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Surgical MCQs > Microdermabrasion and Dermabrasion not in 3rd Ed > Flashcards

Microdermabrasion and Dermabrasion not in 3rd Ed Flashcards

1
Q

The most common indication for dermabrasion is facial acne scars

A

T

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2
Q

Regarding dermabrasion, wounds need to be limited to a deep-reticular dermal depth, as wounding deeper than this results in surface changes that are perceived as a scar.

A

F mid-reticular depth

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3
Q

Traditional dermbrasion utilises a wire brush or diamond fraise on a rotary hand engine to mechanically remove tissue.

A

T

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4
Q

Scarring, dyspigmentation and infection are potential complications of any deep abrasion procedure.

A

T

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5
Q

Acne scars that disappear by stretching the skin are an indication for recontouring with dermabrasion.

A

F Scars that don’t disappear with stretching.

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6
Q

Dermabrasion should not be combined with CO2 laser.

A

F Can be combined to ‘tighten’.

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7
Q

Surgical procedures for scars should be performed 6-8 weeks or more before dermabrasive or laser resurfacing.

A

T

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8
Q

CO2 laser and Nd:YAG laser will tighten and smooth superficial acne scars and rhytides.

A

F - Er:YAG (not Nd:YAG).

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9
Q

Dermabrasion is a helpful resurfacing adjunct for sculpting the elevated ridges of wrinkles that persist despite 2-3 passes with an ablative laser.

A

T

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10
Q

Dermabrasion removes the thermal coagulum left after heat-induced injury of CO2 lasers, thereby promoting healing and reducing postoperative erythema.

A

T

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11
Q

Rhinophyma tends not to respond to dermabrasion.

A

F Responds well.

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12
Q

There is a significant risk of scarring associated with dermabrasion of rhinophyma.

A

F Minimal risk due to sebaceous nature of rhinophymatous tissue.

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13
Q

Epidermal naevi, seborrhoeic keratoses, syringomas, angiofibromas and trichoepitheliomas can be dermabraded with good results.

A

T

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14
Q

Decorative tattoos can be abraded followed by the application of 1% gentian violet directly to the abraded surface and dressed with Adaptic gauze.

A

T Gentian violet promotes removal of tattoo pigment by stimulating phagocytes to carry away abraded pigment.

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15
Q

Traumatic and surgical scars cannot be treated with dermabrasion.

A

F Can perform as early as 6-8 weeks following injury of surgery.

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16
Q

Cosmetic patients undergoing dermabrasive surgery should expect 50-70% improvement in the appearance of deep acne scars and adynamic rhytides.

A

F 30-50%.

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17
Q

Distensible acne scars and dynamic rhytides that disappear by stretching are best treated with tissue tightening procedures such as ablative and non-ablative laser resurfacing treatments.

A

T

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18
Q

Sharp shoulders of scars of chicken pox or acne and deep non-distensible rhytides should be treated with surgery only.

A

F Can treat with mechanical dermabrasion or laser sculpting.

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19
Q

For full-thickness defects, surgical excision punch grafting and/or dermal grafts should be performed at least 6-8 weeks before resurfacing.

A

T

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20
Q

Patients with a history of impetigo should have a nasal swab to assess for S.aureus colonisation prior to dermabrasion.

A

T These patients will need prophylactic Abs.

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21
Q

Only patients with a history of HSV require prophylactic antiviral medication for dermabrasion.

A

F All patient should take until fully re-epithelialised. 14 days is recommendation.

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22
Q

Most herpetic infections occur 1-2 days after resurfacing surgery.

A

F 7-9 days after.

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23
Q

Delayed re-epithelialisation and hypertrophic scarring have been reported in patients undergoing dermbrasion during or shortly after isotretinoin therapy.

A

T

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24
Q

Dermabrasion should be postponed 1-2 months after a course of isotretinoin.

A

F 6-12 months.

