exam 2 material Flashcards
should your incision be parallel or perpendicular to tension lines
parallel
T/F: skin sutures are not for tension relief
true. they are for apposition only
what can be used for tension relief
far-near-near-far, far-far-near-near stents, bolsters, skin stretching, cruciate
what is mechanical creep
elongation of skin with a constant load over time
where should you undermine? what do you need to preserve?
deep to cutaneous trunci/platysma/sphincter colli muscles, down to the muscle fascia, preserve the subdermal plexus
describe walking sutures
strong bites of dermis parallel to direction of pull. be judicious with number used as it can compromise blood supply
what is a bipedicle flap
a single relaxing incision. allows you to close the primary wound/incision and the relaxing one heals by second intention
what are mesh relaxing incisions
1 cm incisions 1 cm from the wound edge, rows spaced 1 cm apart. be very judicious with use b/c risk of skin necrosis
what dimensions need to be maintained for a subdermal plexus flap
base should be slightly wider than with of flap
what are single pedicle flaps
subdermal plexus flaps with 2 skin incisions in equal length to defect. simply advance the flap to cover the defect
what are bipedicle flaps
subdermal plexus flaps with incision parallel to long axis of defect. flap length no more than 2x width of defect. may or may not close the flap incision
what are subdermal plexus rotation flaps
used in an area of tight skin with loose skin nearby. cut a semicircle near the defect and pull like a fan to cover it
what are transposition flaps
1 border adjacent to defect. width of flap=width of defect. cut the flap on 3 borders and move it over to cover the defect
what are skin fold flaps
skin rotated in from areas with a lot of extra skin like the flank fold or the elbow fold
what is the blood supply to axial pattern flaps? what is the benefit of these?
direct cutaneous artery and vein. can be longer and larger and rotated up to 180 degrees
what are peninsular flaps
axial pattern flaps with intact skin at the base. this leaves a dog ear in the skin but reduces risk b/c vessels are protected
what are island flaps
axial pattern flaps with skin cut all the way around where the vessels are completely exposed
where can axial pattern flaps be used
thoracodorsal, caudal superficial epigastric, omocervical. need to know anatomy and exactly where the vessels are
what is a reverse saphenous flap
axial pattern flap on the distal limb that is flipped upside down
how are free skin grafts different from flaps
they are completely removed from the body and moved elsewhere
what is the blood supply to free skin grafts
the wound bed
what is the process of engraftment (healing of a skin graft)? describe the stages
- adherence - fibrin strands become fibrous adhesion
- plasmacytic imbibition - 1st 24-48 hours, donor tissue receives nutrients thru absorption of plasma from wound bed via capillary action
- inosculation - vascular network is established btwn cut vessels
- vascular ingrowth/revasculatization - vessels are connected
what are the types of free skin grafts? which is not suitable in cats? which is ideal?
- split thickness unmeshed - not for cats
- full thickness unmeshed
- full thickness mesh
- split thickness mesh - ideal (b/c can take smaller donor section and required less vasculature than full thickness)
what is important for healing of grafts
no movement in the site!
T/F: ice packs should be applied after reconstructive surgery
false! may apply heat packs
