27 - Plastics and Reconstructive Surgery

Split-thickness grafts

This type of skin graft is the simplest method of superficial reconstruction

Meshed

Split-thickness skin grafts can be ___ to allow egress of wound fluid and contour matching of the wound bed by the graft

Full-thickness grafts

___ skin grafts include the epidermis and a complete layer of dermis

Full-thickness

___-thickness grafts have the best cosmetic appearance and the highest durability

Imbibition

Inosculation

Revascularization

What are the three phases of skin graft take?

Imbibition

Which phase of skin graft take occurs within the first 24-48 hours?

Inosculation

Which phase of skin graft take occurs after 48 hours and involves the formation of a fine vascular network within the fibrin layer

Split-thickness

____-thickness grafts have less primary contraction but more secondary contraction

Flaps

In plastic surgery, these refer to a vascularized block of tissue mobilized from its donor site and transferred to another location for reconstructive purposes

Graft

Graft vs flap: derives its blood flow from recipient site revascularization

Muscle with overlying skin and intervening tissue

What are the components of a myocutaneous flap?

Free flaps

This type of flap is completely detached from the source and is transferred via microsurgery

Axial pattern

Flaps supplied by an anatomically defined configuration of vessels are described as having ____ pattern blood supply

Angiosome

The ____ refers to a block of tissue reliably supplied by a given artery

Clinical observation

Warning signs for poor flap perfusion include dusky color, brisk blue dermal bleeding after pinprick test, swelling or turgor

What is the gold standard method of monitoring flap vascularity?

Blue dermal bleeding

Performed by making a pinprick on the flap surface. Oozing dark blue blood from the pinprick site suggests venous congestion

What is considered the best clinical warning sign for inadequate perfusion of a flap?

Orofacial clefting

What is the most common birth defect in the world?

Family history

What is the strongest known predictive factor for cleft lip or palate?

3 and 6 months

What is the age by which most lip repairs for cleft lip and palate are done?

Orbital floor

What is the most common fracture of the orbit?

Latissimus dorsi musculocutaneous flap

What is the most common flap transfer used in conjunction with breast implants?

Internal mammary vessels

What is the most common recipient vessel for free tissue transfer in breast reconstruction?

Placement of an inflatable silicon elastomer balloon

Most commonly used for breast reconstruction post-mastectomy

Tissue expansion is a surgical technique that enables the body to grow additional skin, subcutaneous tissue, and sometimes muscle by mechanically stretching tissue over time. What is the most common method of skin expansion?