Fundamentals of Plastic Surgery Flashcards
what is an ulcer?
An ulcer is a discontinuity of an epithelial surface (not unique to skin), which fails to heal spontaneously
what is a sinus?
A sinus is a blind track, lined by granulation tissue, leading from an epithelial surface into the surrounding tissues.
what is a fistula ?
A fistula is an abnormal connection between two epithelially-lined surfaces e.g. gut and skin
where can’t a skin graft be used ?
Bone stripped of periosteum Tendon stripped of paratenon Cartilage stripped of perichondrium Exposed metalwork Open joints
what is a flap?
A flap is a transferable block of tissue that may or may not include skin, which has its own blood supply.
what are the three main requirements of wound healing ?
vascular response
inflammatory response
cellular response
state 4 characteristics of hypertrophic scars?
Scar tissue raised above the normal level of the scar
Scar tissue stays within the original scar boundaries
Scar often red in appearance
Often resolve with time
state 3 characteristics of keloid scars?
Scar tissue extends out with the boundaries of the original scar
Surrounding normal tissue involved
Excision usually leads to recurrence
what is the treatment for bowens disease?
cryotherapy, topical chemotherapeutic agents, curettage, excision, lasers, photodynamic therapy and radiotherapy
what is bowens disease?
squamous cell carcinoma in situ
usually from sun exposure
what are the four classical appearance of BCC (basal cell carcinoma)
Raised, rolled edge
‘Pearly’ appearance
Telangectasiae
Ulcerated centre
what is the treatment for BCC?
surgical excision
if surgery isn’t appropriate what is the treatment for BCC?
cryotherapy or topical chemotherapeutic agents such as 5-Fluorouracil are generally reserved for patients who are unfit for anaesthesia or where surgery is not in their best interests.
are SCC or BCC more aggressive?
SCC
what is the presentation of SCC?
crusted lesion, with or without ulceration.
for malignant melanoma, what are the major or minor features ?
Major Features
A change in size of a pre-existent pigmented lesion
A change in shape of a pre-existent pigmented lesion, particularly if irregular
A change in colour/colour pattern, or the presence of three or more colours/li
Minor Features
Symptomatic lesion - itch is commonest
Oozing or crusting. Bleeding and ulceration are late signs
Inflammation of lesion or surrounding tissue
Lesion with diameter greater than 5mm
what criteria is used to measure a malignant melanoma ?
glasgow 7 point checklist
what are the 5 clinical types of Malignant melanoma?
Superficial spreading (up to 80%
Nodular - raised, rapidly growing
Lentigo maligna - arise in pre-existent patches of pigmentation (lentigo)
Acral - on palms or soles of feet
Amelanotic - lack distinct pigmentation, therefore making diagnosis more difficult (up to 10% of MM’s)
what is the thickness of the melanoma called?
breslow
where does bowens disease commonly occur?
legs of elderly women
what 5 characteristics should be noted about an ulcer?
site
ulcer edge
sensation
peripheral pulses
surrounding tissues
what would cause a punched out ulcer?
ischaemic ulcer
what appearance of ulcer does a BCC have?
pearly edge
what investigations should be done for ulcers?
Peripheral pulses should be checked and ankle-brachial pressure indices measured by Doppler ultrasonography
autoantibodies to check for SLE
biopsy
state some common places for pressure sores to be?
Sacrum
Ischial tuberosities
Greater trochanter of the femur
Heels
