ABPS Plastic Surgery flashcards

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

Wound tensile strength timeline

Tensile strength is about 5% at one week, 20% at three weeks, and 70-80% of unwounded skin by six weeks, never fully returning to normal.

Collagen type in early wound

Type III collagen predominates in early granulation tissue and is progressively replaced by stronger type I collagen during the remodeling phase.

Langer lines

Relaxed skin tension lines follow the orientation of dermal collagen fibers; incisions parallel to them experience less tension and produce less conspicuous scars.

Hypertrophic scar vs keloid

Hypertrophic scars remain within the original wound and regress over time; keloids extend beyond wound borders, rarely regress, and commonly recur after excision.

Random-pattern flap ratio

Random-pattern skin flaps generally tolerate a length-to-width ratio near 1:1; axial flaps based on named direct cutaneous arteries exceed this limit safely.

Skin graft take phases

Grafted skin survives by plasmatic imbibition in the first 24-48 hours, inosculation at 48-72 hours, and subsequent revascularization from the recipient bed.

Split vs full-thickness graft

Full-thickness grafts contract less and provide better color match but require a well-vascularized bed; split-thickness grafts survive on poorer beds and re-epithelialize from adnexal remnants.

Pressure injury staging

Stage 1 is non-blanchable erythema; Stage 2 partial-thickness loss; Stage 3 full-thickness to fascia; Stage 4 to bone or tendon; eschar-obscured wounds are unstageable.

Wound healing phases

Healing proceeds through hemostasis (minutes to hours), inflammation (days 1-5), proliferation (days 5-21), and remodeling (weeks to more than a year).

DIEP flap

Deep inferior epigastric perforator flap is a perforator-based autologous breast reconstruction that preserves rectus abdominis muscle, reducing hernia and bulge risk.

TRAM flap drawback

Transverse rectus abdominis myocutaneous flap sacrifices rectus muscle, increasing risks of abdominal wall hernia, bulge, and weakness compared with perforator flaps.

Carpal tunnel syndrome signs

Median nerve compression causes nocturnal paresthesias in thumb, index, and middle fingers, positive Tinel and Phalen tests, and late thenar atrophy.

Dupuytren disease

Fibrosis of the palmar fascia forms nodules and cords causing finger contracture; metacarpophalangeal contracture is addressed before proximal interphalangeal joint contracture.

Cleft lip repair timing

Cleft lip repair is typically performed at 3-6 months using the rule of 10s: about 10 weeks, 10 pounds, and 10 g/dL hemoglobin.

Cleft palate repair timing

Cleft palate repair is usually performed at 9-12 months of age to restore palatal function before speech development and reduce otologic complications.

Parkland burn formula

Parkland formula gives 4 mL/kg per percent total body surface area of lactated Ringer's in 24 hours, half in the first 8 hours from burn time.

Free flap venous congestion

Venous congestion often presents earliest as a dusky, swollen flap with brisk dark bleeding and is a sign of compromised outflow requiring urgent revision.

Reduction mammaplasty pedicles

Common pedicle designs include inferior, superomedial, and vertical patterns; nipple-areola viability depends on preserving its dermal and ductal blood supply.

Craniosynostosis suture shapes

Sagittal fusion causes scaphocephaly, coronal fusion causes plagiocephaly, metopic fusion causes trigonocephaly, and lambdoid fusion causes posterior plagiocephaly.

Apert syndrome features

Apert syndrome, an FGFR-related craniosynostosis syndrome, includes midface hypoplasia and complex syndactyly of the hands and feet (mitten deformity).

Z-plasty effect

A Z-plasty with 60-degree angles lengthens the scar along its central limb by about 75% and reorients it to reduce contracture.

Kanavel signs

Flexor tenosynovitis shows finger held in flexion, fusiform swelling, tenderness along the sheath, and pain on passive extension, requiring urgent drainage.

Digital nerve repair

Sharp digital nerve lacerations are repaired primarily with epineurial sutures; gaps over 2-3 cm may need nerve graft or conduit, with better recovery distally.

Spreader grafts

Spreader grafts placed between upper lateral cartilages and the septum widen the internal nasal valve, improving airway and preventing middle vault collapse.

Abdominoplasty complications

Abdominoplasty risks include seroma, wound dehiscence, umbilical necrosis if the stalk is devascularized, and thromboembolism; rectus plication narrows the waist.

Lipedema vs lymphedema

Lipedema is bilateral, symmetric, painful leg fat deposition sparing the feet; lymphedema is often asymmetric with pitting edema and dorsal foot involvement.

Basal cell carcinoma

Basal cell carcinoma is the most common skin cancer, locally destructive with rare metastasis; surgical excision with margin control is standard treatment.

Melanoma sentinel node biopsy

Sentinel lymph node biopsy is generally offered for melanoma with Breslow depth greater than 0.8-1.0 mm or other high-risk features such as ulceration.

Immediate vs delayed reconstruction

Immediate breast reconstruction is performed at mastectomy, often with skin preservation; delayed reconstruction follows oncologic treatment, sometimes after radiation.

Mandible fracture fixation

Displaced or unstable mandible fractures are treated with anatomic reduction and open rigid internal fixation using plates; many condylar fractures are managed closed.

Nipple-areola blood supply

The nipple-areola complex is supplied by dermal, subdermal, and ductal perforators; preserving an appropriate pedicle prevents necrosis in reduction or mastopexy.

Stemmer sign

Inability to pinch and lift the skin on the dorsum of the toe or finger suggests lymphedema rather than lipedema or simple edema.