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25
Q

Topical tretinoin cream applied daily for 2-3 weeks before dermabrasion has been shown to reduce the time required for re-epithelialisation.

A

T

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26
Q

A test spot dermbrasion is recommended in patients with a history of keloids or koebnerising conditions.

A

T

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27
Q

There is no need to observe universal precautions in performing dermabrasiion.

A

F Aerosolised viral particles can be produced.

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28
Q

The areas to be abraded should be outlined preoperatively with gentian violet while the patient is lying supine.

A

F Patient sitting.

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29
Q

Dermabrasion should be performed along the angle of the mandible and along the inferior jawline.

A

F Should perform to 1-2 fingerbreadths below to hide transition zone.

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30
Q

Partial abrasions (eg. around mouth, nose) should follow lines of facial cosmetic subunits.

A

T

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31
Q

Tumescent anaesthesia should be used to anaesthetize the entire face for dermabrasion.

A

T

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32
Q

Some microdermabrasion devices employ aluminium oxide crystals, which are sharp-edged and hard, as an abrasive.

A

T

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33
Q

Microdermabrasion is essentially painless, quick, easy to perform and has few associated risks.

A

T

34
Q

The clinical benefits of microdermabrasion can be profound.

A

F Clinical benefits are modest.

35
Q

Following treatment with microdermabrasion, mild erythema is present, but resolves quickly.

A

T

36
Q

Eye protection is not needed for microdermabrasion.

A

F Corneal abrasions can occur from crystals.

37
Q

The fraises used for dermabrasion are available in a variety of sizes, shapes and grades of coarseness.

A

T

38
Q

Cone-shaped fraises should be used on broader surfaces on the forehead and cheeks.

A

F Confined areas around nose, mouth, eyelids.

39
Q

Wheel-shaped fraises or the wire brush should be used on confined areas around the nose, mouth and eyelids.

A

F On broader surfaces.

40
Q

The extra coarse fraise is more forgiving than the wire brush.

A

T

41
Q

The bristles of the wire brush are angled such that clockwise rotation cuts more deeply in the skin, whereas counterclockwise rotation brushes the bristles over the surface more gently.

A

T

42
Q

For dermabrasion, the abrading endpiece is passed over the skin in arciform strokes parallel to the direction of endpiece rotation.

A

F Perpendicular.

43
Q

To abrade, the hand engine in pushed over the skin surface.

A

F Pulled.

44
Q

For dermabrasion, the direction of rotation is only important when a wire brush is used.

A

T

45
Q

For deep surfacing of acne scarring on the mid cheek, traumatic or surgical scars, or debulking large nodules of rhinophyma, clockwise rotation is more efficient.

A

T

46
Q

For full-face procedures, it is best to start abrading along the jawline or preauricular area and progress toward the centre of the face and nose.

A

T This allows for bleeding from the abraded areas to flow away from the skin being abraded.

47
Q

Two-point retraction of skin should be used to stabilise the area being abraded.

A

F Three-point retraction.

48
Q

When using spray refrigerant during dermabrasion, the scar or rhytide should be frozen in its stretched position.

A

F Unstretched position.

49
Q

The depth of abrasion can be monitored by closely observing the abraded surface.

A

T Papillary dermis appears as glistening white surface. Points of bleeding with depth.

50
Q

Yellow globules of sebaceous glands are seen with deep dermabrasion of acne scars in the mid-cheek or rhinophyma of the nose.

A

T

51
Q

The dermal fibrosis of acne scars tends to be resistant to abrasion.

A

F It will crumble and become friable.

52
Q

The peripheral margin of the abraded regions should be feathered to create a natural-looking transition zone.

A

T

53
Q

Acriform strokes should be perpendicular to the border of the abraded areas

A

F Parallel.

54
Q

Upon completion of a full-face dermabrasion procedure, most of the abraded areas will still be bleeding.

A

F Most will have stopped.

