, the dorsal nasal flap, and the Abbe flap.

Answer 13

T

Question 14

When most of a nasal subunit has been removed with tumour extirpation, the optimal reconstructive result may be achieved by replacing selective parts of the subunit.

Answer 14

F Replacing the entire subunit.

Question 15

Random pattern flaps are an effective repair choice for nasal defects >2cm, alar or distal nasal defects, or full-thickness wounds

Answer 15

F

Question 16

The forehead is generally preferred for nasal reconstruction when there is insufficient dorsal nasal skin.

Answer 16

T

Question 17

The paramedian forehead flap and the cheek melolabial interpolation flap are both interpolation flaps with the base of the flap’s pedicle residing some distance away from the surgical wound (non-contiguous).

Answer 17

T

Question 18

The cheek (melolabial) interpolation flap is a true axial pattern flap.

Answer 18

F

Question 19

The paramedian forehead interpolation flap is a true axial pattern flap.

Answer 19

T Named vascular supply is the supratrochlear artery.

Question 20

The cheek interpolation flap is suitable for defects on the nasal tip.

Answer 20

F Ala or lower nose, not tip.

Question 21

The vascular supply of the forehead is supplied by four paired arteries: the dorsal nasal (angular) arteries, the supratrochlear arteries, the supraorbital arteries and the superficial temporal arteries.

Answer 21

T

Question 22

For the paramedian forehead interpolation flap, undermining in a subfascial plane just superior to the periosteum near the flap’s origination ensures inclusion of the nutrient vessel within the body of the elevated flap.

Answer 22

T

Question 23

Discontinuation of anticoagulants before axial pattern flaps is necessary.

Answer 23

F

Question 24

For the paramedian forehead flap, incisions should go below the brow.

Answer 24

F Shouldn’t dt risk of distal flap necrosis.

Question 25

Surgical scars present on the forehead may be associated with increased operative risk of flap necrosis when performing the paramedian forehead flap.

Answer 25

T

Question 26

The paramedian forehead flap is designed based on the location of the supratrochlear vessels at approximately the medial end of the eyebrow.

Answer 26

T

Question 27

The paramedian forehead flap’s base or pedicle is designed to be ideally 1.2-1.7cm in width.

Answer 27

T

Question 28

The primary sources of auricular cartilage for composite grafting in the paramedian forehead flap are the conchal bowl and antihelix.

Answer 28

T Yield significant amounts of cartilage to reconstruct the lower nose.

Question 29

When performing a paramedian forehead flap, additional flaps or grafts may be needed to improve the aesthetic outcome when repairing the donor site at the cephalic margin of the wound on the forehead.

Answer 29

F Unlikely to improve the aesthetic outcome.

Question 30

For the paramedian forehead flap, the distal aspect of the axial flap should not be aggressively thinned of all muscle and subcutaneous fat.

Answer 30

F This allows the flap to drape over the cartilaginous framework of the nose and restore contour.

Question 31

For the paramedian forehead flap, typically the pedicle is divided as a second-stage procedure at approximately post-operative day 21.

Answer 31

T

Question 32

The dorsal nasal flap is utilised to repair defects of the nasal tip, supratip, or dorsum/sidewall that are less than 2.5cm diameter.

Answer 32

T

Question 33

The success of a dorsal nasal flap is dependent entirely on the laxity of the dorsal nasal skin.

Answer 33

T

Question 34

The more the dorsal nasal flap extends into the glabella, the easier the flap and secondary defect are to close without introducing anatomic distortion.

Answer 34

T

Question 35

The Abbe cross-lip flap is a pedicled axial pattern flap supplied by the labial artery.

Answer 35

T

Question 36

The labial artery is between orbicularis muscle and mucosa posterior to the vermillion.

Answer 36

T

Question 37

The course of the labial artery remains unchanged throughout life.

Answer 37

F Becomes more tortuous and superficial w age.

Question 38

For the dorsal nasal flap, inclusion of the angular artery in the base improves vascular support, allowing a more generous backcut

Answer 38

T

Question 39

The dorsal nasal flap is a good option for defects up to 2.5cm in diameter in patients with any shaped nose

Answer 39

F Ok if large nose, but can compress the cartilage and change tip projection when repairing large defects in patients with thin noses

Question 40

For the paramedian forehead flap, the pedicle is designed in a true vertical axis to ensure that the maximum length of the named vessel is included.

Answer 40

T

Question 41

Curvilinear incision on the nose minimise the potential for postoperative trapdoor deformity.

Answer 41

F Should use more acute angles.

Question 42

Conservatively undermining the surgical defect of the nose just above the periosteum and perichondrium before insertion of the flap may prevent postoperative trapdoor deformity.

Answer 42

T

Question 43

When elevating the paramedian forehead flap, there is no need to avoid removal of calvarial periosteum.

Answer 43

F Removal will significantly slow second intention healing at the flap’s donor site.

Question 44

For the paramedian forehead flap, the only common postoperative event is continued oozing from the transected pedicle near the glabella.

Answer 44

T

Question 45

For the dorsal nasal flap, it is important for the leading edge of the flap to extend just to the edge of the defect.

Answer 45

F Should extend past to compensate for flap shortening with rotational movement.