Plastics Flashcards
(173 cards)
1
Q
stop aspirin 2 weeks prior to
A
anticoagulant causes hematoma
2
Q
stop smoking 2 weeks prior to
A
vasoconstrictor
ischemia
necrosis
stops wound healing
3
Q
chlorhexidine gluconate
A
not for eyes or ears toxic
4
Q
4 dyes for skin marking
A
methylene blue
indigo carmine
gentian violet
Bonny’s blue
5
Q
epi to local
A
prolong effect
hemostasis/vasoconstrictor
6
Q
goals of postop dressing
A
immobilize
even pressure
drainage
comfort
protect
7
Q
pressure dressing
A
eliminate dead space
prevent seroma/hematoma
prevent 3rd spacing
8
Q
stent/tie-over dressing
A
pressure dressing when bandage doesn’t fit
9
Q
2 closed-wound suction devices
A
hemovac
jackson pratt
10
Q
why use closed-wound suction drains
A
prevent seroma/hematoma
11
Q
2 local anesthetics
A
xylocaine/lidocaine/marcaine/bupivicaine
12
Q
2 topical anesthetics
A
tetracaine eyes
cocaine nose
13
Q
4 drugs for sedation with local
A
diazepam
fentanyl
meperidine (demerol)
midazolam
14
Q
allograft
A
tissue from same species
15
Q
autograft
A
tissue from self
16
Q
xenograft
A
tissue from different species
17
Q
isograft
A
tissue from genetically identical person
18
Q
homograft
A
tissue from same species
19
Q
heterograft
A
tissue from different species
20
Q
dermatome
A
STSG graft procurement
21
Q
4 knife dermatomes
A
ferris smith
watson
weck
Desilva
22
Q
drum dermatome
A
Reese
Padgett
23
Q
why use dermatape/dermacement
A
reese
adhere drum to skin
24
Q
motor driven dermatome
A
brown
25
what is a skin mesher
uniform slits in graft to make it larger
26
loupes
magnifying lenses to improve cosmetics
27
wood's lamp
UV to determine vascularity of skin graft
28
sodium florescin with woods lamp
makes blood vessels purple
IV
29
why use a colorless prepping agent for grafting procedures?
see true skin color
access vascularity of donor graft
30
why are donor sites prepped separately but concurrently for grafting?
CHECK
prevent cross contamination
31
how are free grafts preserved
cool saline
32
what is used to access the vascular perfusion of grafts
wood's lamp
33
what is a composite skin graft
epidermis
dermis
fat
other structures
34
how does a composite skin graft become vascularized?
ingrowth of vessels from recipient site
35
what is a STSG, Thiersch
from free knife
superficial defects
36
what is a FTSG, Wolfe
exact size/shape for face neck hands
joints
37
pros of STSG
cover large area
donor site reusable in 2-3 weeks
38
cons of STSG
contraction
fragile
poor look
39
pros of FTSG
minimal contracture
looks better
stronger
over areas of flexion
40
cons of FTSG
donor site can't be used again
41
how does the donor site of STSG heal
regenerate epithelium from dermal elements
42
how does the donor site of FTSG heal
primary closure with a STSG over
43
why use topical thrombin, epi, or phenylephrine on donor site of skin graft
hemostasis
44
what is a composite graft
skin separated from blood supply
fat
hair follicles
45
example of a composite graft
hair transplant
46
omental graft
from omentum in abdominal cavity
47
why use an omental graft
soft tissue defects in face, neck, scalp
control infection/inflammation
vascular support for burns
48
pedicle flaps
attachment of elevated tissue w/vascular bundle
49
when is a pedicle flap used
reconstruct deformities of soft tissue loss
50
arterialized tissue flap
FTSG
skin graft with vascular bundle and subQ
51
myocutaneous flap
muscle with fascia, subQ, sin
vascular pedicle and nerves accompany
52
applications of myocutaneous flaps
soft tissue defects in lower extremities
pressure sores
after head/neck surgery or mastectomy
53
tissue expander
streches tissue
filled during an office visit
54
free flap
tissue moved from one area of the body to another with its own blood supply
55
why is a free flap autogenous
comes from the patient
56
why is microsurgery required when working with free flaps
vascular work
57
what is rhinoplasty
reshaping the nose
58
why is rhinoplasty performed
improve appearance of external nose
59
what is septoplasty, SMR,
straighten nasal septurm
60
goal of septoplasty
separate nasal cavities for a clear airway
61
blepharoplasty
excision of redundant skin/orbital fat
correct deformity of upper/lower eyelids
62
rhytidectomy
facelift
removal/redraping excess skin in the face
