Surgery- Plastics Flashcards
What type of cells are recruited during the inflammation-sterilization phase of wound healing?
PMNs, Macrophages, Lymphocytes, Fibroblasts
What is the main chemotactic factor for fibroblasts during the proliferation phase?
PDGF
What is the maximum wound strength that can be achieved by a healed wound?
70-80% of original tissue’s tensile strength
This refers to dense collagen matrixes that lack dermal appendages.
Scar
What cells are responsible for wound contracture that persists for 4-6 weeks?
Myofibroblasts
Cytokines: Triggers mitosis of fibroblasts and keratinocytes and induces collagen production. A. IFN-y B. IGF-1 C. PDGF D. TNF-a
B. IGF-1
Cytokines: Also triggers mitosis of fibroblasts and keratinocytes in addition to matrix production. A. IFN-y B. IGF-1 C. TGF-b D. VEGF
C. TGF-b
The minimum tissue oxygen tension requirement for oxygenases to function properly.
~20 mmHg
What is the minimum bacterial load per gram of tissue that prevents wound healing?
10 to the fifth power/g tissue
This chronic disease impairs wound healing due to hypoxia, neuropathy, glycosylated protein malfunction and impaired immune cell localization.
Diabetes mellitus
What systemic factor that inhibits wound healing is due to a relative upregulation of matrix metalloproteinase 2 and 9 thereby decreases collagen synthesis?
Aging
The type of collagen that is the primary form in early phases of wound healing and persists in children, making scars less obvious.
Type III collagen
The type of collagen found in the lens of the eye.
Type IV collagen
The type of collagen that is found in healed wounds.
Type I collagen
The type of wound closure that occurs when tissues are not initially closed or are too extensive to close and instead are closed via tissue proliferation at skin edges.
Secondary closure
The type of closure that occurs when a wound is purposely left open or has remained open for >6-8 hours and is reapproximated at a later time.
Tertiary closure
What is the basic gold standard suturing technique?
Simple interrupted
What type of suturing technique has improved tissue eversion and better hemostatic properties especially when used on thick skins?
Horizontal mattress
What type of suturing technique involves the superficial closure of the dermo-epidermal junction thus, minimizing external scars?
Subcuticular running
Suture removal times: How many days? Face Neck/scalp Trunk Extremities
Face: 3-5 days
Neck/scalp: 5-7 days
Trunk: 10-14 days
Extremities: 10-14 days
Inflammation occurs from the time of tissue injury until how many days?
3-4 days
What is the recurrence rate for keloids with surgical therapy alone?
45-100%
What is the most frequent complication resulting in free flap failure?
Venous congestion leading to flap ischemia
This type of pedicled flap is an alternative to TRAM reconstruction in patients who have anatomic contraindications.
Latissimus dorsi flap
Reconstructive flaps: Cutaneous flap used in areas where wounds cannot be closed primarily or where a skin graft would fail. Its blood supply is derived from the dermal-subdermal plexus or direct cutaneous unnamed vessels.
Local flap
Reconstructive flap: Fasciocutaneous or myocutaneous flap used in wounds in which the defect is too large for a local advancement or requires additional tissue bulk. Its blood supply is based on named vessels or known cutaneous angiosomes.
Pedicled flap
Reconstructive flap: Refers to tissue transfer to a distant location. The tissue requires microvascular anastomoses or arterial and venous systems.
Free flap
What is the relative contraindication for performing implant reconstruction in post-mastectomy patients?
Adjuvant radiation therapy
This process allows the skin graft to align its vessels and anastomose with the recipient bed to provide a blood supply until angiogenesis begins.
Inosculation
