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382 Cards in this Set

  • Front
  • Back
collagen

normal ratio

hypertrophic scar ratio
I:III

normal = 4:1

hypertrophic = 2:1
wound healing

inflammatory phase
PMN's and macrophages
% hemangiomas noted in

first year of life
80%
% lidocaine removed by

liposuction
10-30%
drugs associated with gynecomastia
amphetamine,aldactone, antidepressants (tricyclic), digitalis, methyldopa, opiates, tagamet,

NOT ambien
serrtus flap

which ribs
ribs 6-8
lateral thigh flap

size
artey
sensorynerve
large
3rd branch of perf femoris
sensate medial and lateral femoral cutaneous nerves
osteo-radionecrosis

Rx ?
hyperbaric O2

surgery for pain, fracture, exposure, fistula
Pet scan
resolution = 4-5 mm
specificity = 80-90%
Delay of flap results in
inc capillaries 2-7 days

vasosonstriction early

hypertrophy and reorganization of vessels along the axis of the flap
hydorxyapetite

%of skeleton
onlay vs inlay
cement vs ceramic
70% of calcific skeleton

inlay = osteoconductive
onlay = non "
cement = resorbable
ceramic = non "
giant hairy nevus
>20 cm diameter

Malig rate = 8 - 10%
scleroderma

crest syndrome
calcium soft tissue

calcinosis
reynaud's
esophageal involvement
sclerodactyly
telangiectasia
Surgical delay of flap
choke vessels dilate day 7-8
dil begins day 3

prior to day 3 = vasoconstriction
physical exam false pos or neg for regional lymph nodes
30%
trapezius flap

artery
transverse cervical
integra

when to remove silicon layer
2-3 weeks
Becker nevus
hamartoma (not a nevus)
bipivicaine

duration of action related to
protein binding
calciphylaxsis
skin necrosis

hyperparathyroid
dextran

actions
decrease factor VIII

decrease platlets

modify fibrin

antigen risk
Mongolian spot

Nevus of Ito

Nevus of Oto
Mong. = sacrum

Ito = blue nevus, post supraclavicular shoulder

Oto = trigeminal distribution
hemophelia A

Rx
factor VIII decreased

operative hemostasis need 80-100% concentration

must maintain 30% for 2 weeks

1/2 life = 12 hrs. --50%gone in 12 hours
burn immunology
dec func leukocytes

dec t lymphocyte and immunoglobulins

inc supresion lymphocyte and complement
gene mutation

SCC

AK
P53
pectoralis major

nerves
medial pectoral nerve = infior and lateral muscle

lateral pectoral nerve = medial muscle
Scorpion bite Rx

adult

child
adult = observe

child = admit + antivenum (neurotoxin)
rabies bite Rx
wound edge = 1 dose RIG (rabies immune globullin)

vaccine = 5 doses HDCV (human diploid cell vaccine)
bacteria

leech

human bite

cat bite
lee = aeromana hydrophylia Rx = aminoglycocide,trisulfa, 3rd gen. ceph

human = eikonella corrodens Rx= pen/ampicillin

cat = pasturella multicida Rx - pen/amoxicillin
fanconi

klippel trinau

parks weber

maffucci
fan = radial club hand, progressive pancysopenia,life threatening, auto dom

klipp trau = port wine (one extrem) venous and lymphatic

park web = same as klippel trauney + a-v fistula
polands

sturge weber
poland = fanconi + syndactyly

sturge weber = port wine stain + siezure
rendu osler weber

von hipple landau
rend = hemorraghic telangiectasia in mucous membrane, hematuria etc

von = retina and meningeal hemangiomas
xeroderma pigmentosa

malignancy develops when
<10 yrs
indications for radio rx tumor
large

close margin

multiple ln's

extracapsular or perineural involvement
hemangioma (characteristics)
plump endothelial cells