63
why perform rhytidectomy
tighten sagging skin
64
anesthesia for rhytidectomy
hypotensive for hemostasis
65
incision for rhytidectomy
CHECK
above and in front of the ear and behind pinna
66
what is mentoplasty
altering size or shape of the chin
67
why perform mentoplasty
functional bite disorder
aesthetics
micrognathia-underdeveloped jaw
68
what is otoplasty
repairing external ear
69
why perform otoplasty
burns
traumatic avulsion
70
what is dermabrasion
mechanical or chemical peeling of the skin
71
why perform dermabrasion
smooth skin damaged by acne scars
remove tattoos/wrinkles
72
3 methods of dermabrasion
mechanical
chemical
CO2 laser
73
scar revision with Z-plasty
z-shaped incision in same direction as skin line
less noticeable
74
what is a keloid
growth of extra scar tissue
75
what is liposuction
vacuuming fat
76
where is liposuction performed
abdomen
back
face
hips thighs knees
breasts
77
what is tumescent solution
local anesthetic with Wydase, epi, and saline
no GA, hemostasis, liquefy fat
78
max tissue removed by liposuction
1500-2000ml
2500-3000ml with tumescence
79
what is abdominoplasty
tummy tuck
80
goal of abdominoplasty
thinning fat, tightening muscles, remove fat and excess skin
81
indications for abdominoplasty
discomfort
unable to wash
82
how is the umbilicus preserved in abdominoplasty
vascularized stalk
repositioned after dissection
83
augmentation mammoplasty
inserting implants under breast tissue or psoas muscle
84
indications for breast augmentation
aesthetics
85
3 incisions for breast augmentation
periareolar
inframammary
transaxillary
86
what are breast implants filled with
saline or silicone
87
complications with breast implants
capsular contraction
skin necrosis
hematoma
88
what is reduction mammoplasty
remove excess breast tissue
89
indications for breast reduction in females/males
macromastia with back pain, intertrigo (skin infection), grooving in shoulders from bra
gynecomastia-large male breast
90
indication for breast reconstruction
post mastectomy
91
3 ways breast reconstruction can be done
available tissue + implant
tissue expanders
autogenous flaps
92
how are tissue expanders used with breast reconstruction
create skin by stretching
93
what solution is placed in expander
saline
94
complication due to seroma with tissue expander
rotation or malposition of expander
95
why use myocutaneous flap for breast reconstruction
significant tissue deficiency
when abdominal flap can't be used
96
2 myocutaneous flaps for breast reconstruction
latissimus dorsi: lateral, donor side up
transverse rectus abdominis: supine
97
2 modifications for TRAM in breast reconstruction
pedicle-vascular bundle
free-from another part
98
2 ways a nipple can be reconstructed
autogenous tissue
tattooing
99
3 common causes of burns
thermal
chemical
electrical
100
4 classifications of burns according to depth
1st degree
2nd degree
3rd degree
4th degree
101
1st degree
outer epidermis
redness
heals rapidly
102
2nd degree
epidermis and dermis
blisters, redness
103
how does a 2nd degree burn heal
reepithelialization, thickened scars
104
3rd degree
skin, dermis, subQ
dry, pearly white, charred, no sensation
eschar
105
how does a 3rd degree burn heal
skin grafts
106
4th degree
bones, tendon, muscle, nerves
107
what is eschar
dry dark scab of dead skin
108
2 methods of burn %
lund-browler: kids
rule of 9s: adults
109
IV fluid for burn patients
fluid and electrolyte balance to maintain plasma
110
warm environment for burn patients
skin loses ability to thermoregulate
keep core temp stable
111
why is cleaning of burns important
reduces growth media of pathogens/prevent infection
112
excisional debridement
tangenital excision
escharectomy
113
tangenital excision
remove burned tissue until dermal tissue is reached
for deep partial thickness
114
escharectomy
remove full thickness eschar to fascia
115
why are tangenital excision and escharectomy performed
remove devitalized tissue so healing may occur with reduced chance of infection
prevents extensive tissue loss
116
escharotomy
incision into eschar to improve circulation to lower extremities
117
fasciotomy
incision into fascia to relieve compression
118
biologic dressing use
skin over burned area to prevent infection and regulate fluids
