Plastic Surgery Flashcards
risk factors for malignant melanoma
- pale skin, freckles, fair hair
- multiple benign neavi
- atypical neavi
- UV exposure, sunburns
- family history of malignant melanoma
- immunosuppression
what is the glasgow scoring system for skin lesion referral?
Needs 3 or more to be referred to specialist:
MAJOR (2 points)
- changing in size
- irregular pigment
- irregular border
MINOR (1 point)
- Diameter > 7
- Inflammation
- Itching/altered sensation
- Oozing/bleeding/crusting
what is the most common type of melanoma?
-superficial spreading melanoma
where are the most common sites for a superficial spread melanoma?
FEMALE -legs
MALE - back
how does nodular melanoma present?
Black/brown nodule with associated areas of ulceration/bleeding
Lentigo maligna melanoma AKA
hutchingsons freckle
who/where is lentigo maligna melanoma present?
eldery people - face
in which population is acral lentiginous melanoma most common?
Dark-skinned people
where does acral lentiginous melanoma tend to occur?
- palms/soles
- nails
Managment of melanoma
- wide local excision of 1- 2 cm
- sentinal lymph node biopsy
- Adjuctive immunotherapy / radiotherapy
- For recurrence: isolated limb perfusion chemotherapy
Ix for melanoma
- excisional biopsy with 2 mm margin
- staging CT for all melanomas > 1mm
- baseline bloods
which locations of SCC tend to spread earlier?
-lip, ear, perineum
how does SCC spread?
lymphatics
appearance of an epidermal burn?
- erythematous, bright/shiny
- brisk cap refill
appearance of a partial thickness burn?
- dark red, blotchy, blisters
- slow cap refill
appearance of a full thickness burn?
- leathery appearance, white
- no cap refill or sensation
what is the name of the chart used to determine percentage of body covered in burns?
Lund-Browder
what does the parkland formula tell you?
how much fluid a burn patient needs
what is the parkland formula?
4 ml Hartmanns solution x body weight (kg) x % body burned
complicatoin of a cirumferential burn?
can act like a tourniquet and reduce blood supply
treatment of ischemia in the setting of a circumferential burn?
escharotomy (incision to release stricture)
respiratory complications of burns
- edema + obstruction
- inhalation injury
Hypovolemia from burns may lead to what renal complicaiton?
acute tubular necrosis
Difference between hypertrophic and keloid scars?
Hypertrophic - abornmal proliferation within original wound margins
Keloid - abnormal proliferation that goes beyond original wound margins
which regresses over time - hypertrophic or keloid scars?
hypertrophic
what type of collagen makes up a hypertrophic scar?
type III
what type of collagen makes up a keloid scar?
type I and II
what is a split thickness skin graft?
the epidermis with variable parts of the dermis
what is a full thickness skin graft?
epidermis with the entire dermis
does a graft come with its own blood supply?
NO. gets blood supply from recipient site
does a flap come with its own blood supply?
YES
what conditions are associated with dupuytrens contracture?
- high alcohol intake
- liver cirhosis
- diabetes mellitus
- epilepsy
Convservative management of dupustrens contracture?
- steroid injections
- collagenase injections
Surgical options for dupuytrens contracture?
- open fasciotomy
- limited fasciotomy
- regional fasciotomy
- dermatofasciotomy
what do you do with an amputated part?
- wrap in wet gauze
- put it in plastic bag
- put plastic bag in ice water