inc mast cells

inc 17-beta estradiol

multilaminate basement memb.
madilung's disease
benign symmetric lipomatosis
bone graft

osteocyte life
advantage vascualr bone
effect of radiation
ostercytes die 2 hours

vasc.=less resorp of cort bone
fewer fracture
rapid union
rapid hypertrophy

raadiation = dec bone regeneration by 70%
gracilis flap

nerve
obturator
fibular free flap
peroneal artery
posterior medial knee
flexor hallicus longus
classification

tibial fractures
I = open 1 cm
II = open >1cm w/o drainage
III = extreme soft tiss. damag
a = able to close
b = loss tissue,
periosteum stripped
bone exposed
c = above + art. injury
BCC

second primary
50% in 5 years
sternocleidomastoid

artery
occipital artery

note - spinal acc nerve (XI) runs in the muscle
pectoralis major

artery
rib
complication rate
thoracoacromial artery

5th rib (or sternum)

60% complication rate
melanoma

prognosis factor

stains

risk of 2nd primary
ulcer decreases prognosis

s100 and hmb45

2nd prim = 2-3%
atypical mole syndrome

risk melanoma
10%
lymphatic laser
ErbYag
saphenous aretery

branch of
genicular
hydradenitis

organism(s)
staph

strep viredens
brown recluse spider

Rx
dapsone

(not with G-6-Phos deficiency)
gracilis

located
immediatley posterior to adductor magnus
heterotopic calcificatio

Rx
etidronate

pamidronate

(does not effect bone healing)
purpura fulminans
toxic shock syndrome

staph aureus (include pneumonia)
nissseria meningitis
hemophilus influenza

remove implant
amputation lower ext.

absolute indication
complete division post. tib n.

crush with warm ischemia > 6 hrs.
acute burn

neutrophil function
inc chemotaxsis

inc degranulation therefore tissue necrosis
cultured allgenic keratocytes

survival
30 months
av malformation

effect on bone
destruction
pressure ulcer

stages
I skin intact

II blister skin

III into muscle no infection

IV involves bone or joint
lidocaine

peaks a ______ hours
12
ISLE

immediate physical change
reallign collagen
local anesthetic

mech of action
Na+ transport
defect lower extremity

primary choice of closure
fasciocutaneous flap
cidex
gluturaldehyde
xylocaine (lidocaine)
dose4.5 mg/kg
Maffucci syndrome
multiple enchondromas and hemangiomas
1st Rx of expanding hemangioma
oral conticosteriods
Carcinoma caused by chronis exposure to nickel
SCC nasal sinuses
scapula free flap

bone
augment using angular artery (branch of thoracodorsal)
Actinic Keratosis to SCC
10% in 5 years
presure ulcer recurrence post repair (in paraplegia)
80%
gracilis flap
type II

prim, art = medial circumfles

second art = superficial fem.
saphenous flap

artey
saphenous art.

branch of genicular artery
fibular flap

bone
25 cm

maintain 6 cm prox and dist.
lower ext. flap choice

prox 1/3

middile 1/3
grastocnemius

soleus
Flap types
I one dom

II one dom several minor

III two dom

IV mult segmental

V one dom several segmental
eg. flap

type I
TFL
gastrocnemius
vastis lateralis
flap type II
gracilis
soleus
flap type III
gluteus
rectus
serratus
flap type IV
ext hall longus
serratus
tib ant
flap type V
lat dorsi
pect major
reverse sural flap
5 cm above lat malleous
center over saph vein
width = 2 cm
contains lesser saph vein
deep fascia
sural n.
superfic sural art.
gastrocnemius flap

art
sural
dx osteomylitis in pressure ulcer
MRI
contraindication to hyperbaric O2
optic neuritis

