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Old Notes > Recon > Flashcards

Recon Flashcards

1
Q

What are the options for sternal wound?

A
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2
Q

Describe a pec major flap.

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3
Q

What are the options for back reconstruction?

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4
Q

What are the regional flaps in back reconstruction?

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5
Q

What are the options for Mylomengicele?

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6
Q

How will you plan your abdominal wall repair?

When immediate or delayed?

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7
Q

What are the options for abdominal wall repair?

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8
Q

What are the Mathes zones for abdominal recon?

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9
Q

Describe your component separation.

What are the increments?

A

Two landmarks: Skin to Ant Ax line

Release EO from IO at linea semilunaris

RA from posterior sheath to LSL

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10
Q

What are the options for upper 1/3 ear?

How will you do Anti-buch flap?

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11
Q

How would you do a Levator advancement?

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12
Q

What is the algorthim of eye defects?

A

UL

Sliding (Lateral) Tenzel (Central) Composite

Frick CB share

LL

Direct, Tripier (bucket handel), Mustarde aka like tenzel of UL, also Sliding Conj) Composite

Hughes, Share, Composite (Reverse FForhead)

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13
Q

Describe a Tenzel flap.

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14
Q

Describe a sliding TC flap.

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15
Q

Describe a Cutler Beard flap.

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16
Q

Describe a Fricke Forehead flap.

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17
Q

Describe a lower lid sharing flap.

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18
Q

Describe a Tripier flap.

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19
Q

Describe a Hughes Tarsocon Flap +FTSG

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20
Q

How can you repair Medial canthal tendon?

A
21
Q

Where would you anchor LCT and what are the repair options?

A
22
Q

What are the options for partial vaginal defects?

Describe a singapore flap.

A
23
Q

Describe the options for genital defects.

A
24
Q

Describe your repair of penile replant.

A
25
Q

Describe you initial approach to forniers.

A
26
Q

Describe your post forniers reconstruction.

A
27
Q

Describe your penile reconstruction protocol.

A
28
Q

What is your algorthim for Lip recon?

A

UL: 1/3: local +MM,

2/3: Dont 1/2 abbe, also BL advangement with perialar cres excision.

>2/3 NL flaps

29
Q

Describe Johanson stair step.

A

Excise defect as rectangle.

First step extending from defect parallel to vermillion 1/2 width.

Stair pattern at 45o height 8mm, width 1/2 (4mm. 4 steps)

Incise full thickness first box then skin only. Last is trangle with apex inferior.

Cons: Scar, smile distorsion.

30
Q

Describe Abbe flap.

A

Excise as wedge

Draw flap on opposite lip: 1/2 width, h=h of defect, edge (pedicle starting at middle of defect) preserving NL etc.

Full thickness incision in free side, then pedicle side preserving full thickness around pedicle.

Transfer, layered repair with precise alignment of vermillion.

Divide at 3 weeks.

Adv: Reliable, limited motor,

Cons: 2 stage, Oral intake before division.

31
Q

Describe Estlander.

A

Can be used for Lateral and Medial (medial advancement of lower lip incision at commisure)

Pedible medial

Adv: 1 stage

Cons: Blunting of comm

32
Q

Karapansic

A

MucoCutaneous (Skin OO) <80% defects

Adv: Motor and NV preserved , philtrum/mod, 1 stage.

Cons: Microstom/ comm asym.

H= h of verticle defect

Mark incision in NL area/ Labiomental area + Burrow triangle

Incise skin and OO, Muscos just adjavent to defect, IP facial nerve and Labial artery

33
Q

Web- Bernard- Burow + Mucosal Adv flap

A

Draw horizontal limbs then mark triangles.

LL: triangel in NL and Chin

UL: Peri alar and commisure

Cons: microstomia, function.

34
Q

Your lip recon has a recurrance. Represents after radiation.

How will you reconstruct. What are the anchor points?

A

RFF with LABC and PL.

Modiolis or Lateral buttress with anchor to PL. Neirorrhapy to Mental nerve.

Static: Facial graft or pedicled temporalis.

Options for dynamtic recon: MMT, FF Gracilis

35
Q

How will you manage the commisure defect?

Commisureplasty.

Commisure recon.

A
  1. Splint at 2w for 3-12m

Comissureplasty Options

  1. Step length
  2. buccal adv. VY, Rhomb
  3. Steps: Template, new desired location
  4. Incise and raise step flaps , OO step legthening-incise to new commisure and inset.
  5. Or incise to new pt and do bilobe adfanvement of mucosa.

Recon: Zisser technique

  1. Tumor excised as crescent in line with NL fold.
  2. Triangle of equal with incise along later edfe.
  3. Close and neo commisure of buccal mucosa.
36
Q

Cheek defects:

  1. Suborbital
  • <2cm
    • Rhomboid, banner, hatchet, mustarde, VY adv, NL interp.
  • >2cm Cervicofacial (Anchor, Sub q, sub plat, sub fascial)
  • Convert defect to triangle
  • LL, preaur, behind ear, ant border of trap, DP grove, Chest back cut prn
  • Excise dog ear at NL fold.
  • Anterior based - facial artery
  • (posterior - STA)
A
37
Q

What are the options for preauricular and buccomandibular defects.

A
38
Q

What is your approach to lower extremity trauna.

A

Tetanus

Allens

Angio

Vascualr repair = fasciotomy

39
Q

What are the options for groin reconstruction?

A
40
Q

Describe a propeller and keystone flap.

A

Propeller -i.e. list vessle

  • Doppler one perforator in line with septum.
  • Proximal length = L= distance from perforator to distal end of wound +1
  • w= width of defect
  • Dissect perforator in subfascial plane
  • Rotate and inset. SG to close prn

Keystone

  • Extend wound edge at 90o
  • W= width of widest part
  • Cut through deep fascia. I & P perforators during advanvement.
41
Q

What are the flaps of the lower 1/3 leg?

A

Free: Lat, ALT

FC:

  • Propeller,
  • Sural,
  • Lat SuperMal,
  • Dorsalis

Muscle

  • Rev Sol
  • Leg
42
Q

What is your approach to foot and ankle.

A

Things to ask:

Past vascular surgery

Vein grafts to original vessle.

43
Q

What are options for Dorsal, Fore and midfoot coverage?

A

Think of pedicle before local flaps.

Consult Ortho, wound care.

44
Q

What are the options for plantar heel?

A

Planter

  • ADM, ABd Hal
  • Propeller
  • Rev Sural, Rev Lat SuperMal

Lat: Lat calcaneal A

Med: Medial Plantar A FC

45
Q

What are options for Achilles region, Ankle region?

A
46
Q

Approach to pressure sore?

A
47
Q

When would you not use vac?

A
48
Q

What are the surgical principles of pressure sore?

A
49
Q

Describe a posterior thigh flap for ischial recon.

A

Old Notes (13 decks)

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