Plastic Surgery Flashcards
What are the four stages of wound healing?
- Haemostasis (secs-mins): clot formation, vasospasm 2. Inflammation (mins-days): fight infection, remove debris 3. Proliferation (days-weeks): granulation tissue, angiogenesis, epithelialisation, scar formation 4. Maturation (weeks-years): collagen remodelling
List the complications of wound healing.
Infection Keloid/hypertrophic scar Contractures Incisional hernia Dehiscence (wound rupture) Haematoma Marjolin’s Ulcer (SCC from chronic wound)
How does a keloid scar differ from a hypertrophic scar?
Keloid: beyond borders of wound, does not resolve spontaenously, disorganised irregular collagen fibres Hypertrophic: limited to wound borders, resolves spontaenously, collagen loosely arranged
What is the rule of nines for estimating %BSA in burns?
Each leg = 18% Each arm = 9% Torso front = 18% Torso back = 18% Head = 9% Perineum = 1% Palm of hand = 1%
What is the Parkland formula?
4mL x weight x %BSA 50% given within first 8 hours, 50% given over remaining 16 hours
What is the most painful depth of burn?
Superficial partial thickness burn
What are the features of a deep partial thickness burn?
Thick-walled blisters, dull pain, bleeds/blanches slowly Injury extends to reticular dermis
What are the indications for referral to a burns unit?
- Partial thickness >20% (>10% in young or old) - Full thickness >5% - Involvement of face, hands, feet, genetalia, major joints - Significant chemical or electrical burns - Inhalation injury or serious comorbidity
Which organism is commonly implicated in impetigo?
Bullous: staph aureus Nonbullous: strep pyogenes
Which organism is commonly implicated in folliculitis?
Staph aureus ‘Hot tub’ folliculitis = pseudomonas aeruginosa
Which organism is commonly implicated in erysipelas?
Strep pyogenes
Which organism is commonly implicated in cellulitis?
Staph aureus, strep pyogenes
Which organism is commonly implicated in necrotising fascitis?
Type 1: multiple organisms Type 2: strep pyogenes
What is clostridial myonecrosis also known as?
Gas gangrene
What is Marjolin’s ulcer?
SCC arising from leg ulcers
What are the excision margins for skin lesions based on Breslow’s thickness?
<1mm = 1cm excision
1-4mm = 2cm excision
>4mm = 3cm excision
What is the most common site for BCC?
On the face, above the line from the edge of the mouth to the tragus
What is the most common skin cancer?
BCC
What are actinic or solar keratoses?
Patch of thick, scaly or crusted skin that may turn into an SCC if untreated.
What is this lesion?
Squamous Cell Carcinoma
What is this lesion?
Solar or actinic keratosis
What is this lesion?
Malignant Melanoma
What is this lesion?
Basal Cell Carcinoma
What is this rash?
Multiple Seborrheic Kertaoses, called Leser-Trelat sign which is an ominous indicator of internal malignancy (paraneoplastic syndrome
