An advantage of full thickness skin graft (FTSG) versus split-thickness skin grafts (STSG) is:
A. Increased contracture rate
B. Decreased amount of skin appendages
C. Improved overall aesthetics
D. Less resilient to trauma
C. Full-thickness skin grafts are indicated for multiple reconstructive procedures. Long term, they have less of a contracture rate than split-thickness grafts. Due to the fact that it is full thickness, the number of skin appendages is actually increased. This allows for improved graft incorporation. This also makes them more resilient to trauma in both the immediate and long-term recovery. The aesthetics of a FTSG are generally better than a STSG due to the factors noted.
The maximum safe length to width ratio for a random pattern flap is:
B. A random pattern flap does not have a truly dedicated vascular pedicle to keep it alive. Therefore, due to its random pattern the length to width ratio is crucial for its survival. For example, if a 3-cm-long flap is required, the width should not be less than 2 cm, meaning a 1.5:1 ratio.
A 25-year-old man presents with a long-standing ischial pressure sore. After debridement and partial ischiectomy, the best choice for tissue coverage is:
C. Split-thickness skin graft
B. The ischial pressure sore is a commonly encountered problem for the plastic surgeon. Adequate tissue coverage is mandatory, meaning skin graft and primary closure is not adequate. The rectus femoris would not be best suited to reach the ischium. The gracilis flap is a versatile flap that has been thoroughly described for pressure sore management.
Which of the following is characteristic of an arteriovenous malformation (AVM)
C. Growth proportional with patient
C. An AVM develops from arterial and venous misconnections. Over time this can lead to significant health consequences. Glut-1 is associated with hemangiomas. AVMs usually grow in proportion with the patient and do not usually express a rapid growth phase. In most cases, AVMs do not undergo involution on their own.
A 40-year-old woman presents after mastectomy and radiation therapy. The best aesthetic method for breast reconstruction is:
B. Tissue expanders followed by implants
C. Acellular dermal matrices (ADM) with implants
E. The TRAM flap has been shown to be extremely versatile and provides the best aesthetic breast reconstruction for those patients with radiation therapy. When radiation therapy is involved, implants in general have been shown to cause more complications and less than desirable results.