Surgery

Question 1

Indications for open thoracotomy in hemothorax?

Answer 1

Greater than 1500 cc of chest-tube output or continued bleeding and chest-tube output greater than 250 cc per hour

Question 2

Penetrating neck injury approximation

Answer 2

1. Above the angle of the mandible (zone III)
2. Between the angle of the mandible and the cricoid cartilage (zone II)
3. Below the cricoid cartilage (zone I)

Zone I and III: Endoscopy and angiography as surgical exploration of these zones surgically is challenging.

Zone II: managed with surgical exploration.

No-zone approach: based on patient stability and the presence of soft versus hard signs of injury regardless of the location. Soft signs for ex, CT angiography.

Question 3

Split-thickness skin graft

Answer 3

A thin layer of skin is removed from a donor site and transplanted to cover a wound or damaged area.
Include only part of the dermis.

Question 4

Free tissue transfer flap

Answer 4

Also called a free fla, is a microsurgical procedure where a section of tissue (including skin, muscle, fat, or bone) is completely detached from its original blood supply and transferred to another part of the body. The surgeon then reconnects the blood vessels using microsurgery to ensure the tissue survives in its new location.

Question 5

Laparoscopic sleeve gastrectomy is contraindicated in patients with?

Answer 5

GERD and Barret esophagus

Question 6

In necrotizing fascitis what is the most aproppiate step in establishing definitive diagnosis?

Answer 6

Open surgery, to establish the presence and extent of necroting fascitis.