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ACVS Phase II 2022 > Skin Closure and Grafts > Flashcards

Skin Closure and Grafts Flashcards

1
Q

Travis
Quilting SC
VetSurg 2018

A

Incisional seroma lower in quilting group by 0.3 odds ratio

Pain lower in quilting at 24h

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2
Q

Bonaventura
Meshed skin graft after distal limb tumor excision
JAVMA 2021

A

Graft outcome not different between single session vs. staged

bandage changes increased in staged surgeries

Time to healing longer in staged

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3
Q

Jones
Subdermal plexus skin flap
JAVMA 2019

A

Complications 51%

Occurs at 1 week PO

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4
Q

Emmerson
Genicular a. axial pattern flap
JSAP 2019

A

Survival 99%

Minor complications 36%
Major complications 14%

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5
Q

Regier
Intradermal closure monofilament vs barbed
VetSurg 2019

A

Monofilament
~higher max load
~higher displacement at failure

Barbed suture leaked less

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6
Q

Ways to close a dog ear

A 
Remove 2 small triangles
Remove 1 large triangle
Extension of fusiform excision
Remove arrow-headed-shaped
Half Z plasty
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7
Q

Ways to close crescent-shaped defect

A

~Fudging
~Suturing by 1/2s
~End to center and central removal of additional tissue
~One end to other with dog ear at the end
~Center to ends with dog ear removals at ends
~Lengthening short end of the incision
~Remove 1/2 bowtie to Y incision

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8
Q

Ways to close a step defect

A

~Manipulate suture knot
~Placement of suture at same depth on both sides of the incision
~1/2 buried horizontal mattress- intradermal on low side
~Stiff suture from superficial high side to deep on low side

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9
Q

Define Skin Tension

A

determined by the predominant pull of the collagen and elastin fibers in dermal and hypodermal tissues

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10
Q

Define Skin Shear

A

Force acting on one wound edge may oppose the forces acting on the apposed wound edge

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11
Q

Define Viscoelasticity

A

Ability to be mobilized
~initial pliability
~tendency to return to its original shape when deforming stress is removed
~ability to adapt when prolonged stress is applied

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12
Q

Tension relieving Suture Techniques

A 
~Stong SC sutures
~Stent or Bolster Sutures
~Far-Near-Near-Far
~Walking sutures
~Horizontal and Vertical Mattress Sutures
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13
Q

Skin Stretching Techniques

A 
~Pretension sutures
~Posttensioning
~Presturing
~Acute skin stretching
~Chronic skin expansion
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14
Q

Types of Relaxing Incisions

A 
~Mesh Expansion
~Simple Relaxing Incision
~V-Y Plasty
~Z-Plasty
~M-Plasy
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15
Q

Closure of Circular wound

A 
~Linear with dog ears at ends
~Fusiform
~Triangle
~V-Plasty
~O to S
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16
Q

Types of Subdermal Plexus Flaps

A 
~Advancement Flap
~Rotation Flap
~Transposition Flap
~Interpolation Flap
~Plasty
~Distant Flaps
~Composite Flaps
17
Q

Process of Engraftment

A

~Adherence
-Phase 1: 8 h
-Phase 2: 72h
~Plasmatic Imbibition (grafted vessles dilate) 48-72h
~Inosculation (anastamosis of ends) 48-72 h
~Vascular ingrowth: begins 48h
~Reinnervation 3 w

18
Q

Examples of Subdermal Plexus Flaps

A 
~Skinfold flap
~Scrotal flap
~Perivulvar flap
~Preputial Reconstruction
~Phalangeal fillet
~Labial flap
~Lip-to-lid flap
~Direct distal flap (leg tucked into flank)
~Delayed Tube flap
19
Q

Superficial Temporal a. Flap

  • uses
  • development
  • outcome
A

Use: Maxillofacial to eyelid

Development: Caudal zygomatic to lateral orbit

Outcome: Survival 93-99%
69% when extended to the zygomatic arch

20
Q

Caudal Auricular a. Flap

  • uses
  • development
  • outcome
A

Use: neck facial, ear, dorsal head

Development: B/W wing of atlas and ear canal to the spine of the scapula

Outcome: 85% survival

21
Q

Thoracodorsal a. Flap

  • uses
  • development
  • outcome
A

Use: thorax, shoulder, forelimb, axillary

Development: caudal to the scapula

Outcome: 98% sruvival
70% tip necrosis

22
Q

Cranial superficial epigastric a. Flap

  • uses
  • development
  • outcome
A

Use: sternal

Development: caudal to rib cage 3-5

Outcome: 87%

23
Q

Caudal superficial epigastric a Flap

  • uses
  • development
  • outcome
A

Use: Caudal abdomen, flank, inguinal, preputial, perineal, thigh, stifle

Development: up to 2nd mammary gland

Outcome: 90-95% survival

24
Q

Lateral caudal a Flap

  • uses
  • development
  • outcome
A

Use: perianal, caudodorsal pelvis

Outcome 78%

25
Q

Genicular a Flap

  • uses
  • development
  • outcome
A

Use: Medial stifle, medial tibia

Development: Proximal to patella, distal to TT, b/f greater trochanter

Outcome 89%

26
Q

Types of Grafts

A

~Split-thickness

  • 89% survival
  • hair growth absent

~Full-thickness mesh
-90-100% survival

~Split-thickness mesh
~Full-thickness unmeshed
~Pinch and Punch Island
~Strip
~Stamp
~Paw Pad
~Mucosal
27
Q

Burns Zone of Injury

A

Coagulation
-no viable tissue

Stasis
-hypoperfusion

Hyperemia
-inflammation

ACVS Phase II 2022 (43 decks)

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