existing neoplasm

active virus
deep peroneal nerve
sensory to 1st web space

travels with ant tib/dor ped artery
arterial supply

rectus femoris
TFL
vastus lateralis
lateral femoral circumflex
gracilis

artery
medial femoral circumflex
sartorius flap

artery
superficial circumflex iliac
superficial femoral
cover

heel
lateral ankle
medial ankle
flex. dig brevis

abductor dig minimi

abductor hallicus
collagen production/degredation

equlibrium
21 days
which skin flap provides maximun latitude in positioning the skin paddle?
scapula
muscle radiation

transfer risk =
necrosis
tissue expansion in children

highest rate of complication occurs where
lower extremity
burn patients

most common cause of death
pneumonia
dog bite
capnocytophaga carnivorsus

Rx = amoxicillin, clavulanic
lateral thigh flap

artery
3rd branch of profundus femoris

originates immediately caudad to adductor brevis
salmon eggs
&
caviar spots
lymphangioma (assoc. with bine overgrowth)
dural space ends
S 2-3
carbonaceous tatoo
(residual of burn)

Rx
Nd:YAG

(also asphalt, ink from amateur tatoo)
multiple treatments
dermabrasion end point for reticular dermis
confluent bleeding with coarse tissue background
z plasty theoretical gain
dergees percent
30 25
45 50
60 75
75 100
90 120
botox

mech of action
inhibition of acetycholine release at neuromuscular junction
which contain only human dirived material

alloderm
apligraf
biorane
integra
transcyte
alloderm
apligraf
biorane
integra
transcyte
apligraf cultured neonatal epidermocytes and bovine collagen

biorane synthetic nylon/silicone

integra bovine collagen and silicone

transcyte neonatal dermal fibroblasts and silicone/nylon mesh with bovine collagen
which is more likely with erb:yag as opposed to co2

erythema
scar
skin tightening
transudate
transudate

erb:yag absorb in water
burn

cardiac output
decreased 40-60%
(hypovolemia)
male pattern baldness

anogen
telogen
anogen (active)decreased

telogen (resting) increased
parkland formula
4cc/kg/%burn

give 50% in first 8 hours
calculated from time of burn
bipivercaine longer acting because
protein binding
Agdiazine

adverse effect
neutropenia
extremity mass decomrpesses when elevated
venous malformation
wave lengths

erb:yag
pulse dye
nd:yag
co2
erb:yag 2940

pulse dye 585

nd:yag 1064

co2 10,600
hemorrhagic necorsis of skin
dissem intravasc coagulation
fever
shock
purpura fulminans


60% mortality
vascular lesion with central arteiole
spider hemangioma
hair donor dominence
hairs have individual specific genetically definedlife spans

therefore occipital hair is preferred donor site
toxic eipdermal necrosis

scar residua
none = epidermis only
mechanism of action

silicone scar/scar
increasing the static electronegative field
preferred reconstruction of 1cm alar defect
composite graft from ear
primary benefit of using integra for cover full thickness burn
thinner donor site harvest
results from sun exposure
lentigines
in addition to scc,bcc,ak,
painful lesion on margin of ear
chondrodermatitis nodularis helicic
histologic examination of a proliferating hemangioma
decreased 17-beta estradiol binding sites
scar evaluation
RSTL (relaxed skin tension
lines) vs. ATL (anti-
tension lines)

width
color
copntour
landmark allignment (i.e.
mucocutaneous roll)
contracture
dextran
increased complications

no inc. flap survival
pressure ulcer

grades
I = skin not broken

II = full thickness skin

III = to underlying muscle

IV = bone or joint involved
augmentation pocket irrigation
not betadine
(providone-iodine)

ans = bacitracin, cefazolin, gentamycin
spastic paraplegia

wound closure protection
intrathecal baclofen pump
burn admission
2nd 3rd > 20% any age
" " > 10% under 10 over
50 yrs
sig burn face perineum,
3rd deg > 5% any age
inhalation component
burn reconstruction
look carefully at the % tba burn, may preclude flap
avm leg

