Microdermabrasion and Dermabrasion not in 3rd Ed Flashcards Preview

Surgical MCQs > Microdermabrasion and Dermabrasion not in 3rd Ed > Flashcards

Flashcards in Microdermabrasion and Dermabrasion not in 3rd Ed Deck (81):
1

The most common indication for dermabrasion is facial acne scars

T

2

Regarding dermabrasion, wounds need to be limited to a deep-reticular dermal depth, as wounding deeper than this results in surface changes that are perceived as a scar.

F mid-reticular depth

3

Traditional dermbrasion utilises a wire brush or diamond fraise on a rotary hand engine to mechanically remove tissue.

T

4

Scarring, dyspigmentation and infection are potential complications of any deep abrasion procedure.

T

5

Acne scars that disappear by stretching the skin are an indication for recontouring with dermabrasion.

F Scars that don’t disappear with stretching.

6

Dermabrasion should not be combined with CO2 laser.

F Can be combined to ‘tighten’.

7

Surgical procedures for scars should be performed 6-8 weeks or more before dermabrasive or laser resurfacing.

T

8

CO2 laser and Nd:YAG laser will tighten and smooth superficial acne scars and rhytides.

F - Er:YAG (not Nd:YAG).

9

Dermabrasion is a helpful resurfacing adjunct for sculpting the elevated ridges of wrinkles that persist despite 2-3 passes with an ablative laser.

T

10

Dermabrasion removes the thermal coagulum left after heat-induced injury of CO2 lasers, thereby promoting healing and reducing postoperative erythema.

T

11

Rhinophyma tends not to respond to dermabrasion.

F Responds well.

12

There is a significant risk of scarring associated with dermabrasion of rhinophyma.

F Minimal risk due to sebaceous nature of rhinophymatous tissue.

13

Epidermal naevi, seborrhoeic keratoses, syringomas, angiofibromas and trichoepitheliomas can be dermabraded with good results.

T

14

Decorative tattoos can be abraded followed by the application of 1% gentian violet directly to the abraded surface and dressed with Adaptic gauze.

T Gentian violet promotes removal of tattoo pigment by stimulating phagocytes to carry away abraded pigment.

15

Traumatic and surgical scars cannot be treated with dermabrasion.

F Can perform as early as 6-8 weeks following injury of surgery.

16

Cosmetic patients undergoing dermabrasive surgery should expect 50-70% improvement in the appearance of deep acne scars and adynamic rhytides.

F 30-50%.

17

Distensible acne scars and dynamic rhytides that disappear by stretching are best treated with tissue tightening procedures such as ablative and non-ablative laser resurfacing treatments.

T

18

Sharp shoulders of scars of chicken pox or acne and deep non-distensible rhytides should be treated with surgery only.

F Can treat with mechanical dermabrasion or laser sculpting.

19

For full-thickness defects, surgical excision punch grafting and/or dermal grafts should be performed at least 6-8 weeks before resurfacing.

T

20

Patients with a history of impetigo should have a nasal swab to assess for S.aureus colonisation prior to dermabrasion.

T These patients will need prophylactic Abs.

21

Only patients with a history of HSV require prophylactic antiviral medication for dermabrasion.

F All patient should take until fully re-epithelialised. 14 days is recommendation.

22

Most herpetic infections occur 1-2 days after resurfacing surgery.

F 7-9 days after.

23

Delayed re-epithelialisation and hypertrophic scarring have been reported in patients undergoing dermbrasion during or shortly after isotretinoin therapy.

T

24

Dermabrasion should be postponed 1-2 months after a course of isotretinoin.

F 6-12 months.

25

Topical tretinoin cream applied daily for 2-3 weeks before dermabrasion has been shown to reduce the time required for re-epithelialisation.

T

26

A test spot dermbrasion is recommended in patients with a history of keloids or koebnerising conditions.

T

27

There is no need to observe universal precautions in performing dermabrasiion.

F Aerosolised viral particles can be produced.

28

The areas to be abraded should be outlined preoperatively with gentian violet while the patient is lying supine.

F Patient sitting.

29

Dermabrasion should be performed along the angle of the mandible and along the inferior jawline.

F Should perform to 1-2 fingerbreadths below to hide transition zone.

30

Partial abrasions (eg. around mouth, nose) should follow lines of facial cosmetic subunits.

T

31

Tumescent anaesthesia should be used to anaesthetize the entire face for dermabrasion.

T

32

Some microdermabrasion devices employ aluminium oxide crystals, which are sharp-edged and hard, as an abrasive.

T

33

Microdermabrasion is essentially painless, quick, easy to perform and has few associated risks.

T

34

The clinical benefits of microdermabrasion can be profound.

F Clinical benefits are modest.

35

Following treatment with microdermabrasion, mild erythema is present, but resolves quickly.

T

36

Eye protection is not needed for microdermabrasion.

F Corneal abrasions can occur from crystals.

37

The fraises used for dermabrasion are available in a variety of sizes, shapes and grades of coarseness.

T

38

Cone-shaped fraises should be used on broader surfaces on the forehead and cheeks.

F Confined areas around nose, mouth, eyelids.

39

Wheel-shaped fraises or the wire brush should be used on confined areas around the nose, mouth and eyelids.

F On broader surfaces.

