Plastic Surgery: RPN Perioperative Program

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Questions and Answers

Which structure is primarily restored in reconstructive plastic surgery?

Normal appearance

Functional impairment

Abnormal structures (correct)

Skin texture

What is the primary difference between aesthetic and reconstructive surgery?

Aesthetic surgery is less complex than reconstructive surgery.

Reconstructive surgery enhances appearance while aesthetic surgery restores function.

Aesthetic surgery aims to improve or modify appearance, whereas reconstructive surgery treats abnormalities. (correct)

Both surgeries address the same types of cases.

Which of the following is a crucial aspect of equipment safety in plastic surgery?

Using expired instruments

Adhering to strict sterilization protocols (correct)

Avoiding the use of implants

Utilizing one-size-fits-all surgical tools

Which type of skin graft includes both the epidermis and part of the dermis?

Split thickness skin graft Signup and view all the answers

What surgical procedure is indicated for cancerous skin lesions?

Skin grafting Signup and view all the answers

Which type of anesthesia is commonly used for minor surgical procedures in plastic surgery?

Local infiltration Signup and view all the answers

What is the main purpose of using a Jackson Pratt Drain in plastic surgery?

To drain fluid accumulation Signup and view all the answers

What is significant about the dressing used in plastic surgery?

It is instrumental in wound protection and healing. Signup and view all the answers

Which type of skin graft allows the donor site to be utilized again?

Split thickness graft Signup and view all the answers

Which surgical instrument is primarily used for magnification during procedures?

Loupes Signup and view all the answers

Which statement about split thickness skin grafts is incorrect?

The donor site can be reused for another graft. Signup and view all the answers

In the context of breast reconstruction using TRAM flap, what is the primary characteristic?

Blood supply of the rectus abdominis muscle remains intact. Signup and view all the answers

Which procedure involves severing the original blood supply during reconstruction?

Free flap. Signup and view all the answers

What is the purpose of tissue expanders in breast reconstruction?

To gradually stretch the skin to create a breast mound. Signup and view all the answers

Which of the following describes the Z-plasty approach in scar revision?

The central point of Z must align with natural skin lines. Signup and view all the answers

Which of the following does not fall under the category of maxillofacial surgery?

Amputation of a body part. Signup and view all the answers

During breast augmentation, what is an important consideration for the circulating RN?

Documentation of implant information on the chart. Signup and view all the answers

What role does microsurgery play in tissue restoration?

It focuses on replantation and reconstruction of lost tissues. Signup and view all the answers

What distinguishes a Free Tram Flap from a TRAM flap?

It involves microvascular surgery for reanastomosis. Signup and view all the answers

Which type of flap maintains blood supply through a pedicle?

Pedicle flap. Signup and view all the answers

Study Notes

Plastic Surgery Overview

Plastic surgery encompasses two main branches: reconstructive and aesthetic surgery.
Reconstructive surgery addresses abnormal structures due to birth defects, disease processes, and injury, aiming to restore function.
Aesthetic surgery focuses on improving or modifying normal physical appearance.

Anatomy and Layers of the Skin

Understanding skin layers is crucial for performing efficient surgeries and healing.
Skin cancers include basal cell carcinoma, squamous cell carcinoma, and melanoma, necessitating surgical intervention.

Surgical Approaches

Reconstructive surgery restores normal body function, while aesthetic surgery reshapes normal structures for enhancement.
Common surgical interventions in this field include burn surgery, breast reconstruction (e.g., TRAM flap), and maxillofacial surgery.

Perioperative Nursing Considerations

Anesthesia may be general or local, with tumescent local infiltration commonly used.
Accurate count of instruments is crucial; dressings are critically important in plastic surgery.

Key Surgical Instruments

Lead hand retractor, microvascular scissors, tenotomy/Stevens scissors, and microbipolar forceps are essential tools.
Specialized equipment includes tourniquets, Jackson Pratt drains, and loupes for magnification.

Skin Grafting Techniques

Split Thickness Skin Graft: Involves the epidermis and part of the dermis; can be meshed for expansion and stapled, allowing the donor site to heal for reuse.
Full Thickness Skin Graft: Comprises the entire skin layer; typically sutured in place, used for areas requiring strong skin coverage.

Breast Reconstruction Methods

Myocutaneous flaps are employed in breast reconstruction, classified into pedicle (blood supply remains intact) and free flaps (original blood supply severed).
TRAM Flap: Uses rectus abdominis muscle to reconstruct the breast with preserved blood supply via a pedicle.
Free TRAM Flap: Involves severing and microsurgically reconnecting blood supply to achieve breast reconstruction.

Tissue Expansion

Used post-mastectomy to create sufficient breast mound skin; involves implants that stretch skin over time through saline injections.

Microsurgery

Critical for reconstructing or replanning tissue lost due to injury or disease, including replantation of amputated parts.

Maxillofacial Surgery

Addresses facial fractures and congenital anomalies, with common types including zygomatic, mandibular, and maxillary fractures (LeFort I, II, III).

Scar Revision Techniques

Aesthetic procedures aimed at minimizing scar visibility; Z-plasty modifies scar shape to align with natural skin lines for better camouflage.

Breast Augmentation

Aims to correct breast hypomastia, asymmetry, or reconstruct breasts post-mastectomy using silicone or saline implants.
Precise documentation and care required in handling implants during surgery.

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Description

This quiz focuses on the foundational aspects of plastic surgery, including the anatomy relevant to aesthetic and reconstructive procedures. It also explores psychosocial considerations and the importance of safety precautions in the use of specialty equipment and implants. Perfect for those studying the perioperative aspects of plastic surgery.