initial step
mri/mra

rx = surgery for symptomatic lesions or those fairly easily resectable
melasma in fitzpatrick V skin type

rx
1% tretinoin
6 mo. old with vascular lesion rt. temple and calcification of outer tempmoral cortex
capillary hemanioma
(V1 dermatome)

sturge-weber syndrome

inc.risk siezure, devel delay, hemiplegia, glaucoma, retina detach, blindness
silversulfadiazine

causes ?
decrease in granulocytes
hyaluronic acid dermal fillers
said to prolong effect by

molecular cross linking
adding albumin at 24hrs post parkland burn resuscitation =
maintenance intravasc volume
interga

when to remove silicone layer
21 days
anhydrous amonia burn to cornea
results in liquifaction necrosis - can progress for 2 days even with irrigation
ALA 5-aminolevulinic acid
used topically

activated by pulse dye laser

rx for aging and acne
keratoacanthoma
scc
stsg donor site

best for multiple harvest
thick skin

(dermis never recovers)
maximal tensile strength in repaired skin wound\

results from
molecular cross linking
melena - vasc malformation

mucous membrane, lung, abdomenal visera
rendu-osler-weber
cell - wound contraction
myofibroblast
active hair growth phase
anogen

(telogen = resting phase)
best bone graft inductive quality
autologous cancellous
pectoralis major

artery
thoracoacormial
most abundant collagen in healed scar
type I
black and red tatoo
Q-switched Nd:YAG
(switchable)

(532 = red, 1064 = black)
burn - inhalation injury

30% co2 or higher
intubate

40-50% = coma, resp depression and deathe
predom cell respons for wound healing day 2 - 21
fibroblast
integra
said to improve cosmesis

when compared to stsg
meibobian gland malignancy
sebaceous carcinoma
merkel cell carcinoma

origin
neuroendocrine cells in epidermis
2 month old with circumferential subglottic hemangioma

mild stridor = rx
corticosteriod
35% tbsa burn
cause of shock via what mechanism
hypovolemia
large a-v malformation h&n with multiple episodes of bleeding

rx
excison and immediate flap reconstruction
port wine stain

best laser wave length
585 nm

(532 = superficial vasc lesion)
most effective rx for ischemic flap
insure adequate fluid resuscitation
post op alopecia with repeated breakdown

best rx
tissue expansion
local anesthetic allergy
esters (ester cross linked)
benzocaine
cloroprocaine
procaine
tetracaine
amide local anesthetics
licocaine
bipivacaine
mepivacaine
prilocaine
amide local anesthetics
not assoc. with true allergies

when present related to preservatives PABA
"doughy" mass grown comsenurate with child
enlarges with viral infections
lymphangioma
most comm. cause of male pattern baldness
inheritance

only cause (X-linked autosomal dominent gene)
cap hemangioma in 6 mo. old

rx
observation

(yellow pulse-dye laser only effective early in prolif phase)
grade IV pressure ulcer with communication with hip joint

rx
resection femoral head and flap reconstr

(vastus lateralis into acetabular fossa)
artecol

permanent?
said to be permanent

(methylmethacrylate beads in a collagen matrix)
not avail in u.s.
bone, cartilage, fat, muscle

least graft resorption
cartilage
noncoherant light
intense pulse

(not a laser)
nevus most difficult to distinguish form melanoma

(clinically and histoloigically)
spitz nevus
least sensative to inc lidocaine levels

bp, hr, cns, muscle tone
blood pressure
vitamin E
no proof of improving hypertrophic scars
creeping substitution in bone grafting
in all except ftt
thigh/buttock lift

prevent scar widening/recur etc.
suspension superficial fascial

anchor skin to colle's fascia
deep devision of supraorbial nerve

supplies
central scalp
vertical scar reduction mammoplasty
central vertical gland resection
shortening or ectropion lower lid post op/trauma
shortening posterion lamella (capsulopapebral fascia)
1.5 cm defect on nose