40

The extra coarse fraise is more forgiving than the wire brush.

T

41

The bristles of the wire brush are angled such that clockwise rotation cuts more deeply in the skin, whereas counterclockwise rotation brushes the bristles over the surface more gently.

T

42

For dermabrasion, the abrading endpiece is passed over the skin in arciform strokes parallel to the direction of endpiece rotation.

F Perpendicular.

43

To abrade, the hand engine in pushed over the skin surface.

F Pulled.

44

For dermabrasion, the direction of rotation is only important when a wire brush is used.

T

45

For deep surfacing of acne scarring on the mid cheek, traumatic or surgical scars, or debulking large nodules of rhinophyma, clockwise rotation is more efficient.

T

46

For full-face procedures, it is best to start abrading along the jawline or preauricular area and progress toward the centre of the face and nose.

T This allows for bleeding from the abraded areas to flow away from the skin being abraded.

47

Two-point retraction of skin should be used to stabilise the area being abraded.

F Three-point retraction.

48

When using spray refrigerant during dermabrasion, the scar or rhytide should be frozen in its stretched position.

F Unstretched position.

49

The depth of abrasion can be monitored by closely observing the abraded surface.

T Papillary dermis appears as glistening white surface. Points of bleeding with depth.

50

Yellow globules of sebaceous glands are seen with deep dermabrasion of acne scars in the mid-cheek or rhinophyma of the nose.

T

51

The dermal fibrosis of acne scars tends to be resistant to abrasion.

F It will crumble and become friable.

52

The peripheral margin of the abraded regions should be feathered to create a natural-looking transition zone.

T

53

Acriform strokes should be perpendicular to the border of the abraded areas

F Parallel.

54

Upon completion of a full-face dermabrasion procedure, most of the abraded areas will still be bleeding.

F Most will have stopped.

55

Post-operative oedema can be reduced with im kenacort A40 given immediately post-dermabrasion.

T

56

The abraded surface should be dressed with a semipermeable dressing held in place with paper tape and backs with non-adherent pads and gauze.

T

57

The patient should return to clinic for the full-face dressing to be changed every 7 days.

F Every 3-5 days.

58

The development of pain with or without erosions generally indicates a postoperative herpetic infection.

T

59

Superinfection by bacteria or fungi is not uncommon following dermabrasion.

F Much less common than HSV.

60

The presence of bright erythema after the first 2-3 post-operative weeks is the first sign of early scar formation and should be treated with topical high-potency steroid ointment od-bd.

T

61

Pulse dye laser should not be used following dermabrasion.

F Can decrease erythema and scar induration.

62

Intralesional steroid injections can be given if any induration, elevation or hypertrophy develops after dermabrasion.

T

63

After successful aggressive scar management following dermabrasion, the skin should be clear.

F Usually have small focal areas of hypopigmentation.

64

Following 3-5 days of wearing a full-face mask after dermabrasion, an open wound care technique can be employed with topical petrolatum ointment.

T

65

Petrolatum ointment should be applied sparingly after dermabrasion.

F Apply 3-4 times daily.

66

The open wound produced by dermabrasion heals by the mechanism of second intention wound healing.

T

67

Regions rich in sebaceous glands (eg. nose and mid-cheek) re-epithelialise more slowly than skin over the bony prominences of the forehead, malar cheek and mandible after dermabrasion.

F More quickly.

68

In dermabrasive wound healing, the collagen fibres align perpendicular to lines of tension before intermolecular cross-linkages are complete.

F Parallel.

69

Following dermabrasion, increased tenascin expression may promote cellular migration, while integrin mitigates the epithelial mesenchymal interaction of wound healing.

F Increased integrin expression may promote cellular migration, tenascin mitigates epithelial mesenchymal interaction of wound healing.

70

As wound healing progresses following dermabrasion, intradermal oedema continues to dissipate for up to 3 months.

T

71

Continuing improvement of the skin surface irregularities and depressions occur for up to 24 months following dermabrasion.

F 6-12 months.

72

Re-epithelialisation is usually complete within 7-10 days following dermabrasion.

T

73

The skin heals faster with open techniques of wound care compared to using a semi-permeable dressing.

F Faster with semi-permeable dressing.

74

Normal skin tone tends to return within 2-3 months following dermabrasion.

T Need to avoid sun exposure during this time.

75

Most patients will develop some degree of transient post-inflammatory hyperpigmentation over the malar prominences and jawline following dermabrasion.

T

76

Bleaching regimens can be used from the 3rd-4th week after dermabrasion and continued for 4-8 weeks or until hyperpigmentation resolves.

T

77

Permanent pigment alteration occurs in less than 5% of patient following dermabrasion.

F 20-30%.

78

Skin types V-VI are more likely to develop post-inflammatory hyperpigmentation following dermabrasion.

F Skin types III and IV.

79

Pseudohypopigmentation refers to the phenomenon of when normally repigmented abraded skin appears to have a different tone and appearance than adjacent non-abraded skin.

T Can correct non-abraded areas with chemical peels, IPL or non-abalative laser.

80

Increased milia formation is an expected postoperative sequelae of dermabrasion.

T Treat with gentle extraction after 1 week.

81

Acne flares following dermabrasion are due to the occlusive nature of postoperative wound care.

T Treat with routine acne regimens.