Introduction to Plastic Surgery and Skin Grafting Techniques
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Questions and Answers

What is the main aim of plastic surgery?

  • To mold tissue according to individual preferences
  • To restore the function and appearance of damaged tissue and skin (correct)
  • To create artificial skin
  • To provide cosmetic enhancements

    • What is the origin of the term 'plastic' in plastic surgery?

  • It is a modern invention in medical terminology
  • It derived from an ancient Greek word meaning to mold or give form (correct)
  • It means artificial in Latin
  • It comes from the Latin word for beauty

    • What is a common misunderstanding about the term plastic surgery?

  • It refers to using artificial materials in surgery (correct)
  • It has no relation to molding or shaping tissue
  • It originated from the Latin word for tissue
  • It means surgery with minimal scarring

    • What type of tissue is plastic surgery primarily concerned with?

    <p>Skin and damaged tissue</p> Signup and view all the answers

    What does the word 'plastikos' mean?

    <p>To mold or give form</p> Signup and view all the answers

    What is the purpose of providing tension on the incision during surgery?

    <p>Separating tissue layers and controlling incision depth</p> Signup and view all the answers

    In plastic surgery, what is recommended for skin closure techniques to avoid when leveling both wound edges?

    <p>Creating side-to-side step offs</p> Signup and view all the answers

    Which technique is suggested to bring like margins together during skin closure?

    <p>Everting skin margins</p> Signup and view all the answers

    Why is it important not to create 'death by a thousand cuts' during incision planning in plastic surgery?

    <p>To maintain a smooth cut for better healing</p> Signup and view all the answers

    What risk is associated with inverted margins in skin closure techniques?

    <p>Formation of a larger scar bridge between tissue types</p> Signup and view all the answers

    How long is the recommended timing for suture removal on the face?

    <p>5 to 7 days</p> Signup and view all the answers

    How many wound edges should be leveled during the skin closure process?

    <p>Both</p> Signup and view all the answers

    At what timing is the removal of sutures recommended for the neck?

    <p>5 days</p> Signup and view all the answers

    How many days of timing is suggested for suture removal on the trunk and upper extremities?

    <p>7 days</p> Signup and view all the answers

    What is the suggested duration for suture removal on the lower extremities?

    <p>7 to 10 days</p> Signup and view all the answers

    In skin grafting, what distinguishes an axial flap from a random flap?

    <p>Blood supply mechanism</p> Signup and view all the answers

    What is the fundamental ratio for the basic fusiform ellipse in closing a wound with a skin defect?

    <p>3:1 with 30-degree angles</p> Signup and view all the answers

    What factor determines the survival of a skin graft according to Bennett's lecture on GRAFT?

    <p>Recipient site blood supply</p> Signup and view all the answers

    Which type of skin graft requires undermining to advance the flap?

    <p>V-Y island flap</p> Signup and view all the answers

    What technique involves tissue rearrangement to redirect tension in plastic surgery?

    <p>Z-Plasty</p> Signup and view all the answers

    How much length increase can be achieved in a skin flap with a 30-degree angle Z-Plasty?

    <p>25%</p> Signup and view all the answers

    In Z-Plasty, what is the significance of orienting the original lateral arms close to Relaxed Skin Tension Lines (RSTLs)?

    <p>It enhances the final length of the flap</p> Signup and view all the answers

    Which type of skin graft relies entirely on blood supply from the recipient site for survival?

    <p>Full thickness graft</p> Signup and view all the answers

    What is the purpose of using a porcine graft as a temporary biological dressing?

    <p>To prewound the recipient site and stimulate blood vessel formation</p> Signup and view all the answers

    Why is it important to ensure that the wound bed is clean enough before placing a porcine graft?

    <p>To prevent gram-negative bacteria from thriving</p> Signup and view all the answers

    When should a porcine graft typically be removed?

    <p>After 3-4 days</p> Signup and view all the answers

    What happens if a porcine graft does not progress in 'take' during the healing process?

    <p>The autograft will not take either</p> Signup and view all the answers

    Which type of skin graft is more prone to secondary contracture?

    <p>Full thickness skin grafts</p> Signup and view all the answers

    What is the purpose of meshing a skin graft?

    <p>To allow fluid drainage and cover larger areas</p> Signup and view all the answers

    What is the function of a stent or bolster dressing in skin grafting?

    <p>Reduces fluid accumulation</p> Signup and view all the answers

    Which characteristic is associated with pie crusting in skin grafting?

    <p>Minimal expansion compared to meshing</p> Signup and view all the answers

    Why is negative pressure wound therapy used in skin grafting?

