Egyptian Board Plastic Surgery flashcards

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

Rule of nines adult

Head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%. Used to estimate total body surface area burned for fluid resuscitation.

Parkland formula

4 mL/kg/% total body surface area burn of lactated Ringer's in the first 24 hours, half given in the first 8 hours from injury time; urine output goal 0.5-1 mL/kg/h.

Kanavel signs

Four signs of flexor tenosynovitis: fusiform swelling, tenderness along the flexor sheath, pain on passive extension, and the finger held in slight flexion.

Z-plasty lengthening

Two triangular flaps transposed to lengthen a contracture. A 60-degree angle gives about 75% theoretical lengthening, 45 degrees about 50%, and 30 degrees about 25%.

Skin graft take phases

Grafts survive by plasmatic imbibition for 24-48 hours, then inosculation and revascularization. Full-thickness grafts need a well-vascularized bed for reliable take.

Fibula free flap

Osseous free flap used for segmental mandibular reconstruction. It provides reliable bone stock, a long pedicle, and allows osseointegrated dental implants.

Radial forearm flap

Thin fasciocutaneous free flap based on the radial artery and venae comitantes, commonly used for tongue, floor of mouth, and other head and neck defects.

Seddon nerve injury

Neurapraxia is conduction block with recovery in weeks; axonotmesis is axon loss with intact endoneurium and spontaneous regeneration; neurotmesis is transection requiring repair.

Hypertrophic scar vs keloid

Hypertrophic scars stay within the original wound and often regress. Keloids extend beyond the wound boundary, rarely regress, and recur after excision alone.

Cleft lip repair timing

Lip repair is typically performed at 3-6 months using the rule of 10s: 10 weeks of age, 10 lb weight, and 10 g/dL hemoglobin.

Cleft palate repair timing

Palate repair is typically performed at 9-12 months of age to support speech development, using techniques such as von Langenbeck, Bardach, or Furlow.

Craniosynostosis patterns

Sagittal synostosis causes scaphocephaly; coronal synostosis causes plagiocephaly; metopic synostosis causes trigonocephaly; surgical release relieves raised intracranial pressure.

Pierre Robin sequence

Micrognathia, glossoptosis, and cleft palate. Airway management includes prone positioning, nasopharyngeal airway, or mandibular distraction.

Infantile hemangioma

Benign vascular tumor that proliferates then involutes; propranolol is first-line therapy. Vascular malformations do not involute and require intervention based on type.

Informed consent elements

Diagnosis, proposed procedure, alternatives including no treatment, material risks, benefits, and the right to withdraw consent at any time.

WHO surgical checklist

Sign in before induction, time out before incision, and sign out before leaving the operating room; reduces wrong-site surgery and communication errors.

Operating room fire triad

Fire requires fuel, oxidizer, and ignition. Stop oxygen before electrocautery near the face; use wet drapes and appropriate laser precautions.

Sensitivity and specificity

Sensitivity is true positives divided by all diseased; specificity is true negatives divided by all non-diseased. Predictive values depend on disease prevalence.

Number needed to treat

One divided by the absolute risk reduction; lower NNT means greater clinical benefit. Number needed to harm is the reciprocal of absolute risk increase.

Levels of evidence

Systematic reviews and meta-analyses of randomized trials rank highest; then randomized trials, cohort studies, case-control studies, case series, and expert opinion.

Carpal tunnel syndrome

Median nerve compression causing night pain, thenar atrophy, and positive Tinel and Phalen tests; treatment is release of the transverse carpal ligament.

Dupuytren contracture

Palmar fascia fibrosis with nodules and cords; treatment options include needle aponeurotomy, collagenase injection, and limited fasciectomy, with common recurrence.

Scaphoid fracture risk

Anatomic snuffbox tenderness suggests scaphoid fracture; the proximal pole is at risk of avascular necrosis. Immobilize and use CT or MRI for occult fractures.

Flexor zone II repair

Repairs in no man's land require core suture plus epitendinous repair and early controlled mobilization to limit adhesions and preserve tendon glide.

Tumescent liposuction

Dilute lidocaine and epinephrine infiltration reduces blood loss and pain; limit total aspirate and lidocaine dose and monitor for fat embolism and fluid shifts.

Dual-plane breast augmentation

Implant placement where the upper pole is under the pectoralis muscle and the lower pole is subglandular, improving upper pole coverage and lower pole shape.

BIA-ALCL

Breast implant-associated anaplastic large cell lymphoma, a rare risk associated with textured implants, presenting as late periprosthetic fluid or mass.

SMAS plication

Superficial musculoaponeurotic system suspension during face lift improves jawline and neck contour and longevity compared with skin-only elevation.

Neck dissection levels

Level I submental and submandibular; II upper jugular; III mid jugular; IV lower jugular; V posterior triangle. Selective dissection preserves structures based on nodal risk.

Collagen cross-linking

Collagen hydroxylation requires vitamin C, iron, and alpha-ketoglutarate; deficiency impairs cross-linking and wound strength, as seen in scurvy.

Wound tensile strength

About 5% at 1 week, 20% at 3 weeks, and 70-80% of unwounded skin by 3 months; tensile strength never exceeds roughly 80% of original.

Free flap monitoring

Assess color, capillary refill, temperature, and bleeding with handheld or implantable Doppler; venous congestion is dark and tense, arterial failure is pale and cool.