location for best 2nd healing
medial canthal area

(test answer, be careful with this one)
galactorrhea

evaluation
prolactin level and thyroid function

(also tricyclic antideprss)
dr.'s company

most common procedure resulting in malpractice suit
periqreolar mastopexy

(widening of the areola)
suction lipectomy

most common cause of death
thromboembolism
botox

time of onset of action
2 weeks
brachioplasty

most common complication
widening scar
blepharochalasis
painless edema of lower lids leading to permanent bags
hair transplant

growth pattern
growth 1 month
hair loss
normal growth after 3 months
microtia

rx
autologous reconstruction age 7 - 8 years.
retinoids

mech of action on skin
dec. activation
metalloproteases
2 week old with prominent ears

rx
molding ears with splint and tape.
ear, third crus
stahl's ear
miosis, anhidrosis, blepharoptosis
horner's syndrome
dermabrasion

good for
graumatid tatoo and perioral rhytids
most common branching pattern for 4th intrcostal n. to nac
lateral
blepharoplasty

pain, vomiting, visual disturbances
retrobulbar hematoma
retrobulbar hematoma

rx
exploration and latreal canthotomy
smoking and mastectomy
risk for native skin flap loss
smoking and tram flap
not assoc. with inc risk of
thrombosis
fat necrosis
flap loss
infection
gynecomastia

least appropriate rx
wise pattern

(looks like a female)
gracilis

immediate posterior to ?
adductor longus
groin flap artery
superficial circumflex iliac

artery 45-50% common origin with superficial inferior epigastric
z-plasty

theoretical gain
30 deg = 25%
45 deg = 50%
60 deg = 75%
75 deg = 100%
90 deg = 120%
3rd degree burn

mech assoc with progession to tissue destruction
increased chemotaxis
chondrodermatitus helicus

rx
excision
tram flap

delay =
increaded diameter of superion epigrastic artery
stsg immediate graft survival
plasmatic imbibition
HFl burn

rx
10% calcium gluconate

inject or topical
most common unfavorable result from augmentation with acellular dermal homograft
resorption
holo nevus

reason to treat
only when the nevus resembles a melanoma
Dapsone

complication
hemolysis

(used to rx brown spider bite)
silicone implant rupture

when
mean = 13 years
multiple keratoacanthomas (or scc/bcc) assoc with viseral malignancy
Muir-torre syndrome

colon,kidney,bladder, ovary, pancreas, breast
lidocaine,

max safe dose in child
4.5 mg/kg
best test to see avm assoc with surrounding tissue
mri
sclerosing bcc

best rx
moh's
(test answer)
autologous fat injection and blindness +/- cns cmplx
glabellar injection
vit c deficiency
results in
decreased
hydroxylation of amino acids (lysine and proline)
% hemangiomas noted in 1st month of life
80%
accelular dermal sheet lip augmentation

anatomic placement
subcutaneous
along wet/dry vermillion border
spitz nevus

most common location
head and neck
Hutchin's melanotic freckle
lentigo maligna melanoma
(melanoma in situ)
topical reversing potential of developing premilagnant skin lesions
retinoids
fracture not visable on initial x-ray

Dx
wait 2 weeks and repeat x-ray
dysplastic nevus and melanoma
very few dysplastic nevi go on to become melanoma

cancer65:12321,1990
most effective method of clearing bone adherent bacteria in an open wound
surgical soap
melanoma biopsy

lesion size
lesions less than 1.5 cm should be completely excised
melonma biopsy

thickness of biopsy
always full thickness skin
melanoma

sentinel lymph node indications
breslow 1.0 - 3.99mm
male trunk lesion breslow
>.76mm
thin melanoma with the following
regression, lymphocytic infiltrate, ulceration, clark level III
doughy mass growing comensurate with the child
lymphangioma
saphenous artery is a branch of ?
genicular
dermabrasion end point bleeding

papillary dermis
reticualar dermis
pap = sparse pin point

retic = confluent
mech of action of botox
inhibits acetylcholine release at neuromusc. junction
organisms in hydradenitis
staph aureus
strep viridans
becker nevus