    <p>To accelerate wound healing</p> Signup and view all the answers

    What are reasons for skin graft failure?

    <p>Poor tissue handling and excessive stretching</p> Signup and view all the answers

    Which factor plays a crucial role in selecting the placement of skin incisions?

    <p>Target tissue exposure</p> Signup and view all the answers

    What is the consequence of making an incision perpendicular to Relaxed Skin Tension Lines (RSTLs) in plastic surgery?

    <p>Minimal available movement resulting in more tension</p> Signup and view all the answers

    What is the significance behind choosing an incision orientation parallel to the skin's RSTLs?

    <p>Less tension during wound healing</p> Signup and view all the answers

    Which medical professional performed a cadaveric study in 1861 to map the Relaxed Skin Tension Lines on the foot and ankle?

    <p>Karl Langer</p> Signup and view all the answers

    What is the main reason why skin tension is crucial in choosing incisional placement?

    <p>To achieve optimal wound healing</p> Signup and view all the answers

    How do incisions made across the skin's maximal tension typically affect scar appearance in wound healing?

    <p>Lead to stretched, hypertrophic scars</p> Signup and view all the answers

    What is the primary function of providing tension on the incision during surgery?

    <p>Separate tissue layers and maintain control of incision depth</p> Signup and view all the answers

    Why is it advised to draw 'crosshatches' for skin re-approximation but avoid creating them during incision planning?

    <p>To prevent the 'death by a thousand cuts' approach</p> Signup and view all the answers

    In plastic surgery, what is the purpose of everted skin margins during skin closure?

    <p>To reduce the risk of unlike tissue approximation</p> Signup and view all the answers

    What is a critical characteristic of good techniques for skin closure to avoid during suturing according to the text?

    <p>No vertical step off</p> Signup and view all the answers

    Why do skin margins need to be leveled during skin closure in plastic surgery?

    <p>To avoid side-to-side step off in wound alignment</p> Signup and view all the answers

    What is the function of a bolster dressing in skin grafting procedures?

    <p>To mechanically stabilize the graft in position</p> Signup and view all the answers

    What is the ideal location for making an incision between two pedal angiosomes?

    <p>At the exact border of both angiosomes</p> Signup and view all the answers

    Which type of angiosome does the dorsalis pedis artery supply?

    <p>Anterior Perforating</p> Signup and view all the answers

    In the context of pedal angiosomes, where is the Lateral Plantar angiosome located?

    <p>Between the medial and lateral calcaneal angiosomes</p> Signup and view all the answers

    Why is the subdermal arteriolar plexus significant in foot and ankle design?

    <p>It assists in creating pedal angiosomes for surgical techniques</p> Signup and view all the answers

    What connection does the lateral plantar artery make with the dorsalis pedis artery?

    <p>In a circumferential wraparound pattern</p> Signup and view all the answers

    What is the primary function of the lateral plantar angiosome?

    <p>Providing blood flow to the lateral sole and heel</p> Signup and view all the answers

    What is the purpose of a Limberg rhomboid in plastic surgery?

    <p>To create a transpositional flap with angles of 60 and 120 degrees</p> Signup and view all the answers

    What makes an autograft different from a xenograft in skin grafting?

    <p>An autograft relies on the recipient site's blood supply for survival</p> Signup and view all the answers

    In skin grafting, what distinguishes an isograft from an allograft?

    <p>The isograft is from one genetically identical person to another</p> Signup and view all the answers

    What is the key characteristic of a double rhomboid flap in plastic surgery techniques?

    <p>Creating a transpositional flap with two adjacent rhomboid shapes</p> Signup and view all the answers

    What is the major drawback of skin grafting in comparison to synthetic skin substitutes?

    <p>Reliance on the recipient site's blood supply for graft survival</p> Signup and view all the answers

    What is the main benefit of using a transpositional flap in plastic surgery?

    <p>Allowing for revascularization of the flap before releasing the pedicle</p> Signup and view all the answers

    What is the purpose of using a stent or bolster dressing in skin grafting?

    <p>To decrease fluid accumulation</p> Signup and view all the answers

    What factor primarily determines the survival of a skin graft?

    <p>Recipient vascularity</p> Signup and view all the answers

    Why is it crucial to avoid creating 'death by a thousand cuts' during incision planning in plastic surgery?

    <p>To prevent tissue damage and ensure proper healing</p> Signup and view all the answers

    Which type of skin graft is more prone to secondary contracture?

