Plastic Surgery Flashcards
What is Primatrix composed of?
Fetal bovine dermis
What is Oasis composed of?
Porcine small intestinal mucosa
What are the pros and cons of full thickness grafts?
Pros: Contain the epidermis and all the dermis.
Grafts do not shrink. Less susceptable to trauma.
Cons: More likely to become infected with less “take”
What are the pros and cons of split thickness grafts?
Pros: Excellent take, less likely to become infected. Carries more blood vessels for revascularization.
Cons: Shrinks, tends to pigment abnormally, more susceptible to trauma.
What type of grafts receive meshing?
Only partial thickness grafts get meshing!
What is the length to width ratio that you want for full thickness graft harvesting?
3:1 length to width is best for adequate closure when harvesting full thickness grafts
What are the best harvesting sites for full thickness grafts?
Flexor surfaces
Sinus tarsi pinch
Groin
What are the best harvesting sites for split thickness grafts?
Anterior or lateral thigh
Upper inner arm
gluteal region
Dorsum of the foot.
What mixture can be used on the graft placement site to prevent excess bleeding?
Epinephrine and thrombis
What are the phases of skin graft healing?
Plasmatic 24-48 hours Nutrients by diffusion
Inosculation 3-5 days Capillary buds begin to form
Angiogenesis >5 days Capillaries fully formed and graft is vascularized.
Two most common causes for graft failure?
Hematoma (First)
Infection (second)
Seroma, shearing, poor wound bed are all reasons as well.
What are the angles used in the Z-plasty?
Between 45 and 60 degrees.
Angles less than 45 result in impaired blood flow to the flaps.
Angles greater than 60 result in severe tension.
60 degrees allow for a 75% increase in skin length.
