plastics pt1

largest organ of body

skin

what does the skin aid in

defense against bacteria/ trauma

protect tissues and organs

epidermis

keratin and melanin development

dermis

hairfollicles, nerves, blood supply

how thick is the skin

1-2 mm

thickest

palms/ soles of feet

thinnest

eyelid

4 layers of stata

corneum

lucidium

grandulosum

spinosum

basalle

sebaceous gland

sebum/ oil

keeps skin and hair soft

sebum most concentrated in where

scalp and face (acne)

memocrine

directly to surface

aprocrine

opens via hairfollicle

sweat glans concentrated mostly where

pals and soles of feet

nevus

pigmented area of skin

birthmark

port wine stains

hemanginomas “ strawberry”

mole, skin tags,

atypical moles

irregular fried agg center/ flat edges

uneven edges/ bumpy

size of mole

1/4

sun exposere cause what % of all skin cancers

90%

A- symetry

mole diff than other half

B- order

uneven edges

C-olor

any variations in color

D- iameter

larger than pencil eraser

E- volving

is mole changing

basal call carcinoma

most common, sun exposed areas

squamous cell carcinoma

dangerous, metastizise and lead to death

melanoma

most serious, metastizize, likely to spread

ABSI

abbreviated skin severity index

sevarity

age/gender

inhalation injury

% burned

burn degree

Lund Browder meathod

hart of variables depending on age

rule of 9s

most common, incraments of 9%

1 degree

erythmeia of skin

2 degree

epidermis/dermis blistering

3 degree

eschar, penetrates underlying structures

high risk of infection

what is needed for 3rd degree

debridment/ grapht

4th

char burns, damages to all structures

autographt

from pt self

allographt/ homographt

same speices ( cadaver)

xeno/ heterographt

diff species ( cow/pig)

isographt/ syngrapht

identical twin

skin grapht

cannot survive without blood supply

nectrotic tissue/ infection free

may require clean/dirty set up

STSG Layers

epidermis portion of dermis used

FTSG layers

epidermis and entire dermis

FSTG closure

donor site- sutured closed

friction prone and joint areas

PIE CRUSTED

pie crusted

allow blood and fluid to drain

STSG

dermatome/mesher used

donor site will reepethelize

MESHER

dermatome connects to

nitrogen tank

never keep SG what?

dry- keep moist

close grapght with what suture

4-0 chromic gut

recepient site

wound vac. pressure dressing

pressure dressing

3-0 pop off

zerofoam/ cottonball

pedicle grapgt

donor skin remains attatched to recepient site

never cut loose until new blood supply reesablished

supertrochlear artery

blood supply to forehead

rotational flap

rotating adjacent skin to cover defect/ own blood supply

Bilobed Flap

1st slap cover 2nd flap, 2nd flap cover defectsimple scar revision

simple scar revision

old scar removed to realigh skin closure w/ primary closure

#15 blade

z plasty

better alignment and less tension at a 60 degree angle