Plastic Reconstructive Dental Maxillofacial Surgery Flashcards
Blepharoplasty: definition
surgical reconstruction of the eyelids to improve facial appearance by removing excess skin or periorbital fat deposits
Blepharoplasty pathophysiology: dermatochalasis (2)
- aka blepharochalasis*
- orbital defects, excessive sun exposure, aging process
- relaxation and hypertrophy of eyelid skin/periorbital fat protrusions
Brow Lift: definition
procedure to reduce/eliminate horizontal/vertical wrinkles of forehead and eyelid skin
Submalar Augmentation: definition
surgical reconstruction of the cheeks using synthetic prothesis to create facial contour for patients with bone structure/soft tissue deficiency
Mentoplasty: definition
- aka genioplasty*
- chin augmentation using synthetic prosthesis to enhance lower jawline/establish contour
Mentoplasty pathophysiology: MICROGNATHIA
underdevelopment abnormal smallness of lower jaw
Mentoplasty pathophysiology: RETROGNATHIA
one or both jaws positioned posterior to facial plane
Otoplasty: definition (2)
- reconstruction of the external ears
- reposition auricles to appear proportionate/contoured
Otoplasty pathophysiology: MICROTIA/PROMINAURIUS
Microtia: small ears
Prominaurius: prominent ears
Rhinoplasty: definition/wound class (3)
- elective aesthetic*
- reshape external nose without physical change to internal nasal passages
- wound class 2: clean contaminated wound*
Septoplasty:
corrects anatomic defect of nose, not aesthetic procedure
Rhinoplasty: anesthesia (2)
- lidocaine w/ epinephrine or cocaine provide hemostasis and decongestion
- peformed under local anesthesia with IV sedation
Rhinoplasty: position
supine position in slight reverse trendeleburg
Rhinoplasty: skin prep
do not use CHLORHEXIDINE GLUCONATE (oculotoix/ototoxic agent)
Rhinoplasty: instrumentation (2)
- ballenger swivel knife
- jansen-middleton septum forceps
Rytidectomy: definition
aka facelift
remove or eradicate wrinkles/sagging skin of face and neck to improve appearance
Rhytidectomy: incision
made bilaterally within temporal hairline (5cm above ear), inferior to front of ear, around ear lobe to terminus at occipital cap
Rhytidectomy: specialty equipment/ wound classification (2)
- class 1 wound*
- due with closed wound drainage
- 1 or two closed wound suction drainage systems (jackson pratt/hemovac)
Augmentation Mammoplasty: definition
- reconstruction of female breast mounds
- complete SUBMUSCULAR (
- partial sub muscular (below pectorals major)
- submammary approach (below breast tissue)
Augmentation Mammoplasty incision: PERIAREOLAR (2)
- incision along inferior circumference of areola
- typically best concealed scar
Augmentation Mammoplasty incision: INFRAMAMMARY (2)
- incision under natural breast crease
- most common incision
Augmentation Mammoplasty: tissue expanders
allows for gradual creation of excess soft tissue to support underlying prosthesis
Augmentation Mammoplasty pathophysiology: HYPOMASTIA
condition of having abnormal small breast
Augmentation Mammoplasty: Mastopexy (2)
- re-positioning of the nipple
- involves little to no removal of breast tissue
Breast Reconstruction (TRAM flap): definition
treat breast cancer when significant soft tissue loss from mastectomy makes prosthesis contraindicated
Breast Reconstruction (TRAM flap): 3 types of flaps
- myocutaneous
- pedicle flaps
- free flaps:
Breast Reconstruction (TRAM flap): TRAM (2)
- most common*
- Transverse Rectus Abdominis Myocutaneous (flap)
- pedicle or free flap
Breast Reconstruction (TRAM flap): Latissimus dorsi myocutaneous flap
pedicle flap used in conjunction with prosthesis
Breast Reconstruction (TRAM flap): doppler scanning/angiography
- allows assessment of flap vascularity
- uses doppler probe
Breast Reconstruction (TRAM flap): medication/eqipment
- fluroescein sodium (woods lamp)
- 2 cloused wound drainage systems to prevent deadspace
Abdominoplasty: definition
- elective aesthetic*
- improve appearance of abdominal wall by removing redundant skin & adipose tissue
Abdominoplasty: panniculectomy
- medically indicated*
- removal of pendulous apron to improve hygiene/skin breakdown
Abdominoplasty: suction lipectomy
- elective aesthetic*
- liposuction
- removal of fat deposits
Abdominoplasty: incision
bikini incision
low transverse curvilinear incision from iliac crest to iliac crest
Abdominoplasty: drains/wound class
*wound class 1* 1-2 closed wound suction drainage systems to prevent deadspace/hematoma