    <p>Full thickness skin grafts</p> Signup and view all the answers

    What is the main disadvantage of Negative Pressure Wound Therapy (NPWT) or Vacuum Assisted Closure (Wound VAC) in skin grafting?

    <p>Attached to a pump</p> Signup and view all the answers

    What is the primary characteristic of Pie Crusting technique in skin grafting?

    <p>Minimal expansion</p> Signup and view all the answers

    When do Myofibroblasts in the recipient bed pull on the skin graft in skin grafting procedures?

    <p>During the process of secondary contracture</p> Signup and view all the answers

    Why is meshing a skin graft recommended in certain cases?

    <p>To allow it to adhere to irregular surfaces</p> Signup and view all the answers

    What characteristic sets biological skin substitutes like amnionic grafts apart from synthetic substitutes?

    <p>Ability to promote granulation</p> Signup and view all the answers

    What common technical error can lead to skin graft failure?

    <p>Applying the graft with the dermis side facing down</p> Signup and view all the answers

    What is claimed to be the normal degrees of ankle joint dorsiflexion for human ambulation?

    <p>10 degrees</p> Signup and view all the answers

    Which muscle forms the superficial flexor group of the leg along with the gastrocnemius and plantaris muscles?

    <p>Triceps surae</p> Signup and view all the answers

    How many joints does the gastrocnemius muscle crossover?

    <p>3</p> Signup and view all the answers

    The triceps surae muscle consists of which of the following two muscles?

    <p>Gastrocnemius and Soleus</p> Signup and view all the answers

    Which muscle crosses two joints in the lower extremity?

    <p>Gastrocnemius</p> Signup and view all the answers

    What is a common clinical exam finding associated with equinus?

    <p>Forefoot pressure ulcers</p> Signup and view all the answers

    Which of the following is NOT a type of equinus mentioned in the text?

    <p>Fibula equinus</p> Signup and view all the answers

    What is a likely sequela of equinus according to the text?

    <p>Hypermobile first ray</p> Signup and view all the answers

    In equinus, what is the clinical significance of the Silfverskiold Test being positive?

    <p>Indicates gastrocnemius contracture</p> Signup and view all the answers

    Which of the following conditions is not mentioned as a cause of equinus in the text?

    <p>Patellar tendon rupture</p> Signup and view all the answers

    What is a potential biomechanical result of equinus in the lower extremity?

    <p>Reduction in knee extension moment arm</p> Signup and view all the answers

    What is a key characteristic of Equinus described in the text?

    <p>It is commonly associated with constricted ankle joint dorsiflexion</p> Signup and view all the answers

    Which conditions are NOT mentioned as potentially related to Equinus in the text?

    <p>Headache and nausea</p> Signup and view all the answers

    What is the normal range for ankle joint dorsiflexion?

    <p>0 degrees to 16.5 degrees nonweightbearing</p> Signup and view all the answers

    What is one objective mentioned in the text regarding Equinus?

    <p>Describe the clinical examination of Equinus</p> Signup and view all the answers

    Which term is NOT used as a symptom related to Equinus in the text?

    <p>Myocardial infarction</p> Signup and view all the answers

    What is one of the conditions NOT directly treated by addressing the Equinus component?

    <p>Inguinal hernia</p> Signup and view all the answers

    What radiographic findings are commonly seen in patients with Equinus?

    <p>Talar lipping and osteophytes</p> Signup and view all the answers

    What is a non-invasive option to help reduce calf muscle tightness in equinus?

    <p>Night splint</p> Signup and view all the answers

    What defines the condition described as Pseudoequinus in podiatric biomechanics?

    <p>Forefoot equinus position using less available ankle joint motion</p> Signup and view all the answers

    How does wearing shoes with moderate heels help in managing equinus symptoms?

    <p>Takes stress off the Achilles tendon</p> Signup and view all the answers

    What is a significant feature of casting or splinting in the plantarflexed position for Equinus treatment?

    <p>It targets the widest part of the talus for immobilization</p> Signup and view all the answers

    What is a common treatment for equinus involving custom devices inside the shoes?

    <p>Orthotic devices</p> Signup and view all the answers

    What is the primary treatment approach for Pseudoequinus?

    <p>Conservative treatment with immobilization devices</p> Signup and view all the answers

    Which treatment option for equinus specifically focuses on keeping weight distributed properly in the foot?

    <p>Orthotic devices</p> Signup and view all the answers

    Why are exercises that stretch the calf muscles recommended in equinus treatment?

    <p>To reduce calf muscle tightness</p> Signup and view all the answers

    What differentiates Hemophilic Equinus Contracture from other Equinus types?

