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Chapter 41. Plastic & Reconstructive Surgery

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:

A. 1:1

B. 1.5:1

C. 2:1

D. 2.5:1

E. 3:1

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:

A. Rectus femoris

B. Gracilis

C. Split-thickness skin graft

D. Primary closure

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)


B. Rapid growth

C. Growth proportional with patient

D. Sporadic involution

C. An AVM develops from arterial and venous misconnections. Over time this can lead to significant health consequences. Glut-1 is ...

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