Flashcards in Plastic Surgery Deck (44):
What is blepharoplasty?
Eyelid surgery, removing excess skin or fat
What is a face lift?
Removal of excess facial skin via hairline/chin/ear incisions
What are Langer's lines?
Natural skin lines of minimal tension.
Incisions perpendicular to Langer's lines result in larger scars than incision parallel to the lines.
What is mammoplasty?
Breast surgery, reduction or augmentation
What is polydactyly?
What is rhinoplasty?
Nose surgery, after trauma or cosmetic
What is syndactyly?
What are the phases of wound healing?
"In Every Fresh Cut"
What is the inflammation phase of wound healing?
Vasoconstriction followed by vasodilation, capillary leak
What is the epithelialization phase of wound healing?
Epithelial coverage of wound
What is the fibroplasia phase of wound healing?
Fibroblasts and accumulation of collagen, elastin, and reticulin
What is the wound contraction phase of wound healing?
Myofibroblasts contract wound
What is the maximal contraction of a wound in mm/day?
What degree of bacterial contamination prevents epithelialization?
> 100,000 organisms/g tissue
In which structures does the epithelium grow from superficial burns and wounds?
Epithelial lining of sweat glands and hair follicles
In which structures does the epithelium grow in full-thickness burns?
From wound margins, grows in < 1 cm from wound edge because no sweat glands or hair follicles remain.
This epithelium has no underlying dermis.
What malignant ulcer is associated with a long-standing scar or burn?
Which contracts more: an STSG or an FTSG?
STSG contracts up to 41% in surface area, whereas an FTSG contracts little, if at all
What is granulation tissue?
Within 4-6 days after an open wound, development of capillary beds and fibroblasts provides a healthy base for epithelial growth from wound edges.
This tissue also resists bacterial infection.
What local factors impair wound healing?
Hematoma, seroma, infection, tight sutures, tight wrap, movement or disturbance of the wound
What generalized conditions impair wound healing?
Anemia, malnutrition, steroids, cancer, radiation, hypoxia, sepsis
What helps wound healing in patients taking steroids?
When does a wound gain more than 90% of its maximal tensile strength?
After 6 weeks
What is a laceration?
A jagged wound
What is an abrasion?
Superficial skin removal
What is a contusion?
Bruise without a break in the skin
What is a hypertrophic scar?
Hypertrophic scar within original wound margins
What is a keloid?
Proliferative scar tumor progressively enlarging scar beyond original wound margins
Why not clean lacerations with Betadine?
Harmful to and inhibits normal healthy tissue
What is the best way to clean out a laceration?
Normal saline irrigation
What is an STSG?
Split Thickness Skin Graft:
Includes the epidermis and a variable amount of the dermis.
What is a FTSG?
Full Thickness Skin Graft:
Includes the entire epidermis and dermis.
What are the prerequisites for a skin graft to take?
1. Bed must be vascularized (a graft to a bone or tendon will not take).
2. Bacteria must be < 100,000.
3. Shearing motion and fluid beneath the graft must be minimized.
What is a better bed for a skin graft: fascia or fat?
Fascia (better blood supply)
How do you increase surface area of a STSG?
Mesh it (also allows for blood/serum to be removed from underneath the graft)
How does an STSG get nutrition for the first 24 hours?
Where does a random skin flap get its blood supply?
From the dermal-subdermal plexus
Where does an axial skin flap get its blood supply?
It is vascularized by direct cutaneous arteries
What is the arterial supply to the forehead flap?
Superficial temporal artery.
Often used for intra-oral lesions.
What is the arterial supply to the deltopectoral flap?
Second, third, and fourth anterior perforators of the internal mammary artery.
Often used for head and neck wounds.
What is the arterial supply to the groin flap?
Superficial circumflex iliac artery.
Allows coverage of hand and forearm wounds.
What is the most common cause of flap loss?
What is a free flap?
Flap separated from all vascular supply that requires microvascular anastomosis