Plastic, Oral, Maxillofacial on 9/16 Flashcards
Adip/o
fat
caus/o
burn
cauter/o
heat
burn
derm/o
skin
Dermat/o
skin
diaphor/o
sweat
eryther/o
red
erythemat/o
red
hydr/o
water
kerat/o
hard or horny tissue
cornea
leuk/o
white
lip/o
fat
lipid
melan/o
black
myc/o
fungus
onych/o
nail
phyt/o
plant
pil/o
hair
py/o
pus
seb/o
sebum
sebace/o
sebum
squam/o
squamous
steat/o
fat
trich/o
hair
ungu/o
nail
xer/o
dry
What makes up the integumentary system?
skin, hair, nail, and exocrine glands
What is he most visible and largest organ?
skin
What are 6 functions of the skin?
protection: barrier to outside
senses: pain, temp
Regulates: own body temp
Prevents loss of body fluids
Excretes through sweat glands
Absorption
What are the 3 main layers of skin?
Epidermis
dermis
hypodermis
What does the dermis layer of skin do for us?
provides strength and elasticity
callagen fibers
vascular layer
AKA true skin
What does the epidermis layer of skin do for us?
AKA false skin
continually replaces itself
non vascular
What does the hypodermis layer of skin do for us?
attaches skin to tissue
thick and fatty
AKA subcutaneous tissue
What are the purpose and goals of reconstructive skin procedures?
restore normal function/ appearance
correct congenital deformities/ disfigurements
scars or trauma
slef body immage
What is done to prep the skin for a face procedure? And what solution is used?
eyebrow/ lashes left alone
colorless prep solution used
hibiclense & betadine used
Hibiclense NOT near eyes and ears
What kind of draping used for plastic surgeries?
creative to expose several areas
universal drape
What kind of sutures are used in most plastic procedures?
fine sutures swagged to needles
2-0 to 8-0 depending on tissue
8-0 to 11-0 during microsurgeries (nerve & vessel)
What kind of anesthesia is used?
frequently local on WIWO
general on children or confused
What are the common anesthesia meds used?
xylocaine/lidocaine (1% or 2%)
bupivacaine/sensorcaine/
Marcaine (0.25%, 0.5%, 0.75%)
epinephrine as a local
What kind of visual equipment is used?
fiberoptic headlamp
lighted retractors
loupes- magnifying glasses
microscopes
What is an ESU?
electrosurgical unit used for coagulating and cutting tissue
What is a smoke evacuator?
used in conjunction with the ESU helps remove the smoke made
What is a pneumatic tourniquet? what are the steps to putting one on?
stops blood flow to extremity
What is a doppler used for?
identify sufficient blood flow through grafts
What is a nerve stimulator?
identifies nerves
used in craniofacial and hand reconstruction
facelift- facial and trigeminal nerve (cranial 5)
What powered instruments are used in plastic, oral, maxillofacial surgeries?
drills
z-serter for inserting small pins, plates, and screws
What is the liposuction vacuum machine and curettes used for?
removing excess subcutaneous fat
When handling plastics instruments what should be looked for on the forceps? scissors?
malocclusion- miss aligned teeth
burrs- uneven cuts
What are two reasons for doing implants and prostheses?
replace diseased, injured, or missing body parts
augment body parts
(mammoplasty-breast or mentoplasty- chin)
What does alloplastic mean?
material made from environmental materials
What kind of alloplastic materials are used?
dacron
silicone
silastic
mesh
teflon
stainless steel
Pressure dressing are frequently used when?
(FTSG) full thickness skin graft
aka stent dressing
What is the vacuum assisted closure device?
VAC
assists drainage with negative pressure
post-op dressing
used for pressure ulcers, flaps, and skin grafts to eliminate dead space
What is another name for neoplasm?
skin lesion
What is a skin lesion?
abnormal growth
benign or cancerous
anywhere on body
excised for cosmetic/ health
What is Basal cell carcinoma?
BCC
malignant tumor (most common)
head and neck
sun exposure
locally aggressive but rarely metastasizes
How is a lesion assessed?
Asymmetry
Border
Color
Diameter
Evolution
What is squamous cell carcinoma?
SCC
older people exposed to sun
rapid growing that can metastasize through lymph and blood
What is a malignant melanoma?
tumor of pigment cells
common on fair skin
can remain small or grow fast
tx- wide local excision
Prognosis determined by depth of tissue invasion
genetic predisposition
What is a pressure ulcer?
prolonged compression of soft tissue over bony prominences
Where are common sites of pressure ulcers?
sacrum
ischium
trochanter (hip)
malleolus (ankle)
heel
How many pressure ulcer stages are there?
4
Describe a stage 1 pressure ulcer
a reddend painful area that does not turn white when pressed on
Describe a stage 2 pressure ulcer
the skin is blistering or causing an open sore
Describe a stage 3 pressure ulcer
the skin develops an open or sunken hole called a crater or ulcer
need debridement
Describe a stage 4 pressure ulcer
sore deepens and may involve, muscle, bone, or tissue
need debridement and grafts
What are the classifications of burns?
first degree
second degree
third degree
fourth degree
Explain a second-degree burn
deep partial thickness burn damage into dermis
heals by regeneration if some dermis viable
blisters, severe pain, moist red pink appearance
EX bad sunburn
Explain a third degree burn
Full thickness burn epidermis and dermis destroyed
Eschar develops
lack of sensation
skin infection possible
Explain a fourth degree burn
char burns
damage to blood vessels, nerves, muscles, and tendons
extensive reconstruction
What is the rule of nines?
tool to estimate percentage of skin burned
What are the sections and the percentages for the rule of nines?
9% head and neck, and each arm
(27)
18% posterior trunk, anterior trunk, each lower leg (72)
1% for perineum
What is debridement ?
removal of foreign material, necrotic, or damaged tissue from a wound
What is being removed in a burn? (Specific term?
Eschar- dark tissue covering or shedding from wound
When is debridement of a burn performed? on what kind of thickness burns?
partial or full thickness
before healing or skin graft
What tool is used to excise the nonviable tissue
weck knife or
dermatome
How is homeostasis achieved in a burn?
electrocautery and topical thrombin
What are ways neoplasms are removed?
sharp dissection
electrosurgery
cryosurgery
laser surgery
radiation surgery
Mohs micrographic surgery
What is Mohs micrographic surgery?
procedure to treat skin cancer
cut away layers of skin, examine each layer until margins are clear
What is scar revision?
rearranging or reshaping a hypertrophic or keloid scar to improve appearance
What are 4 methods of scar revision?
excision
Z-plasty
W-plasty
Y-V-plasty
What is the simplest method of scar revision
excision and resuture it
What is the most common scar revision method?
Z-plasty
What is Z-plasty?
placing a Z shaped incision into scar and suturing it. The jagged edges help make healing better
What process can be used to improve the appearance of a large scar?
temporary sterile tissue expander
injection of NSS into port stretches the skin
scar is then excised & normal skin is reapproximated
What are the 3 types of skin grafts?
autograft
homograft
heterograft
What is an autograft skin graft?
=self
transfer one part of body to another
What are some example of autografts used?
cortical bone
cancellous bone
ribs
cartilage
tendons
fat
dermis
collagen
What is a homograft skin graft?
=another person
cadaver skin donation or skin bank
acellular dermal graft (alloderm)
placenta
What is another name for autograft skin graft?
autogenous graft
What is another name for a homograft skin graft?
allograft