Misnomer?
yes
is smooth muscle therefore a hamartoma
vascular lesion with central arteriol
spider hemangioma
epidermolysis bullosum

need for splinting to prevent contracture
none
advantage of using "Integra" in full thickness skin loss
able to use thinner autograft
test dose of Zyderm (bovine collagen)

delay time to second injection
4 weeks
gracilis blood supply
medial femoral circumflex

secondary for superficial fem.
lentigo - etiology
caused by sun exposure
mathes/nehai classification
I one dom. ped
II one dom and mult minor
III dual dom ped
IV segmental'
V one dom and mult segmental
oral splinting for electrical burn to commisure
length of time ?
6 months
SENSATE flap with bone for oral reconstruction
lateral arm flap

(bone = 10-15x1-2cm)
black widdow spider venum
name = latrodectus mactans

neurotoxin
black widdow spider

Rx
methocarbamol or valium

antivenum in immunocompromised patient only
brown recluse spider

vinus
sphyngomyelinate (dermonecrotic factor, hemolysis, platelet aggrigation, coagulation)
wolf's law and bone graft survival
stress is necessary
periosteum and bone graft survival
preservation of periosteum increases bone survival at all stages
membraneous vs enchondral bone
membranous bone inc survival
stsg grows proportional with the child

true or false
false only ftsg
bovine collagen most effective when injected into which site
dermis
hydroxyapatite

osteo inductive or conductive
osteoconductive
hydroxyapatite

effect on ct scan
none
radial forearm flap

venous outflow
radial venous comitantes
EMLA cream

delay needed for most effective
60 min.
progressive edema in upper or lower extremity of child with edema since birth
Dx
Milroy's disease
lymphedema praecox
noncongenital
first presents after puberty
will an implanted silicone shell lose biomechanical strength over time
yes
nevus of Oto
trigeminal distribution

Ito = arm and supraclavicular
Rx of hemangioma obstructing vision in an infant
excision

(not sure but believe there is an answer on another card that says steriods, poss. infant is the key word)
amblyopia

duration of onset
some studies say as early as one week

(permanent functional blindness following obstruction of vision)
free osteocutaneous flap with maximum freedom of positioning skin paddle
scapula
burn scar excision and best wound cover
one question = ftsg
sebaceous carcinoma

most frequent site
eyelid
primary closure of sclap defect
answer is < 5cm

(i doubt 4 cm is closable)
paraplegic
most common cause of death
renal falilure (chronic amyloidosis)
isotrentoin inhibits
epitheliazation
(accutane)
erythroplasia of queyrat
scc - penis
which graft tissue shows the least graft resorption
cartilage
skin defect upper eyelid
cannot close primarily
ftsg from other upper lid
percent of patients that have infection with aeromonas hydrophilia after 10 days of leach therapy
20%
port wine stain is ?
cappilary malformation
retin-a (trentinoin) causes
decrease in stratum corneum thickness (or "compacting of statum corneum)
allergic rxn to Zyderm
collagen type?
% allergic?
antibody response
bovine
3%
IgG
what characteristic of ftsg inhibits wound contraction
% of transferred dermis
vascular abnormality leading to bone destruction
avm
collagen equilibrium in wound
production=degredation
21 days
burn allopecia
Rx
tissue expansion
columellar defect

best flap
nasolabial (nlf)

prob better with composite graft
fluroscein and flap monitoring
not useful for continuous monitoring
best method to monitor jejunal free flap for esophygeal reconstruction
exteriorize a portion
periosteal branches of the peroneal artery are found on which aspect of the fibula
posteromedial
septal perforation

