E-Book, Englisch, 1182 Seiten, ePub
Jones / Janis Essentials of Plastic Surgery: Q&A Companion
2. Auflage 2023
ISBN: 978-1-63853-657-4
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 1182 Seiten, ePub
ISBN: 978-1-63853-657-4
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
by renowned plastic surgeons Alex P. Jones and Jeffrey E. Janis mirrors expanded content and new chapters in the parent book, . The third edition of the parent book includes 127 chapters, which reflects the increased scope, breadth, and depth of plastic surgery since publication of the last edition. The companion book employs the same style and formatting, with select illustrations from the parent book, as well as additional unique images created for this text. The print book is accompanied by a complimentary eBook that is accessible on smartphones and tablets.
Key Features
- More than 1600 questions formatted as multiple-choice questions complement and highlight the content contained in the parent book
- Questions specifically designed to test the reader on the clinical application of this knowledge
- Succinct yet detailed answers enhance acquisition and retention of knowledge
- The conveniently compact format fits in a lab coat pocket and is designed and organized to enable quick and easy reading
This is an invaluable, go-to resource for plastic surgeons throughout training and can be used as a refresher and revalidation of knowledge as their careers progress.
This print book includes complimentary access to a digital copy on https://medone.thieme.com.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
Part I Fundamentals and Basics
1 Wound Healing
2 General Management of Complex Wounds
3 Sutures and Needles
4 Basics of Flaps
5 Perforator Flaps
6 Tissue Expansion
7 Vascularized Composite Allografts and Transplant Immunology
8 Basics of Microsurgery
9 Biomaterials
10 Negative Pressure Wound Therapy
11 Lasers in Plastic Surgery
12 Anesthesia
13 Pain Management in Plastic Surgery
14 Photography for the Plastic Surgeon
15 Decreasing Complications in Plastic Surgery
Part II Skin and Soft Tissue
16 The Bascis of Skin
17 Basics of Plastic Surgery: Wound Closure
18 Scars and Scar Management
19 Skin Grafting
20 Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma
21 Burns
22 Vascular Anomalies
23 Congenital Melanocytic Nevi
Part III Head and Neck
24 Head and Neck Embryology
25 Surgical Treatment of Migraine Headaches
26 Craniosynostosis
27 Craniofacial Clefts
28 Distraction Osteogenesis
29 Cleft Lip
31 Cleft Palate
31 Velopharyngeal Dysfunction
32 Microtia
33 Prominent Ear
34 Facial Soft Tissue Trauma
35 Facial Skeletal Trauma
36 Mandibular Fractures
37 Basic Oral Surgery
38 Principles of Head and Neck Cancer: Staging and Management
39 Scalp and Calvarial Reconstruction
40 Eyelid Reconstruction
41 Nasal Reconstruction
42 Cheek Reconstruction
43 Ear Reconstruction
44 Lip Reconstruction
45 Mandibular Reconstruction
46 Pharyngeal and Esophageal Reconstruction
47 Facial Reanimation
48 Face Transplantation
Part IV Breast
49 Breast Anatomy and Embryology
50 Congenital Breast Deformities
51 Breast Augmentation
52 Mastopexy
53 Augmentation-Mastopexy
54 Breast Reduction
55 Gynecomastia
56 Breast Cancer
57 Autologous Breast Reconstruction
58 Implant-Based Breast Reconstruction
59 Secondary Breast Reconstruction
60 Nipple-Areolar Reconstruction
Part V Trunk and Lower Extremity
61 Chest Wall Reconstruction
63 Abdominal Wall Reconstruction
63 Posterior Trunk Reconstruction
64 Perineal Reconstruction
65 Genitourinary Reconstruction
66 Pressure Sores
67 Lower Extremity Reconstruction
68 Foot Ulcers
69 Lymphedema
Part VI Hand, Wrist, and Upper Extremity
70 Hand Anatomy and Biomechanics
71 Basic Hand Examination
72 Congenital Hand Anomalies
73 Carpal Bone Fractures
74 Carpal Instability and Dislocations
75 Distal Radius Fractures
76 Metacarpal and Phalangeal Fractures
77 Phalangeal Dislocations
78 Fingertip Injuries
79 Nail Bed Injuries
80 Flexor Tendon Injuries