55
Q

Post-operative oedema can be reduced with im kenacort A40 given immediately post-dermabrasion.

A

T

56
Q

The abraded surface should be dressed with a semipermeable dressing held in place with paper tape and backs with non-adherent pads and gauze.

A

T

57
Q

The patient should return to clinic for the full-face dressing to be changed every 7 days.

A

F Every 3-5 days.

58
Q

The development of pain with or without erosions generally indicates a postoperative herpetic infection.

A

T

59
Q

Superinfection by bacteria or fungi is not uncommon following dermabrasion.

A

F Much less common than HSV.

60
Q

The presence of bright erythema after the first 2-3 post-operative weeks is the first sign of early scar formation and should be treated with topical high-potency steroid ointment od-bd.

A

T

61
Q

Pulse dye laser should not be used following dermabrasion.

A

F Can decrease erythema and scar induration.

62
Q

Intralesional steroid injections can be given if any induration, elevation or hypertrophy develops after dermabrasion.

A

T

63
Q

After successful aggressive scar management following dermabrasion, the skin should be clear.

A

F Usually have small focal areas of hypopigmentation.

64
Q

Following 3-5 days of wearing a full-face mask after dermabrasion, an open wound care technique can be employed with topical petrolatum ointment.

A

T

65
Q

Petrolatum ointment should be applied sparingly after dermabrasion.

A

F Apply 3-4 times daily.

66
Q

The open wound produced by dermabrasion heals by the mechanism of second intention wound healing.

A

T

67
Q

Regions rich in sebaceous glands (eg. nose and mid-cheek) re-epithelialise more slowly than skin over the bony prominences of the forehead, malar cheek and mandible after dermabrasion.

A

F More quickly.

68
Q

In dermabrasive wound healing, the collagen fibres align perpendicular to lines of tension before intermolecular cross-linkages are complete.

A

F Parallel.

69
Q

Following dermabrasion, increased tenascin expression may promote cellular migration, while integrin mitigates the epithelial mesenchymal interaction of wound healing.

A

F Increased integrin expression may promote cellular migration, tenascin mitigates epithelial mesenchymal interaction of wound healing.

70
Q

As wound healing progresses following dermabrasion, intradermal oedema continues to dissipate for up to 3 months.

A

T

71
Q

Continuing improvement of the skin surface irregularities and depressions occur for up to 24 months following dermabrasion.

A

F 6-12 months.

72
Q

Re-epithelialisation is usually complete within 7-10 days following dermabrasion.

A

T

73
Q

The skin heals faster with open techniques of wound care compared to using a semi-permeable dressing.

A

F Faster with semi-permeable dressing.

74
Q

Normal skin tone tends to return within 2-3 months following dermabrasion.

A

T Need to avoid sun exposure during this time.

75
Q

Most patients will develop some degree of transient post-inflammatory hyperpigmentation over the malar prominences and jawline following dermabrasion.

A

T

76
Q

Bleaching regimens can be used from the 3rd-4th week after dermabrasion and continued for 4-8 weeks or until hyperpigmentation resolves.

A

T

77
Q

Permanent pigment alteration occurs in less than 5% of patient following dermabrasion.

A

F 20-30%.

78
Q

Skin types V-VI are more likely to develop post-inflammatory hyperpigmentation following dermabrasion.

A

F Skin types III and IV.

79
Q

Pseudohypopigmentation refers to the phenomenon of when normally repigmented abraded skin appears to have a different tone and appearance than adjacent non-abraded skin.

A

T Can correct non-abraded areas with chemical peels, IPL or non-abalative laser.

80
Q

Increased milia formation is an expected postoperative sequelae of dermabrasion.

A

T Treat with gentle extraction after 1 week.

81
Q

Acne flares following dermabrasion are due to the occlusive nature of postoperative wound care.

A

T Treat with routine acne regimens.

Surgical MCQs (44 decks)

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