Rx
uni or bipedicle septal mucosal flaps
"clean" laceration

rec. for abiotic
none

rate of infection
5% with abiotic
3% without abiotic
most common complx post excision keloid ear with radiation and cortisone
recurrence
local anesthetic with sympathomimetic actions
cocaine
highest anatomic site for complications with tissue expanders
lower extremity
physiologic effect of vit e
papular and follicular DERMATITIS

(no effect on scars)
clean laceration of face in child with incomplete tet toxoid immunization

recommedation
tet tox at time of Rx then completion of immun schedule
dog bite wound

abiotic
amoxicillin-clavulanic acid

(org = capnocytophaga canimorsus)
Wartenberg sign
inability to adduct small finger
medial plantar flap

artery
location
medial plantar artery

between abd hallucis and flex dig longus tendons
true hand dominence occurs at what age
18 - 24 months
traumatic exposure of extensor mechanism of finger

Rx
"reverse" cross finger flap
weight bearing heal defect

flap?
medial plantar fasciocutaneous flap
pain stiffness and disability relating to a single digit injury

Rx
ray amputation
finger tip amputation in child
heal by secondary intent when part not available
central digit amputations

functional problem =
Rx
fingers cross when making a fist


Rx = transposition of adjacent digit or "metacarpal jog"
canal of guyon
no sensory deficiet
post traumatic scaphoid - radius arthritis

Rx
four corner arthrodesis and excison of scaphoid
(capitohamatotriquetrolunate arthrodesis)
phenol peel vs dermabrasion
which causes less bleaching
dermabrasion
corticosteroids mechanism of action in slowing hemangioma growth
block estradiol receptors
effect of corticosteroids on stable or involuting hemangioma
none
dic in meningococcal sepsis

rx
administration of activated protein c
6 month resorption of injected fat
30% (new answer)
supramuscular site = best survival (81%)
hair grows from where in follicle
base
"best" stsg donor site dressing
op site, tegaderm ("semi-occlusive)

duoderm is considered occlusive
microscopic changes in stsg at 2 days
edema

not ischemic changes
scalp expansion

beneath which layer
galea
advantage of marcaine (bupivacaine)
less motor blockade
Juri flap
anterior hairline reconstruction
(temporoparietaooccipital)
VAC Rx

wound characteristic with greatest negative effect on outcome
fibrosis

(chronic wound)
giant nevus
(congenital melanocytic nevus)

risk of malignancy
Rx
less than 10%

excision if diameter > 20cm
(when feasible)
medial grastrocnemius

artery
medial sural
`pressure ulcers
excision of the ulcer

not debriedement
keloid vs. hypertrophic scar

fibroblast/myofibroblast
mysofibroblasts not found in keloidd
cutaneous herpes post face resurfacing
IV acyclovyr or valacyclovyr
risk of Medpor (high density polyethylene)
increased risk of exposure
most appropriate abiotic for necrotzing fasciitis
clindamycin
restylene

wrinkle correction at 1 year
33%
rib cartilage grafting

most effective at long term warping control
wait 30 minutes before insertion
let initial warping occur and acount for it

(???????)
neurobfibroma with rapid growth or pain
excise

risk malig. (3 - 15%)
neurofibromatosis

von recklinghausen
mild to major
all sex, races
central or peripheral varients
chronic wound

metalloproteinase level
increased
sudden swellin and pain in lymphangioma

Rx
abiotic
telogen phase of hair growth
10% of follicles

lasts 2 - 4 months
cancellous bone vs cortical

inductive, conductive
more osteoinductive and osteoconductive
more easily vascularized and remodelled
Branham sign
slowing of the heart rate with compression proximal to an av malformation
escar present on a composite graft