81 Extensor Tendon Injuries
82 Tendon Transfers
83 Nerve Transfers
84 Hand and Finger Amputations
85 Replantation
86 Hand Transplantation
87 Targeted Muscle Reinnervation
88 Hand Rehabilitation
89 Thumb Reconstruction
90 Soft-Tissue Coverage of the Hand and Upper Extremity
91 Compartment Syndrome
92 Upper Extremity Compression Syndromes
93 Brachial Plexus
94 Nerve Injuries
95 Hand Infections
96 Benign and Malignant Masses of the Hand
97 Dupuytren's Disease
98 Rheumatoid Arthritis
99 Osteoarthritis
100 Vascular Disorders of the Upper Extremity
Part VII Aesthetic Surgery
101 Aesthetic Facial Anatomy
102 Facial Analysis
103 Basics of Skin Care
104 Neurotoxins
105 Soft-Tissue Fillers
106 Chemical Peels
107 Fat Grafting
108 Hair Transplantation
109 Brow Lift
110 Blepharoplasty
111 Blepharoptosis
112 Face Lift
113 Neck Lift
114 Perioral Rejuvenation
115 Rhinoplasty
116 Secondary Rhinoplasty
117 Genioplasty
118 Liposuction
119 Brachioplasty
120 Abdominoplasty
121 Medial Thigh Lift
122 Body Contouring in the Massive-Weight-Loss Patient
123 Buttock Augmentation
124 Male Aesthetic Plastic Surgery
125 Female Aesthetic Genital Plastic Surgery
126 Gender Affirmation Surgery
127 Noninvasive Body Contouring
2.General Management of Complex Wounds
See Essentials of Plastic Surgery, third edition, pp. 12–20
BLOOD GLUCOSE CONTROL
1.A diabetic patient is scheduled to undergo abdominal wall reconstruction. Preoperative hemoglobin A1C is 12% and random blood glucose (RBG) level is 200 mg/dL. Which one of the following is correct?
A.A normal A1C should be 8.5 when expressed as a percentage of glycosylated hemoglobin.
B.The A1C represents the patient’s average glucose control over the previous 180 days.
C.Postoperative infection risk is significantly increased for this patient because the blood glucose level is higher than 180 mg/dL.
D.Tight blood glucose control (<70 mg/dL) during the perioperative period will reduce the postoperative mortality risk.
E.An elevated A1C level linearly correlates with an increased risk of surgical site infections.
PREOPERATIVE ASSESSMENT OF NUTRITION
2.When assessing a patient’s preoperative nutritional status before major surgery by monitoring blood albumin levels, which one of the following is correct?
A.The half-life of albumin is 3 days.
B.A preoperative value of 4.3 g/dL is outside the normal range.
C.Assessment is based on the “rule of fives.”
D.Severe malnutrition would be suggested by preoperative values less than 3.0 g/dL.
E.A low preoperative level is a strong predictor for postoperative mortality risk.
IMAGING IN COMPLEX WOUNDS
3.A 67-year-old smoker has exposed hardware after a wound breakdown over his tibial fracture. The hardware has been removed, but his wound is not progressing. His dorsalis pedis pulse is not palpable, and the posterior tibial pulse is weak. Which one of the following modalities is the most accurate and least harmful for imaging of this patient’s peripheral arterial disease status and leg vessel anatomy?
A.Magnetic resonance angiography (MRA)
B.Plain radiographs
C.Computerized tomography angiography (CTA)
D.Ultrasound
E.Contrast angiography
VASCULAR ULCER MANAGEMENT
4.After assessing a patient who is malnourished and has a punched-out ulcer on the lower lateral leg, you decide to perform an ankle-brachial pressure test, which shows a value of 0.4. What does this result suggest?
A.Normal lower limb vasculature.
B.Imminent ischemic gangrene is likely.
C.Critical stenosis is present that warrants further intervention.
D.Vessels are significantly calcified.
E.Predominantly venous disease.
TISSUE RECONSTRUCTION AND WOUND CLOSURE
5.What was the main limitation of the original reconstructive ladder concept?
A.It did not include free tissue transfer.
B.The concept could only be practiced by plastic surgeons.
C.It did not include dermal matrices or negative pressure therapy.
D.The reconstructive process was performed in a stepwise manner.
E.Primary closure was the first rung on the ladder.
