Reconstruction and Amputation Flashcards
what is the number one reason for amputation?
diabetes
what principles should be considered when choosing amputation level?
circulation (for healing), preserve joints when possible, soft tissue coverage, prosthetic use
what are the two most common types of amputations?
trans-tibial (below knee), trans-femoral (above knee)
why does the prosthetic suspension system need to be changed?
residual limb changes 6mo following amputation
when do most phantom pains occur?
w/i 24hr post-op
what biochemical factors inhibit wound healing?
diabetes, hypothyroidism, renal/liver failure
when should you obtain a surgical consult for wound healing?
healing too slow, if needs to optimize wound environment, no progress of wound
what is the goal of reconstruction (plastic surgery)?
restore form and function to body
what types of wounds indicate secondary intention?
small, no exposed vitals, delayed presentation, contaminated, dead space
what concerns are associated with secondary intention?
scarring, pain, prolonged healing
when is skin grafting utilized?
secondary healing not possible and tissue loss too great for primary closure
what is a full thickness injury?
epidermis and dermis
what are the steps to graft survival?
plasmatic imbibition, inosculation and capillary ingrowth, revascularization
what is the most common type of skin flap?
random (sub-dermal plexus of vessels)