Rx
observation

may be superficial
mechanism of action in compression garment in scar
hypoxia of local tissue
alloplastic cheek implant

under what layer
subperiostal
SGAP flap disadvantage
fat is more difficult to mold
least volume graft loss
dermis
fat
muscle
cartilage
bone
cartilage
with no inhalation injury, early respiratory distress post burn
cause
inflammatory interstitial edema
following primary wound closure - how long for epithelization (epidermis to be restored)
24 hours
how long after acute burn injury is optimal for free tissue transfer
4 - 6 weeks
?hypercoaguable state post burn
best timing for free tissue transfer for lower ext. reconstr.
early, within one week
post intrgra stsg application
when
2 - 4 weeks

can do at 2 weeks some suggestion that "take" is better at 4 weeks
frontonasal flap
artery supply
angular
swellin in cheek increasing over weeks post injury

dx
initial dx test
injury to parotid duct (stenson)

canalize the duct
wave length for laser tatoo removal of red dye
532 nm
pain over lateral thigh post iliac bone harvest, which nerve injured
lateral femoral cutaneous
transforming growth factor and fibroblast growth factor come from which cell
platelet
collegenase and cytokines from which cell
macrophages
maximum safe dose of topical cocaine
1.5 mg/kg

vasoconstrictive effect
painful nodule on ear
chondrodermatitis nodularis helicus
apligraf
neonatal foreskin
alloderm
acellular cadaveric dermal matrix
integra
bovine tendo collagen covered with silicone
delay in ischial pressure wound closure awaiting nutritional improvement
vac
advantage of alloderm to alloplatic mesh
resists infetion better
best measure of adequate fluid ressus in acute burn
urine output, 0.5 ml/kg/hr
function of latissimus dorsi muscle
shoulder adduction and extension
port wine stains (cap malformations) respond best in what anatomic area to pulse dys laser
neck

central face area least favorable
alopecia areata

cause
Rx
autoimmune

corticosteroids (25% recover in 3 years)
acute burn wound excision and grafting - most important factor in stsg survival
timing of excision (best early 24 hrs)
peak tensile strength of skin incision
60 days = 80% of normal
Oral abiotic Rx for MRSA
trimethoprim-sulfamethoxazole
Rx of painful vssicles post peal or laser
anti viral (valacyclovir)

herpes simplex type 1
Mafucci syndrome
venous malformation
enchondroma
exostoses
advantage of vasc bone to free bone graft
viable osteocytes

use in defects >6cm
"waxy" friable skin lesion
seborrheic keratosis
Rx of decreasing O2 sat post closed space burn
intubation\ bronchoscope
recurrence rate for Moh's Rx of BCC
3-8%

(and they make that sound good?????)
contraindication to use of endtine fixation brow lift
thin crakial bone or thin scalp
atologous rib cart graft

best method to inhibit post op warping
balanced crossectional carving, use straigt rib segments and wait 30 min after harvest to allow for natual deformities to occur.
most common site for burn contacture above the waist
neck
predom artery supply to lower portion of trapezius
dorsal scapular
predom artery supply to superior trapezius
occipital artery
middle trapezius

artery ?
superficial cervical artery
red mottled color to skin over tissue expander
normal
only filler approved for lipodystrophy Rx in HIV
sculptra (poly-l-lactic acid)
radiesse = ?
hydroxyapatite
hyperbaric O2 effective for rx of what wounds
diabetic lower extermity

????????
complication of Dextran (low molecular weight dextran)
adult resp distess syndrome
application of vac immediately post grafting
improves survival
hair color and laser removal
darker = better
vit C in wound healing
cofactor in hydroxylation of proline and lysine for procollagen formation
most likely local anesthetic for allergic rxn
procaine (ester)
subscapular system supplies
scapula and parascapular
serratus
rib
recurrent infections in subcutaneous increasing mass in infant
Dx
Rx
lymphangioma
resection
secondary procedure timing after forehead flap
3-4 weeks
mechanism of action of silicone sheeting on scar
hydration

(?????)
medial gastroc. flap

artery ?
sural
congentital melanocytic nevus = greatest other system at risk
CNS (neruoleptomeninges)