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Flashcards in Skin grafts Deck (19)
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1
Q

Name the four different types of skin flap

A

Rotational
Advancement
Transposition
Skin fold flaps

2
Q

What are the principles of a skin flap?

A

wider base than body
avoid narrowing
limit size
Go below the panniculus to maintain blood supply
Take from area of ample skin
avoid excess motion or stress at donor site

3
Q

What is the general technique to preform a skin graft?

A
pre-op assessment 
wide clip 
marker to outline flap
meticulous technique (avoid trauma to vessels/flap)
undermine below the panniculus/deep dermis
use stay sutures 
avoid tension/twisting
close recipient site
manage dead space drain vs sutures
close donor site
4
Q

What is an advancement flap?

A

flap parallel to line of least tension
flap stretched onto defect
loose skin adjacent to wound
prone to dehiscene

5
Q

What is a rotational flap?

A

Skin rotates to close triangular defect
radius of rotation= length of the wound
arc 4 times wound width

6
Q

What is a Transposition flap?

A

Flap parallel to tension
rotated into defect
maximise width of base
length equal to pivot arc

7
Q

What is a skin fold flap?

A

Axillary or inguinal skin folds
Versatile large flap
sternal and groin areas

8
Q

What are the complications associated with skin flaps?

A

Dehiscence
Necrosis
seroma

9
Q

What are axial pattern flaps?

A

Very larger flaps more likely to survive maintain arteries
Direct cutaneous artery
superficial landmarks
flap dimensions depend on conformation

10
Q

What are the indications for axial pattern flaps?

A

Size
large wounds, flank, proximal limb, reconstruction after tumour removal
Vascularity
chronic non-healing wound, avascular wound
Tisses
coverage exposed bone provision of muscle bulk

11
Q

What are the advantages of an axial pattern flap?

A
Durable full thickness skin 
predictable blood supply 
normal hair growth 
mobility less of a problem 
much larger than subdermal flaps
12
Q

Why is planning important when creating an axial pattern skin flap?

A

Donor site
defect size and location
draw landmarks, vessel origin and flap outline in marker pen
Is drain placement necessary

13
Q

What is a meticulous technique?

A

Avoid trauma of the blood vessels and tip of flap

undermine below the panniculus muscle

14
Q

How is the axial pattern skin flap isolated?

A

Skin incisions start peripherally
stay sutures at the tip
Work from peripheral tip to ventral vessel
identify blood vessel as soon as possible

15
Q

List the big four types of axial pattern flaps

A

Thoracodorsal
omocervical
caudal superficial epigastric
deep circumflex illiac

16
Q

What are the thoracodorsal flap landmarks, artery it is supplied by and it use?

A
Thoracodorsal artery 
landmarks
Vessel-caudal shoulder depression 
cranial-scapular spine 
caudal- parallel to cranial border
Length-to midline/shoulder 
Use
shoulder forelimb elbow axilla, thorax, carpus (cat)
17
Q

What are the caudal epigastric flap landmarks, artery it is supplied by and it use?

A

Blood vessel
external pudendal, caudal superficial epigastric artery
Landmarks
Vessel-inguinal region
medial-ventral midline
lateral- parrallel to medial
Uses
caudal trunk, inguinal region, perineum, pelvic limb
(take pectoral fascai, incorporate base of the prepuce, mammary tissue remains functional)

18
Q

What post-op care is carried out for skin flaps?

A
aseptic technique 
bandage change always sedated 
immobilisation of the limb 
reduce dead space (via bandaging)
Analgesia
19
Q

What complications may occur with skin flaps?

A
flap necrosis 
recepient wound 
seroma
failure to adhere
dehiscence 
infection