119
biologic dressing vs. autografting
extensive burns where there isn't enough tissue for autograft
prevent infection and fluid loss
120
cultured epithelial autografts
biologically engineered tissue through injection of isolated cells, polymer scaffolds, encapsulated systems, polymer matrices with cells
121
why change dressings frequently for burn patients
control infection
122
silver on burn dressings
silver sulfadiazine: less painful removal, antimicrobial
mafenide acetate: reduce bacteria
silver nitrate
123
principles of maxillofacial surgery
restore anatomy
stabilize fracture
anatomic reduction
healing for function
124
3 classifications of LeFort fractures
transverse maxillary: nasal floor, septum, teeth
pyramidial: nasal cavity, hard palate, eye
craniofacial: zygomas, nose
125
symptoms of maxillary fracture
malocclusion
middle face deformity
126
inermaxillary fixation (arch bars) in maxillary fractures
immobilization for healing
127
purpose of treatment for mandibular fractures
restore dental occlusion
128
immobilization of the mandible
arch bars, plates, screws
129
blow-out fracture
depressed orbital floor fracture
intact infraorbital rim
130
symptoms of blow-out fracture
orbital contents herniate
inferior rectus/oblique become incarcerated
131
treat blow-out fracture
caldwell luc anterostomy
132
orthognathic surgery
rearrangement of the maxilla/mandible
133
why is elective orthognathic surgery performed
fix defects of maxilla/mandible
134
LeFort procedure differences
LeFort 1&2: closed reduction with intermaxillary fixation
LeFort 2&3: open reduction and intermaxillary fixation
135
cleft lip
deficiency in tissue on one or both sides of the upper lip
136
chelioplasty
reconstruct lip by moving tissue to approximate lip
137
why perform chelioplasty
feeding
infant/parent bonding
138
rule of 10s in cleft lip
10 weeks old
10lbs
hemoglobin 10g/dl
139
logan's bow postop chelioplasty
relieve tension
140
cleft palate
separation of the palate in midline
141
functions of the palate
soft: speech
hard: prevent escape of air through nose during speech, liquid food out through nose
142
palatoplasty
adjacent tissue to close defect
143
when is palatoplasty performed
6 months
144
why use a pharyngeal flap in palatoplasty
when abnormal speech remains
145
mouth gag in palatoplasty
Dingman
146
if both cleft lip and palate what is repaired first
palatoplasty to preserve speech
147
syndactyly
webbing of hands or feet
148
how to treat syndactyly
separate and skin graft (full thickness)
after 1yr. old
149
polydactyly
extra fingers or toes
150
how to treat polydactyly
excision
151
microtia
underdeveloped pinna/absent ears
152
how to treat microtia
otoplasty
153
bony anatomy of the hand
14 phalanges (bones of the digits), 5 digits, 5 metacarpals (hand), 8 carpals (wrist)
154
how are the phalanges numbered
distal, middle, proximal
CHECK
155
8 carpals
scaphoid, lunate, triquetrum, pisiform
trapezium, trapezoid, capitate, hamate
156
dorsal/volar hand
dorsal: back
volar: palm
157
why is a tourniquet used in hand surgery
bloodless field
158
where is a tourniquet placed
as proximal as possible with cotton underneath
159
exsanguinate arm prior to tourniquet
3 in. esmarch wrapped distal to proximal
160
avulsion
body part forcibly detached
loss of joint movement
161
laceration
a jagged cut
loss of joint movement
162
repair avulsion/laceration tendon injury
primary flexor or extensor repair
suture tendon ends together
163
suture for tendon repair
3-0, 4-0 double-armed nonabsorbable
164
when is a free tendon graft used
large gap
failed primary repair
165
repair severed nerve
direct approximation of ends or graft
166
suture for nerve repair
nylon nonabsorbable 7-0, 10-0
167
implant arthroplasty
excise diseased joint cartilage
insert implant spacer
168
why perform implant arthroplasty
traumatic/rheumatoid arthritis
169
Dupuytren's contracture
progressive disease of palmar fascia
cord pulls finger down
170
treat Dupuytren's contracture
palmar fasciotomy/ectomy
171
carpal tunnel
volar/palm side with median nerve, tendons through
transverse carpal ligament and 3 bones
172
carpal tunnel syndrome
compression of median nerve
swelling, numbness, pain,
173
treat carpal tunnel
release transverse carpal ligament
