Written Exam - Reconstructive Surgery Flashcards
when positioning an animal for reconstructive surgery/grafts, what should be considered?
access to any skin proposed to be used, clip & prep wide, & position patient to relieve tension
what are 3 types of local flaps?
- single pedicle advancement
- transposition flap
- rotation flap
what is a local flap?
flap is formed in nearby loose, elastic skin
base of the flap maintains circulation to the skin
what is local flap blood supply reliant on?
subdermal plexus
when doing a local flap, what should be avoided?
donor locations where excessive motion & stress is present
what are the general guidelines for local flaps?
create flaps with a base slightly wider than the body to avoid narrowing the pedicle & decreasing blood transfusion
limit the flap to the size required to cover the recipient area without excessive tension
consider 2 smaller flaps for a large wound
what is an advancement flap?
skin moves forward, toward the wound
relies mainly on the stretch of skin
what are transposition flaps?
flap used in small/medium wounds - usually rotated within 90 degrees of the wound with the length being no more than twice the width
when are distant local tissue grafts used?
when there is sufficient local tissue present, elasticity of dog skin, & truncal/neck wounds
what kind of flap is seen here?
distant direct flap
what do you do about the delay phenomenon?
raise flap, vasculature reorganizes/grows, move skin
what are axial pattern flaps reliant on?
pre-defined direct cutaneous artery & vein - has a blood supply that must move with them
what is a distant flap?
constructed at a site distant to the wound - almost used exclusively for wounds on middle/lower extremities & may require less exacting surgical skill & post-op care than a free graft
what are 2 examples of a direct distant flap?
hinge - 1 pedicle
puch - 2 pedicles
what is a tube flap?
distant indirect flap - prevents infection, healing to the donor site, helps eventual transfer with a 2-3 week delay
flaps shrink during delay time - increase size of the flap to about 25% bigger than the recipient site
what is required when using an axial pattern flap?
careful measurements & planning - must identify anatomical landmarks
why are no sutures placed in the middle of an axial flap?
could accidentally ligate the vessel
what is required when doing a free graft?
excellent bandaging & immobilization
what are some examples of free graft variations?
punch, pinch, strip, stamp, split thickness
how is a free graft variation prepared?
prepare the same as full thickness mesh - create donor, angle with angle of the fur
how is a pinch graft done?
angled pocket with a stab incision (better for thin granulation beds) (punch is better for thick granulation beds, use derm biopsy)
apply pressure until hemorrhage is controlled, no suturing, & bandage
when may you perform a foot pad reconstruction?
pad laceration, trauma, mass removals
when are digital flaps used?
closure of distal extremity defects - careful dissection & removal of phalanges provides healthy skin to close defects
what is another name for a digital flap?
phalangeal filet
why is paw pad loss so bad? what can you do?
MC/Mt pads very serious - normal skin can’t withstand daily physical abuse
digital pad transfer, accessory carpal pad transfer, pad grafting
what do you do for a lacerated paw pad?
lavage, debride, closure (SQ & skin) - pads don’t heal as well as other tissues
what happens if you have complete loss of all of the MC/MT paw pad?
may require limb amputation
what are some examples of axial pattern flaps?
caudal auricular, cranial epigastric, lateral tail