Palmar Fasciectomy: definition
partial or total excision of fascia in palm of hand to correct deformity & restore movement/function patients affected by Dupuytrens contracture
Polydactyly Correction: definition
removal of excess fingers/toes (supernumerary digits) and subsequent reconstruction/restoration of function
Polydactyly Correction: syndactyly
fusion of two or more fingers/toes; webbed fused digits
Mandibular Fractures: Arch Bars
outdated means of stabilizing fractured jaw by wiring mouth shut
Cheiloplsty (cleft lip repair): definition/wound class
wound class 2
ciloschisis; hare lip
correct congenital fusion failure of upper lip and possibly nose/palate
Cheiloplsty (cleft lip repair): rule of tens
applied to assess infants likely ability to withstand stress of surgery
- hemoglobin 10 g/dl (grams per decileter)
- 10 lbs
- 10 weeks old
Cheiloplsty (cleft lip repair): speciaty supplies
-logans bow (cheek splint) prevents damage to repair
Cheiloplsty (cleft lip repair): counts (3)
- opening count
- closing count w/ fascia closure
- closing count w/ skin closure
Palatoplasty (cleft palate repair): definition (2)
- palatoschisis*
- correct congenital fusion failure of the palate
- minimize speech difficulties/improve feeding
Palatoplasty (cleft palate repair): position
surgeon may cradle infants head
supine with slight reverse trendelenberg head placed at top edge of table
Palatoplasty (cleft palate repair): specialty supplies (2)
- brunnell needle (tongue suture)
- Oral-Rae endotracheal tube
Palatoplasty (cleft palate repair): instrumentation (2)
- Dingman OR Mclvor mouth gag w/ assorted blades
- Jennings without blades
Palatoplasty (cleft palate repair): dressing
horozontal mattress suture placed through the body of the tongue prior to conclusion to aid in correcting airway obstructions/artificial airways
Palatoplasty (cleft palate repair): wound class
wound class 2
LeFort Maxillary fracture: definition (2)
- reconstructive surgery of the mid-face to correct fractures of the maxillae and craniofacial bones
- fractures result of trauma or surgically created to treat deformities/ bite disorders
LeFort Maxillary fracture: fracture types
LeFort 1: transverse
LeFort 2: pyramidal
LeFort 3: craniofacial disjunction
LeFort 1 Maxillary fracture: position (3)
- supine
- neck hyperextended
- slight reverse trendelenberg
LeFort 1 Maxillary fracture: draping (2)
- throat pack with radiopaque marker
- prevents oral secretions, blood, irrigating, etc from entering pharynx
LeFort 1 Maxillary fracture: instrumentation
rowe forceps
LeFort 1 Maxillary fracture: counts
throat pack is included in count and removed prior to extubation
LeFort 1 Maxillary fracture: wound class
extraoral: wound class 1
intraoral: wound class 2
ORIF Orbital Fracture: pathophsyiology (2)
- trauma from fights/accidents resulting in fractures of the orbital floor and depression of contents into maxillary sinus
- blow out fracture result of force applied to the anterior globe
Skin Grafting: autogaft
tissue obtained from same individual
Skin Grafting: isograft
tissue obtained from genetically identical individual
Skin Grafting: allograft (homograft)
tissue obtained from another individual of same species
Skin Grafting: xenograft (heterograft)
tissue obtained from dissimilar species
Skin Grafting: cultured epithelial autograft
tissue cultured and grown in lab
Skin Grafting: full thickness skin graft (3)
- consists of all elements epidermis/dermis
- donor site mist be closed
- withstands flexion, abrasion, better aesthetic results
Skin Grafting: split thickness skin graft
- epidermis and various depths of dermis
- recipient site vascularizes rapidly
- graft may be meshed
Skin Grafting: skin prep (3)
- prep performed consecutively/concurrently for each site
- donor site (clean) performed first
- recipient (dirty) performed second
Skin Grafting: motor powered dermatomes (2)
- requires use of lubricant/counter traction
- Brown, Padgett & Zimmer
Skin Grafting: drum type dermatomes
Reese, Padgett-Hood
Skin Grafting: handheld knife
- burn wound debridement*
- handheld manually powered instrument containing fixed or disposable blade
Skin Grafting: graft skin mesher
derma carrier mesh board
Skin Grafting: 1,2,3 burns
- 1st superficial/partial (sunburn)
- 2nd deep partial thickness (blister)
- 3rd full-thickness dry, tough, leathery,
Skin Grafting: rule of nines
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