Plastic Surgery

Flaps in Plastic Surgery

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Q: A 48-year-old male undergoes excision of a chronic pilonidal sinus with a rhomboid-shaped defect over the sacrococcygeal region. The reconstructive plan involves a local flap designed adjacent to the defect, where the flap is transposed into the primary defect and the donor site is closed primarily. The flap follows the lines of minimal skin tension and relies on subdermal vascular supply without a named artery. What is the correct classification of this flap?

A. Rotation flap
B. Axial pattern transposition flap
C. Random pattern transposition flap
D. Advancement fasciocutaneous flap

Abbe Estlander Flap

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Q) Abbe Estlander flap is for?
a) Lip
b) Tongue
c) Breast
d) Nose
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Tissue Expanders in plastic Surgery

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Q  Which of the following is false regarding tissue expanders? ( Plastic Surgery Q 46-60) 

a) Distal ports have the advantage of minimizing risk of iatrogenic rupture by accidental puncture.

b)  Integrated ports have the advantage of not having the need to make a separate dissection for the port.

c) Tubing between expander and port gets obstructed in case of integrated ports.

d) The Food and Drug Administration had cleared for the use of carbon dioxide–filled, remote-controlled tissue expanders

Healing by Primary Intention

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Q)What is  false regarding the healing by  primary intention? ( # Gen surgery Wound Healing) 

A)Wound edges opposed.

B)Normal healing.

C)Usually done for dirty wounds

D)Minimal scar.

Answer-C

Primary intention,

Healing by primary intention is also known as healing by the first intention this occurs when there is an opposition of the wound edges

Secondary Intention

Healing occurs when the wound edges are not opposed immediately, which may be necessary for contaminated or untidy wounds.

Primary intention,

  • Would edges opposed
  • Normal healing.
  • Minimal scar.

Secondary intention,

  • Would leave open.
  • Heals by granulation, contraction and epithelialisation.
  • Increased inflammation and proliferation.
  • Poor scar.

Stages of graft uptake

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Q ) First stage of healing in a skin graft is
a. Revascularisation
b. Inosculation
c. Imbibition
d. None of the above

 Ans c

Imbibtion is the 1st stage in 24-48 hrs. It involves fibrin formation between the graft and bed

After 48 hours - Inosculation  by which time new capillary buds develop

3rd stage is revasularization

Ref SCHWARTZ'S PRINCIPLES OF SURGERY 2-volume set 11th edition

 

Submucus cleft palate

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Q) Submucosal Cleft soft palate : True is 
A. Velopharyngeal insufficiency
B. Normal feeding
C. Normal Uvula
D. Cleft of hard palate remains attached to the vomer and nasal septum

Answer 

Melanoma

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 Q) Pigmented lesion suspicious melanoma of size 1cm with ulceration and features of ABCD,
next step
A. Wide Local Excision  with 1cm margin
B. Excision biopsy with 1-2mm margin
C. Punch biopsy at the edge of the lesion
D. Incisional biopsy

Answer in Q 44 

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