ABPlSurg Plastic Surgery key terms

A staged procedure that partially interrupts a flap's blood supply before transfer, conditioning the tissue to survive on fewer vessels and improving perfusion at the far end.

A three-dimensional block of skin, subcutaneous tissue, and muscle supplied by a single source artery and its branches. Mapping these territories guides flap design and predicts safe dimensions.

A flap raised on a named perforating vessel that pierces fascia or muscle to supply skin and fat, sparing the underlying muscle. It reduces donor-site morbidity and allows tailored reconstruction.

Transplantation of tissue detached from its native blood supply and reattached to recipient vessels using microvascular anastomoses. Success depends on meticulous technique and postoperative flap monitoring.

Impaired outflow from a flap causing swelling, bluish discoloration, and brisk dark bleeding. It is the most common cause of early flap failure and requires prompt relief of the obstruction.

Formation of clot within a microvascular anastomosis or pedicle, occluding flow. Arterial thrombosis presents with a pale, cool flap; venous thrombosis with a congested, dusky flap.

A horizontal osteotomy separating the maxilla from the midface, allowing repositioning in three dimensions. It corrects maxillary hypoplasia, vertical excess, and malocclusion in orthognathic surgery.

Simultaneous osteotomies of the maxilla and mandible to correct dentofacial deformity. It requires careful preoperative planning, splint fabrication, and coordination of skeletal and occlusal relationships.

Surgical repositioning of the jaws to correct skeletal and dental discrepancies, improve function, and refine facial proportions. It is planned jointly with orthodontists using cephalometric and occlusal analysis.

Surgical reshaping of the nose to improve appearance, airway function, or both. Techniques include osteotomies, tip suturing, grafting, and septal reconstruction, with outcomes dependent on structural support.

A cartilage graft placed between the upper lateral cartilages and septum to reconstruct the internal nasal valve and prevent mid-vault collapse after dorsal reduction.

Surgical correction of a deviated nasal septum to relieve obstruction. It preserves and repositions cartilage and bone rather than resecting them, maintaining dorsal and tip support.

Reconstruction of a congenital lip defect, typically using rotation-advancement or straight-line techniques. Goals include symmetric Cupid's bow, competent orbicularis, and minimal scar.

Closure of a congenital palatal defect to separate oral and nasal cavities, restore speech, and prevent reflux. Techniques include palatoplasty with intravelar veloplasty and pharyngeal flaps for velopharyngeal insufficiency.

Inadequate closure of the velopharyngeal port during speech, causing hypernasality and nasal emission. It may follow cleft palate repair and is managed with speech therapy or pharyngeal surgery.

Placement of bone into a cleft alveolar defect, usually before canine eruption, to provide bony support for teeth and close an oronasal fistula. It is a standard part of cleft care.

A sheet of epidermis and dermis detached from a donor site and placed on a recipient bed. It survives by imbibition and revascularization and requires a well-vascularized wound bed.

A skin graft containing epidermis and part of the dermis, harvested with a dermatome. It has a larger donor area and better take but contracts more than a full-thickness graft.

A skin graft including epidermis and the entire dermis, often harvested from the groin or postauricular area. It provides better color match and less contraction but requires a smaller, better-vascularized bed.

Sequential shaving of burn eschar in thin layers until viable, bleeding tissue is reached. It preserves deep dermis and is typically performed in the first days after injury.

Surgical division of fascia to relieve compartment pressure and restore perfusion. It is indicated for compartment syndrome and for circumferential deep burns with impaired distal circulation.

Elevated pressure within a closed fascial space that compromises tissue perfusion. Hallmarks include pain out of proportion, tense swelling, and pain on passive stretch; treatment is urgent fasciotomy.

Localized tissue damage from sustained pressure and shear, typically over bony prominences in immobile patients. Staging guides treatment, from offloading and debridement to flap coverage.

Surgical removal of devitalized, contaminated, or infected tissue to promote healing and prepare a wound bed. It is repeated until healthy, bleeding tissue remains.

Implantation of a silicone expander that is gradually inflated to stretch adjacent skin, generating extra tissue for reconstruction. It is used in breast, scalp, and burn scar reconstruction.

Identification and removal of the first draining lymph node(s) from a tumor using dye or radiotracer. It stages regional nodal status in melanoma and breast cancer while sparing unnecessary dissection.

A malignant neoplasm of melanocytes with potential for early metastasis. Management includes wide local excision with margins based on Breslow thickness and consideration of sentinel node biopsy.

Chronic swelling from impaired lymphatic drainage, often after lymph node dissection or radiation. Management includes compression, manual drainage, and surgical options such as lymphovenous anastomosis.

Noninvasive measurement of tissue oxygen saturation, used to monitor flap perfusion. A falling value may signal arterial or venous compromise before clinical signs become apparent.

Radiographic assessment of skeletal and dental relationships from a lateral skull film. It quantifies jaw position and guides orthognathic treatment planning and postoperative evaluation.

The distance between a resected tumor and the surgical edge of the specimen. Adequate margins reduce recurrence risk and are measured on pathologic examination to guide further treatment.

A patient's voluntary agreement to a procedure after understanding its nature, risks, benefits, and alternatives. It is a core ethical and legal requirement in surgical practice.

A collaborative process in which clinician and patient discuss options, evidence, and patient values to reach a treatment choice. It supports patient autonomy and improves satisfaction.

The process of explaining material risks, complications, and expected outcomes of a procedure in terms the patient can understand. It is essential to valid informed consent.

A situation in which financial or personal interests could compromise professional judgment or patient welfare. Disclosure and management are required to preserve trust and integrity.

Evaluation of a clinician's care or scholarly work by colleagues with comparable expertise. It supports quality improvement, credentialing, and the integrity of scientific publication.

A structured, confidential case review meeting where adverse events and complications are analyzed to identify system and process improvements. It is a cornerstone of surgical quality assurance.

Clinical decision-making that integrates the best available research evidence with clinician expertise and patient values. It emphasizes critical appraisal of study design and applicability to the individual patient.