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 (C)</p> Signup and view all the answers

What does the word 'plastikos' mean?

<p>To mold or give form (B)</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 (B)</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 (D)</p> Signup and view all the answers

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

<p>Everting skin margins (B)</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 (D)</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 (B)</p> Signup and view all the answers

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

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

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

<p>Both (A)</p> Signup and view all the answers

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

<p>5 days (B)</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 (A)</p> Signup and view all the answers

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

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

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

<p>Blood supply mechanism (D)</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 (D)</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 (B)</p> Signup and view all the answers

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

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

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

<p>Z-Plasty (B)</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% (B)</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 (B)</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 (D)</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 (B)</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 (A)</p> Signup and view all the answers

When should a porcine graft typically be removed?

<p>After 3-4 days (A)</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 (C)</p> Signup and view all the answers

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

<p>Full thickness skin grafts (C)</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 (D)</p> Signup and view all the answers

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

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

Which characteristic is associated with pie crusting in skin grafting?

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

Why is negative pressure wound therapy used in skin grafting?

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

What are reasons for skin graft failure?

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

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

<p>Target tissue exposure (B)</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 (A)</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 (C)</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 (D)</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 (D)</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 (D)</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 (B)</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 (A)</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 (B)</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 (A)</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 (B)</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 (A)</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 (C)</p> Signup and view all the answers

Which type of angiosome does the dorsalis pedis artery supply?

<p>Anterior Perforating (C)</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 (A)</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 (A)</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 (A)</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 (A)</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 (C)</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 (D)</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 (C)</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 (C)</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 (C)</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 (B)</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 (D)</p> Signup and view all the answers

What factor primarily determines the survival of a skin graft?

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

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

<p>Full thickness skin grafts (A)</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 (C)</p> Signup and view all the answers

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

<p>Minimal expansion (C)</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 (C)</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 (B)</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 (D)</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 (A)</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 (B)</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 (A)</p> Signup and view all the answers

How many joints does the gastrocnemius muscle crossover?

<p>3 (D)</p> Signup and view all the answers

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

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

Which muscle crosses two joints in the lower extremity?

<p>Gastrocnemius (C)</p> Signup and view all the answers

What is a common clinical exam finding associated with equinus?

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

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

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

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

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

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

<p>Indicates gastrocnemius contracture (A)</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 (A)</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 (C)</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 (A)</p> Signup and view all the answers

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

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

What is the normal range for ankle joint dorsiflexion?

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

What is one objective mentioned in the text regarding Equinus?

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

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

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

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

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

What radiographic findings are commonly seen in patients with Equinus?

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

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

<p>Night splint (B)</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 (B)</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 (C)</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 (D)</p> Signup and view all the answers

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

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

What is the primary treatment approach for Pseudoequinus?

<p>Conservative treatment with immobilization devices (B)</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 (A)</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 (C)</p> Signup and view all the answers

What differentiates Hemophilic Equinus Contracture from other Equinus types?

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

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

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

How is Equinus primarily resolved?

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

What are the radiographic findings commonly associated with Equinus?

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

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

<p>Equinusentation (D)</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 (C)</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 (A)</p> Signup and view all the answers

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

<p>Pseudoequinus (D)</p> Signup and view all the answers

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

<p>Gastrocnemius muscle (A)</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 (B)</p> Signup and view all the answers

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

<p>10 degrees (D)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Gastrocnemius (B)</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 (B)</p> Signup and view all the answers

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

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

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

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

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

<p>Pseudoequinus (D)</p> Signup and view all the answers

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

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

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

<p>Developmental Equinus (A)</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. (C)</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. (A)</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. (C)</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. (C)</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. (C)</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. (A)</p> Signup and view all the answers

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

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

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

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

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

<p>Medial approach (D)</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 (B)</p> Signup and view all the answers

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