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Oral Surgery II > Flaps and Grafts > Flashcards

Flaps and Grafts Flashcards

1
Q

Tissue that’s transferred WITHOUT an intact blood supply and relies on the ingrowth of new vessels.

A

Graft

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2
Q

Tissue transferred WITH ITS OWN BLOOD SUPPLY.

A

Flap

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3
Q

A flap that’s supplied by a named artery and vein..

A

Axial flap

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4
Q

What does “pedicle” mean?

A

Blood supply

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5
Q

Tissue is immediately adjacent to or near the primary defect.

A

Local flap

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6
Q

The tissue is not immediately adjacent to or near the site, but with pedicle sufficiently long to reach the primary defect.

A

Regional flap

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7
Q

Flaps with the pedicle distant enough not to streatch the the face or neck.

An example is a free flap.

A

Distant flap

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8
Q

Types of distant flaps.

A

Pedicled

Free

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9
Q

Flaps physically detached from their native blood supply and then reattached to vessels at the recipient site.

A

Free flap

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10
Q

A flap that has an unnamed blood supply.

A

Random flap

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11
Q

An advantage of an axial pattern flap.

A

You don’t have to obey the length to width ratios, the flap dimensions can be as long as the axial vessel.

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12
Q

This flap depends on the subdermal/subcutaneous plexus fused from perforators at the base of the flap.

A

Random pattern flaps.

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13
Q

Disadvantage of a random pattern flap.

A

Have to obey the 3:1 length to width ratio to ensure flap survival.

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14
Q

Length to width ratio of a flap if it’s not an axial pattern flap.

A

3:1

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15
Q

Types of pedicled flaps.

A

1) Advancement flaps
2) Transposition flaps
3) Rotation flaps

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16
Q

Epidermis is made of what kind of epithelium?

A

Keratinizing stratified squamous

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17
Q

Mnemonic for layers of the epidermis.

A 
Come
Lets
Get
Some 
Beers
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18
Q

Predominant cell type of the epidermis.

A

Keratinocyte (80%)

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19
Q

Layer of the epidermis that has the keratinocytes.

A

Basal

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20
Q

Thickness of the epidermis.

A

.075 - .15 mm

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21
Q

This is attached to the epidermis by the basement membrane.

A

Dermis

22
Q

Components of a pilosebaceous unit.

A

1) Hair shaft
2) Sebaceous glands
3) Follicle

23
Q

Where does epithelialization occur in full and split thickness grafts?

A

At the wound edges around the pilosebaceous unit.

24
Q

Layers of the dermis

A

1) Papillary

2) Reticular

25
Q

Thinnest dermis is found where?

A

Eyelid

26
Q

Thickest dermis is found where?

A

Back

27
Q

Thickness of the dermis as we age (after 5th decade).

A

Decreases

28
Q

Men or women have thicker dermis?

A

Men

29
Q

What are these indications for?

  • Cutaneous defect not amenable to primary closure or local flap.
  • Surface coverage of a vascularized (pedicled or free) myofascial flap.
  • Large mucosal defects not amenable to primary closure.
  • Tumor surveillance
  • Older patients (better match).
  • Temporary coverage.
A

Grafts

30
Q

When you can’t do primary closure or local flaps, what is indicated?

A

Graft

31
Q

Grafts are contraindicated when…

A

1) Vessels at the wound bed are exposed.
2) Exposed bone, cartilage, tendon.
3) No soft tissue wound bed.
4) Avascular defects

32
Q

Thickness graft where you take the epidermis and some dermis.

A

Full thickness

33
Q

Thickness graft where you take some epidermis.

A

Split thickness

34
Q

Which has a greater survival rate: Full or Split Thickness skin graft?

A

Split

35
Q

Does full or split thickness skin graft have a longer healing time?

A

Full thickness

36
Q

Advantages of a FULL thickness skin graft:

1) Texture and pigmentation closer to normal skin compared to Split Thickness.
2) Less contour irregularities.
3) Durability in areas of friction is concern.
4) No special harvest equipment.
5) Less contracture.
6) Donor site heals primarily.

A

True

37
Q

Indications for full or split thickness skin grafts?

1) Very large defects
2) Non-mobile site
3) Esthetics are not a concern
4) Visceral lining (oral) reconstruction.

A

Split thickness

38
Q

Advantage of full or split thickness skin graft?

  • Less tissue that requires revascularization.
  • Can be used when revascularization is a concern.
A

Split thickness

39
Q

Disadvantages of full or split thickness grafts?

1) Poor color and texture match with normal skin.
2) Contracts more
3) Patchy appearance to face

4) Donor site concerns:
- Takes 3 weeks to heal.
- Significant discomfort
- Sites always have color and texture changes that are unesthetic.

A

Split Thickness

40
Q

The first flap based on a known axial blood supply.

A

Deltopectoral flap

41
Q

Restore function and have bacteria resistance.

A

Flaps

42
Q

Do NOT have function or bacterial resistance.

A

Grafts.

43
Q

Name the flap:

1) Complete detachment with devascularization from the donor site.
2) Revascularization of the flap with microvascular anastomoses between flap pedicle vessels and recipient site vessels to nourish the flap with new arterial and venous drainage.
3) Intervening period of flap ischemia.

A

Free Flap (Distant flap)

44
Q

Qualities of which flap?

1) No lymph drainage
2) Denervated with respect to the sympathetic NS.
3) Usually only a single feeder artery and vein.

A

Free flap

45
Q

This tissue procedure RESTORES form and function.

A

Free flap

46
Q

A composite free flap/tissue transfer includes:

A

Skin
Fascia
Muscle
Bone

47
Q

Advantages of a free flap:

A
  • Wide variety of tissue types can be oriented in many configurations to improve inset.
  • Large amount of composite tissue.
  • Defect size of little consequence.
  • Can be harvested from almost any region of the body to match tissue characteristics.
  • Fewer surgical stages and reduced time to complete rehabilitation vs. regional reconstructions.
  • Potential for sensory and motor innervation
48
Q

Magnification for tissue preparation.

A

x4 or x6

49
Q

Magnification for vessel anastomosis.

A

x10

50
Q

Artery that supplies the fibula.

A

Peroneal artery

51
Q

Two of these run parallel to the peronealartery in the fibula.

A

Venae comitantes

Oral Surgery II (11 decks)

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