Soft tissue defect Flashcards
4 distinct phases of wound healing?
- Haemostatic
- Inflammatory
- Proliferative
- Remodelling
Between which two phases is failiure in wound healing most common?
Inflammatory (debris cleaning) and proliferative
What happens with collagen in remodeling phase?
Type 1 replaces type 3.
the same in dupyutrens, can create contraction
Normal skin graft healing
- Imbibition (passively absorbs oxygen)
- Inosculation (vascular network establishes)
- Revascularization
4 types of flaps
- Local (immediate vicinity of the wound)
- Regional (same anatomical area)
- Distant (different anatomical ex groin)
- Free
Reconstructive ladder
- Secondary intention
- Primary closure
- Skin graft
- Local flap
- Distant flap
- Free flap
3 other types of reconstrutive “ladders”
Supermarket, pie, elevator
4 important aspects to adress in hand skin defects
- Wound closure (size and depth of wound)
- Hand function (how to preserve)
- Additional procedures beneath?
- Specialized tissue? (pulp, thumb sensate, web space, joints
4 types of vascularity for flaps
- Random flaps
- Axial pattern
- Reverse axial pattern
- Island flaps
What is Atasy flap?
A distal V-Y fingertip flap, not very useful
What is Tranquilli-Leali neuromuscular flap (Elliot)?
Similar to Moberg but for finger, not mor proximal than PIPj with advancement of neuromuscular bundle. Works if you protect dorsal artery branches raising from PIP
4 flaps for thumb pulp?
- Moberg
- Snow (Moberg with V-Y)
- Kite-flap
- Dorsoulnar Brunelli flap
Becker flap vascularity?
Recurrent artery branch from ulnar artery that is constant
Flaps for coverage of wrist and hand?
- Radial artery
- PIA flap
- Becker flap
- Groin flap
- Free flaps (ALT, LD, gracilis)
