Plastic Surgery Flashcards
Blepharoplasty
Eyelid surgery
Removing excess skin/fat
FTSG
Full Thickness Skin Graft
Includes entire epidermis and dermis
Langer’s lines
Natrual skin lines of minimal tensions
Incisions perpendicular to them result in larger scars than those parallel to the lines
STSG
Split thickness skin graft
Includes the epidermis and a variable amount of the dermis
10/1000 to 18/1000 of an inch thick
What are the phases of wound healing?
Inflammation
Epithelialization
Fibroplasia
Contraction
“In Every Fresh Cut”
Which contracts more - an STSG or an FTSG?
STSG contracts up to 41% of the surface area
FTSG contracts little, if at all
What helps wound healing in patients taking steroids?
Vitamin A
Counteracts the effect of steroids on wound healing
Jagged wound
Laceration
Bruise without a break in the skin
Contusion
Overgrowth of collagen stays within the original wound margins
Hypertrophic scar
Overgrowth of collagen that progressively enlarges beyond the original wound margins
Keloid
What are the prerequisites for a skin graft to take?
Bed must be vascularized - not bone or tendon
Bacteria <100,000
Shearing motion and fluid beneath the graft must be minimal
What is better bed for a skin graft - fascia or fat?
Fascia (better blood supply)
How do you increase the surface area for a STSG?
Mesh it (allows for blood/serum to be removed from beneath the graft)
Where does a random skin flap get its blood supply?
From the dermal-subdermal plexus
Random flaps are simpler and have no named blood supply. Rather, they are supplied by generic vascular networks.
What is the most common cause of flap loss?
Venous thrombosis
What is a simple advancement flap?
Incisions are extended out parallel from the wound, creating a rectangle with one edge remaining intact.
This rectangle is freed from the deeper tissues and then stretched (or advanced) forward to cover the wound.
What is a rotational flap?
A rotation flap is similar except instead of being stretched in a straight line, the flap is stretched in an arc.
The more complex transposition flap involves rotating an adjacent piece of tissue, resulting in the creation of a new defect which must then be closed.
What is a “free flap”?
Flap separated from all avascular supply that requires microvascular anastomosis
What is a TRAM flap?
Transverse Rectus Abdominis Mycutaneous flap
What is a “Z-plasty”?
Functional (elongate and relax scars)
or cosmetic (realign scars to make them less noticeable).
The transposition of two triangular flaps.
What is a V-Y advancement flap?
A surgical method for lengthening tissues in one direction
by cutting in the lines of a V,
->sliding the two segments apart,
->and closing in the lines of a Y.
