ABPlSurg Plastic Surgery flashcards

31 cards. Read the term and the definition here. The deck at the top of this page is optional.

Parkland formula

Burn resuscitation formula: 4 mL lactated Ringer's per kg body weight per percent total body surface area burned over 24 hours, with half given in the first 8 hours after injury.

Rule of Nines

Adult burn surface estimate: head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, and perineum 1%, totaling 100%.

Breslow thickness

Maximum depth of melanoma invasion measured in millimeters from the granular layer; it guides excision margins and determines eligibility for sentinel lymph node biopsy.

Sentinel lymph node biopsy threshold

Offered for melanoma with Breslow thickness of at least 0.8 mm, or thinner tumors with ulceration or other high-risk features such as increased mitotic rate.

Basal cell carcinoma

Most common cutaneous malignancy, arising from basal keratinocytes; locally invasive but rarely metastasizes, with nodular, superficial, and morpheaform subtypes.

Marjolin ulcer

Squamous cell carcinoma arising in a chronic wound, scar, or burn site; it warrants biopsy of any nonhealing ulcer in previously injured skin.

Carpal tunnel syndrome

Median nerve compression beneath the transverse carpal ligament causing numbness in the thumb, index, middle, and radial ring finger, with thenar atrophy in advanced cases.

Dupuytren contracture

Fibroproliferative disease of the palmar fascia producing cords and nodules that cause flexion contractures, most often of the ring and small fingers.

Zone II flexor tendons

Fibro-osseous canal from the A1 pulley to the flexor digitorum superficialis insertion; repairs here risk adhesions and carry poorer outcomes than other zones.

Rule of 10s

Timing guideline for cleft lip repair: weight of 10 pounds, hemoglobin of 10 g/dL, and age of 10 weeks, indicating readiness for elective surgery.

Cleft palate repair timing

Typically performed at 9 to 12 months of age to support speech development while allowing facial growth before school age.

Scaphocephaly

Elongated, narrow skull deformity caused by premature fusion of the sagittal suture, the most common form of craniosynostosis.

Trigonocephaly

Triangular forehead deformity with a midline ridge caused by premature fusion of the metopic suture; may be associated with hypotelorism.

Anterior plagiocephaly

Asymmetric forehead flattening on the affected side with contralateral bossing, caused by unilateral coronal synostosis.

Positional plagiocephaly

Deformational flattening of the posterior skull without sutural fusion; distinguished from lambdoid synostosis by a parallelogram head shape and absence of a ridge.

Flexor tenosynovitis

Purulent infection of a flexor tendon sheath with Kanavel signs: fusiform swelling, tenderness along the sheath, finger held in flexion, and pain with passive extension.

Kanavel signs

Four clinical findings of flexor tenosynovitis: fusiform swelling, tenderness along the tendon sheath, slight finger flexion at rest, and pain on passive extension.

Necrotizing fasciitis

Rapidly spreading infection of fascia with systemic toxicity, pain out of proportion, and crepitus; it requires urgent surgical debridement and broad-spectrum antibiotics.

Immediate breast reconstruction

Reconstruction performed at the time of mastectomy; generally preferred for early-stage disease but avoided when postmastectomy radiation is anticipated.

Delayed breast reconstruction

Reconstruction performed after mastectomy and completion of radiation therapy, used when radiation is planned because it harms reconstructed tissue.

Transversus abdominis release

Posterior components separation technique that divides the transversus abdominis muscle to medialize the rectus complex and allow mesh placement in the retrorectus plane.

Anterior components separation

Abdominal wall reconstruction technique that releases the external oblique aponeurosis to allow medial advancement of the rectus complex for midline closure.

Stage I pressure ulcer

Intact skin with nonblanchable erythema that does not resolve with pressure relief; it signals imminent tissue breakdown and requires offloading.

Stage IV pressure ulcer

Full-thickness tissue loss extending to muscle, bone, or supporting structures; it often requires flap coverage after debridement and infection control.

Venous flap congestion

Flap compromise with purple color, brisk dark bleeding, and rapid capillary refill; it requires release of tight sutures and urgent anastomotic revision or leech therapy.

Arterial flap insufficiency

Flap pallor with delayed capillary refill, cool temperature, and scant bleeding; it requires exploration for arterial thrombosis or vasospasm.

Implantable Doppler

Device placed on a flap pedicle to monitor blood flow acoustically; loss of signal prompts urgent clinical assessment and possible reexploration.

Gustilo-Anderson classification

Open fracture grading from I to IIIC based on wound size, contamination, and vascular injury; higher grades require more aggressive debridement and antibiotic coverage.

Informed consent elements

Discussion of diagnosis, proposed procedure, material risks and benefits, reasonable alternatives including no treatment, and confirmation of patient understanding and voluntariness.

Free flap failure timing

Most failures occur within the first 24 to 48 hours from thrombosis; survival depends on early recognition and prompt reexploration of the anastomosis.

Skin graft vs flap

Skin grafts require a vascularized recipient bed and cannot cover exposed bone without periosteum, tendon without paratenon, or hardware; flaps carry their own blood supply.