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12 Cards in this Set
- Front
- Back
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How does a z-plasty re-orientate a scar?
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perpendicular to its original position
lengthens and re-direct scars: used to release scar contractures in areas such as the face |
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When is a permanent scar guaranteed to form?
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if the skin is breached down to the level of the deep dermis
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What is the most important factor in determining the appearance of a scar in a given person?
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site
best: eyelid (invisible) worst: pectoral: predictable hypertrophic scarring response e.g. after a sternotomy (initially itches, widens over a year, if want to revise this scar wait 6-12m but unlikely to work): silicone gel pressure pads/cortisol injections may hasten above process |
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When is cortisol injection used in scar management?
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Only use for symptomatic scars e.g. itch as may case excessive thinning of scar tissue (transparent wide concave scars- usually with telangectasia)
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Scars in the sole of the foot?
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intense, intractable, hyperkeratotic
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Scars on the middle/lower back?
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wide, stretched but rarely hypertrophic
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Scars on the ear?
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can have keloid, lump
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Scars on face, hands, feet?
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usually fine
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scars on the upper abdomen?
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reactive/thickened phase and flat later
lower and transverse abdominal scars generally heal better |
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What is done to make a clinically useful nerve graft?
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Only clinically useful if very thin to avoid central necrosis. Sural or medial cutaneous nerve of the forearm used- cut into multiple segments and lay side by side to match volume of larger nerves.
This is called a cable graft Revascularises within 4days |
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Types of vascularity of flaps?
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Axial: along axis of flap
Myocutaneous: depends on underlying muscle e.g. latissimus dorsi, TRAM fasciocutaneous: blood supply from perforators arising in deep compartment via fascioseptal layers e.g. limb skin |
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What kind of local flap do you do for defects with no adjacent skin redundancy (like in the skull)?
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rotation flap
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