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Surgical Recall > SR 68 - Plastic Surgery > Flashcards

SR 68 - Plastic Surgery Flashcards

1
Q

Blepharoplasty

A

Eyelid surgery

Removing excess skin/fat

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2
Q

Face lift

A

Removal of excess facial skin

Hairline/chin/ear incisions

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3
Q

FTSG

A

Full Thickness Skin Graft

Includes entire epidermis and dermis

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4
Q

Langer’s lines

A

Natrual skin lines of minimal tensions

Incisions perpendicular to them result in larger scars than those parallel to the lines

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5
Q

Mammoplasty

A

Breast surgery (reduction or augmentation)

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6
Q

STSG

A

Split thickness skin graft
Includes the epidermis and a variable amount of hte dermis
10/1000 to 18/1000 of an inch thick

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7
Q

What are the phases of wound healing?

A

Inflammation
Epithelialization
Fibroplasia
Contraction

‘In Every Fresh Cut’

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8
Q

What are the actions of the following phases of wound healing? Inflammation

A

Vasoconstriction followed by vasodilation, capillary leak

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9
Q

What are the actions of the following phases of wound healing? Epithelialization

A

Epithelial coverage of wound

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10
Q

What are the actions of the following phases of wound healing? Fibroplasia

A

Fibroblasts and accumulation of collagen, elastin, and reticulin

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11
Q

What are the actions of the following phases of wound healing? Wound contraction

A

Myofibroblasts contract wound

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12
Q

What is the maximal contraction of the wound in mm/day?

A

0.75mm/day

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13
Q

What degree of bacterial contamination prevents epithelialization?

A

> 100,000 organisms/gm tissue

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14
Q

In what structures does the epithelium grow from superficial burns/wounds?

A

Epithelial lining of sweat glands and hair follicles

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15
Q

In what structures does the epithelium grow from full-thickness burns/wounds?

A

From wound margins

Grows in

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16
Q

What malignant ulcer is associated with a long-standing scar/burn?

A

Marjolin’s ulcer

aka Burn scar carcinoma

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17
Q

What are myofibroblasts?

A

Specialized fibroblasts that behave like smooth muscle

Pull the wound edges together following granulation

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18
Q

Which contracts more - an STSG or an FTSG?

A

STSG contracts up to 41% of the surface area

FTSG contracts little, if at all

19
Q

What is granulation tissue?

A

Days 4-6 after open wound
Development of capillary beds and fibroblast provides a healthy base for epithelial growth from wound edges
This tissue is resitant to bacterial infections

20
Q

Local factors that impair wound healing?

A 
Hematoma
Seroma
Infection
Tight sutures
Tight wrap
Movement/disturbance of the wound
21
Q

What systemic conditions inhibit wound healing?

A 
Anemia
Malnutrition
Steroids
Cancer
Radiation
Hypoxia
Sepsis
22
Q

What helps wound healing in patients taking steroids?

A

Vitamin A

Counteracts the effect of steroids on wound healing

23
Q

When does a wound gain more than 90% of its maximal tensile strength?

A

~6 weeks

24
Q

Laceration

A

Jagged wound

25
Q

Contusion

A

Bruise without a break in the skin

26
Q

Hypertrophic scar

A

Overgrowth of collagen stays within the original wound margins

27
Q

Keloid

A

Overgrowth of collagen that progerssively enlarges beyond the original wound margins

28
Q

Why do you not clean lacerations with Betadine?

A

It is hearmful to and inhibits normal healthy tissue

29
Q

What is the best way to clean out a laceration?

A

Normal saline irrigation

30
Q

What are the prerequisites for a skin graft to take?

A

Bed must be vascularized - not bone or tendon

Bacteria

31
Q

What is better bed for a skin graft - fascia or fat?

A

Fascia (better blood supply)

32
Q

How do you increase the surface area for a STSG?

A

Mesh it (allows for blood/serum to be removed from beneath the graft)

33
Q

What does a STSG get nutrition for the first 24 hours?

A

Imbibition

34
Q

Where does a random skin flap get its blood supply?

A

From the dermal-subdermal plexus

Random flaps are simpler and have no named blood supply. Rather, they are supplied by generic vascular networks.

35
Q

Where does an axial skin flap get its blood supply?

A

It is vascularied by direct cutaneous arteries
Axial flaps are supplied by a named artery and vein. This allows for a larger area to be freed from surrounding and underlying tissue, leaving only a small pedicle containing the vessels.

36
Q

Name some axial flaps and their arterial supplies?

A

Forehead flap - superficial temporal artery (used for intraoral lesions)
Deltopectoral flap - anterior perforators of the internal mammary artery (head and neck wounds)
Groin flap - superficial circumflex iliac artery (hand and forearm wounds)

37
Q

What is the most common cause of flap loss?

A

Venous thrombosis

38
Q

What is a simple advancement flap?

A

Incisions are extended out parallel from the wound, creating a rectangle with one edge remaining intact.
This rectangle is freed from the deeper tissues and then stretched (or advanced) forward to cover the wound.

39
Q

What is a rotational flap?

A

A rotation flap is similar except instead of being stretched in a straight line, the flap is stretched in an arc. The more complex transposition flap involves rotating an adjacent piece of tissue, resulting in the creation of a new defect which must then be closed.

40
Q

What is a ‘free flap’?

A

Flap separated from all avascular supply that requires microvascular anastomosis

41
Q

What is a TRAM flap?

A

Transverse Rectus Abdominis Mycutaneous flap

42
Q

What is a ‘Z-plasty’?

A

Functional (elongate and relax scars) or cosmetic (realign scars to make them less noticeable).
The transposition of two triangular flaps.

43
Q

What is a V-Y advancement flap?

A

A surgical method for lengthening tissues in one direction by cutting in the lines of a V, sliding the two segments apart, and closing in the lines of a Y.

Surgical Recall (32 decks)

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