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Section III Subspecialty Surgery P517 > Plastic Surgery, C68 P572-578 > Flashcards

Plastic Surgery, C68 P572-578 Flashcards

1
Q

Define the following terms:
Blepharoplasty
P572

A

Eyelid surgery—removing excess

skin/fat

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2
Q

Define the following terms:
Face lift
P572

A

Removal of excess facial skin via hairline/

chin/ear incisions

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3
Q

Define the following terms:
FTSG
P572

A

Full Thickness Skin Graft

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4
Q

Define the following terms:
Langer’s lines
P573 (picture)

A

Natural skin lines of minimal tension
(e.g., lines across the forehead), incisions
perpendicular to Langer’s lines result in
larger scars than incision parallel to the
lines

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5
Q

Define the following terms:
Mammoplasty
P573

A

Breast surgery (reduction/augmentation)

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6
Q

Define the following terms:
Polydactyly
P573

A

Extra fingers

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7
Q

Define the following terms:
Rhinoplasty
P573

A

Nose surgery, after trauma or cosmetic

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8
Q

Define the following terms:
STSG
P573

A

Split Thickness Skin Graft

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9
Q

Define the following terms:
Syndactyly
P573

A

Webbed fingers

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10
Q

WOUND HEALING
What are the phases of
wound healing?
P573

A

Think: “In Every Fresh Cut” = IEFC:

1. Inflammation
2. Epithelialization
3. Fibroplasia
4. Contraction
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11
Q 
WOUND HEALING
What are the actions of the
following phases:
Inflammation?
P574
A

Vasoconstriction followed by vasodilation,

capillary leak

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12
Q 
WOUND HEALING
What are the actions of the
following phases:
Epithelialization?
P574
A

Epithelial coverage of wound

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13
Q 
WOUND HEALING
What are the actions of the
following phases:
Fibroplasia?
P574
A

Fibroblasts and accumulation of collagen,

elastin, and reticulin

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14
Q 
WOUND HEALING
What are the actions of the
following phases:
Wound contraction?
P574
A

Myofibroblasts contract wound

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15
Q 
WOUND HEALING
What is the maximal
contraction of a wound in
mm/day?
P574
A

0.75 mm/day

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16
Q 
EPITHELIALIZATION
What degree of bacterial
contamination prevents
epithelialization?
P574
A

> 100,000 organisms/gm tissue (10(5))

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17
Q 
EPITHELIALIZATION
In which structures does the
epithelium grow from
superficial burns/wounds?
P574
A

Epithelial lining of sweat glands and hair

follicles

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18
Q

EPITHELIALIZATION
In full-thickness burns?
P574

A

From wound margins, grows in 1 cm
from wound edge because no sweat
glands or hair follicles remain; this
epithelium has no underlying dermis

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19
Q 
EPITHELIALIZATION
What malignant ulcer is
associated with a longstanding
scar/burn?
P574
A

Marjolin’s ulcer (a.k.a. burn scar

carcinoma)

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20
Q

WOUND CONTRACTION
What are myofibroblasts?
P574

A

Specialized fibroblasts that behave like
smooth muscle cells to pull the wound
edges together following granulation

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21
Q

WOUND CONTRACTION
Which contracts more: an
STSG or an FTSG?
P574

A

STSG contracts up to 41% in surface
area, whereas an FTSG contracts little,
if at all

22
Q

WOUND CONTRACTION
What is granulation tissue?
P575

A 
Within 4 to 6 days after an open wound,
development of capillary beds and
fibroblasts provides a healthy base for
epithelial growth from wound edges; this
tissue also resists bacterial infection
23
Q

WOUND CONTRACTION
Name the local factors that
impair wound healing.
P575

A

Hematoma, seroma, infection, tight sutures,
tight wrap, movement/disturbance of the
wound (i.e., poking it with a finger)