    <p>Association with repeated hemarthrosis</p> Signup and view all the answers

    Which treatment option for equinus aims to relieve symptoms through footwear modification?

    <p>Heel lifts</p> Signup and view all the answers

    How is Equinus primarily resolved?

    <p>Immobilization in a dorsiflexed position</p> Signup and view all the answers

    What are the radiographic findings commonly associated with Equinus?

    <p>Talar lipping, osteophytes</p> Signup and view all the answers

    What theory suggests that abnormal foot function occurs when 'equinus' is present?

    <p>Equinusentation</p> Signup and view all the answers

    Which type of Equinus might describe a forefoot in equinus position using up limited ankle joint motion?

    <p>Pseudoequinus</p> Signup and view all the answers

    Which muscle group forms the bulk on the back of the calf along with the plantaris muscle?

    <p>Superficial flexor group</p> Signup and view all the answers

    Which Equinus type does well with conservative treatment and accommodative care?

    <p>Pseudoequinus</p> Signup and view all the answers

    What is the primary muscle that crosses three joints in the lower extremity?

    <p>Gastrocnemius muscle</p> Signup and view all the answers

    In Equinus, what is the distinguishing feature of the forefoot with an anterior cavus deformity?

    <p>Forefoot loads earlier</p> Signup and view all the answers

    What is considered the normal amount of ankle joint dorsiflexion required for human ambulation?

    <p>10 degrees</p> Signup and view all the answers

    What is a characteristic of the Charger view imaging for Equinus diagnosis?

    <p>Lateral projection with dorsiflexion stress</p> Signup and view all the answers

    Which Equinus type results from trauma with improper immobilization and recurrent synovitis?

    <p>Recurrent synovitis Equinus</p> Signup and view all the answers

    Which muscle is part of the triceps surae muscle group in the lower leg?

    <p>Gastrocnemius</p> Signup and view all the answers

    What is a possible medical condition that could cause a clonic spasm of triceps surae?

    <p>Tonic spasm of triceps surae</p> Signup and view all the answers

    Which factor could contribute to the development of an acquired Equinus?

    <p>Back pain</p> Signup and view all the answers

    What could be a possible cause of an excessive pronation leading to Equinus?

    <p>Tarsal coalition</p> Signup and view all the answers

    Which type of Equinus may involve a combination of Gastrocnemius and Osseous factors?

    <p>Pseudoequinus</p> Signup and view all the answers

    Which condition is more likely to result in Pes valgus as a sequelae?

    <p>Excessive pronation</p> Signup and view all the answers

    What could be a possible causative factor for Genu Recurvatum in Equinus?

    <p>Developmental Equinus</p> Signup and view all the answers

    What extreme view is expressed about Equinus in the text?

    <p>Equinus should always be surgically treated without exception.</p> Signup and view all the answers

    What is the implied attitude towards the surgical correction of Equinus in the text?

    <p>Surgery should be the first and only option considered for Equinus treatment.</p> Signup and view all the answers

    What aspect of Equinus treatment is heavily promoted in the text?

    <p>Addressing Equinus surgically as soon as possible after diagnosis.</p> Signup and view all the answers

    What ethical concern is raised related to Equinus in the text?

    <p>The undisclosed financial interests of healthcare professionals in Equinus surgery.</p> Signup and view all the answers

    What is the extreme point of view presented regarding Equinus and its consequences?

    <p>Equinus is a severe issue that affects the entire body's functionality.</p> Signup and view all the answers

    What message is strongly conveyed about Equinus surgery in the text?

    <p>Routine Equinus surgery is essential for overall body health.</p> Signup and view all the answers

    What does the Hoke Achilles Lengthening Procedure primarily aim to reduce?

    <p>Forefoot pressure</p> Signup and view all the answers

    In Z-Plasty, what does the 'Z' refer to in sagittal Z-lengthening?

    <p>Medial and lateral pieces</p> Signup and view all the answers

    What is the commonality between Distal Z Lengthening and Percutaneous Tendo-Achilles Lengthening?

    <p>Utilization of TAL</p> Signup and view all the answers

    What distinguishes the PTAL or TAL procedure from the open surgical correction of ankle equinus?

    <p>Length of the incision</p> Signup and view all the answers

    In percutaneous Tendo-Achilles Lengthening, what surgical approach does the 'More Medial' technique utilize?

    <p>Medial approach</p> Signup and view all the answers

    What is the primary reason for recommending the 'Triple Stab' minimal incision technique in the Hoke Achilles Lengthening Procedure?

    <p>Minimizing scarring</p> Signup and view all the answers

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