24
Q

WOUND CONTRACTION
What generalized conditions
inhibit wound healing?
P575

A 
Anemia
Malnutrition
Steroids
Cancer
Radiation
Hypoxia
Sepsis
25
Q

WOUND CONTRACTION
What helps wound healing
in patients taking steroids?
P575

A

Vitamin A is thought to counteract the
deleterious effect of steroids on wound
healing

26
Q 
WOUND CONTRACTION
When does a wound gain
more than 90% of its
maximal tensile strength?
P575
A

After ≈6 weeks

27
Q

WOUND CONTRACTION
Define the following terms:
Laceration
P575

A

Jagged wound

28
Q

WOUND CONTRACTION
Define the following terms:
Abrasion
P575

A

Superficial skin removal

29
Q

WOUND CONTRACTION
Define the following terms:
Contusion
P575

A

Bruise without a break in the skin

30
Q

WOUND CONTRACTION
Define the following terms:
Hypertrophic scar
P575

A

Hypertrophic scar within original wound

margins

31
Q

WOUND CONTRACTION
Define the following terms:
Keloid
P575

A

Proliferative scar tumor progressively
enlarging scar beyond original wound
margins

32
Q

WOUND CONTRACTION
Why not clean lacerations
with Betadine®?
P575

A

Betadine® is harmful to and inhibits

normal healthy tissue

33
Q

WOUND CONTRACTION
What is the best way to
clean out a laceration?
P575

A

Normal saline irrigation; remember,

“The solution to pollution is dilution”

34
Q

SKIN GRAFTS
What is an STSG?
P576

A

Split thickness: includes the epidermis

and a variable amount of the dermis

35
Q

SKIN GRAFTS
How thick is it?
P576

A

10/1000 to 18/1000 of an inch

36
Q

SKIN GRAFTS
What is an FTSG?
P576

A

Full thickness: includes the entire

epidermis and dermis

37
Q

SKIN GRAFTS
What are the prerequisites
for a skin graft to take?
P576

A 
Bed must be vascularized; a graft to a
    bone or tendon will not take
Bacteria must be <100,000
Shearing motion and fluid beneath the
    graft must be minimized
38
Q

SKIN GRAFTS
What is a better bed for a
skin graft: fascia or fat?
P576

A

Fascia (much better blood supply)

39
Q

SKIN GRAFTS
How do you increase surface
area of an STSG?
P576

A 
Mesh it (also allows for blood/serum to
be removed from underneath the graft)
40
Q 
SKIN GRAFTS
How does an STSG get
nutrition for the first
24 hours?
P576
A

Imbibition

41
Q

FLAPS
Where does a random skin
flap get its blood supply?
P576

A

From the dermal-subdermal plexus

42
Q

FLAPS
Where does an axial skin
flap get its blood supply?
P576

A

It is vascularized by direct cutaneous

arteries

43
Q

FLAPS
Name some axial flaps and
their arterial supply
P576

A 
Forehead flap—superficial temporal
    artery; often used for intraoral lesions
Deltopectoral flap—second, third, and
    fourth anterior perforators of the
    internal mammary artery; often used
    for head and neck wounds
Groin flap—superficial circumflex iliac
    artery; allows coverage of hand and
    forearm wounds
44
Q

FLAPS
What is the most common
cause of flap loss?
P577

A

Venous thrombosis

45
Q

FLAPS
What is a simple
advancement flap?
P577 (picture

A

(see picture)

46
Q

FLAPS
What is a rotational flap?
P577 (picture

A

(see picture)

47
Q

FLAPS
What is a “free flap”?
P577

A

Flap separated from all vascular supply
that requires microvascular anastomosis
(microscope)

48
Q

FLAPS
What is a TRAM flap?
P577

A 
Transverse Rectus Abdominis
Myocutaneous flap (see page 410)
49
Q

FLAPS
What is a “Z-plasty”?
P577 (picture)

A

(see picture)

50
Q

FLAPS
What is a “V-Y advancement
flap”?
P578 (picture)

A

(see picture)

Section III Subspecialty Surgery P517 (11 decks)

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