NEGATIVE PRESSURE WOUND THERAPY
6.You are planning to temporize an abdominal wound with a negative pressure dressing after debridement. Which one of the following is correct regarding negative pressure wound therapy?
A.It increases local blood flow and granulation tissue production.
B.It reduces fluid exudate.
C.It is contraindicated in recently debrided wounds.
D.It can be useful for treating fistulas.
E.It reduces mitotic activity in the wound.
WOUND DEBRIDEMENT
7.A 47-year-old paraplegic patient presents with a grade 3 sacral pressure sore. Examination shows a 7 ? 8 cm chronic wound with eschar, fibrinous exudate, and granulation in the wound bed. In order to optimize accuracy at the time of surgical debridement, which one of the following adjuncts would be most useful intraoperatively?
A.Quantitative tissue cultures
B.Frozen section biopsy
C.Iodine brown solution
D.Methylene blue dye
E.Indocyanine green dye
COMPLICATIONS OF RADIOTHERAPY
8.A 68-year-old male has undergone postsurgical radiotherapy to the right side of the neck and mandible for management of an intraoral squamous cell carcinoma (SCC). He now presents with symptoms of pain and swelling over the mandible and has reduced mouth opening. Examination shows bone exposed through the skin surface (sequestrum). Which one of the following would be the most useful for treatment of this clinical problem?
A.Hyperbaric oxygen
B.Transcutaneous oxygen tension
C.Stem cell therapy
D.Platelet-rich plasma
E.Tissue biopsy and cultures
SELECTION OF SKIN SUBSTITUTES
9.You are considering the use of a biologic skin substitute in a patient with a burn. Your patient is concerned about the use of tissues from animals and states that he would only consent to products that are purely synthetic or human derived. Which one of the following products is acceptable for use in this patient?
A.Biobrane
B.Apligraf
C.Transcyte
D.SurgiMend
E.AlloDerm
BIOLOGIC SKIN SUBSTITUTES
10.Which one of the following biologic dressings is a bilayer construct containing bovine collagen, human fibroblasts, and keratinocytes?
A.Matriderm
B.ReCell
C.Acelagraft
D.Epicel
E.Apligraf
Answers
BLOOD GLUCOSE CONTROL
1.A diabetic patient is scheduled to undergo abdominal wall reconstruction. Preoperative hemoglobin A1C is 12% and random blood glucose (RBG) level is 200 mg/dL. Which one of the following is correct?
C.Postoperative infection risk is significantly increased for this patient because the blood glucose level is higher than 180 mg/dL.
In patients with or without diabetes, perioperative hyperglycemia (>180 mg/dL) carries a significantly increased risk of postoperative wound infection.1
The hemoglobin A1C is a blood test used to assess the long-term control of blood glucose. Because hemoglobin molecules remain in the blood for 3 months, it is possible to gauge glucose control over a 120-day period (not 180 days) by measuring glycosylated hemoglobin levels. A normal hemoglobin A1C is around 6%. Tight blood glucose control with intensive insulin therapy and normoglycemia (<110 mg/dL) has shown a reduction in hospital deaths in some trials.2 However, where glucose control is <7 mg/dL, there is an increased risk of death in critically ill patients.3 Although postoperative hyperglycemia and undiagnosed diabetes increase the risk of surgical site infections, elevated hemoglobin A1C does not linearly correlate.4,5
REFERENCE
1.Kwon S, Thompson R, Dellinger P, Yanez D, Farrohki E, Flum D. Importance of perioperative glycemic control in general surgery: a report from the Surgical Care and Outcomes Assessment Program. Ann Surg 2013;257(1):8–14
2.Vanhorebeek I, Langouche L, Van den Berghe G. Tight blood glucose control: what is the evidence? Crit Care Med 2007;35(9, Suppl):S496–S502
3.Finfer S, Liu B, Chittock DR, et al; NICE-SUGAR Study Investigators. Hypoglycemia and risk of death in critically ill patients. N Engl J Med 2012;367(12):1108–1118
4.King JT Jr, Goulet JL, Perkal MF, Rosenthal RA. Glycemic control and infections in patients with diabetes undergoing noncardiac surgery. Ann Surg 2011;253(1):158–165
5.Latham R, Lancaster AD, Covington JF, Pirolo JS, Thomas CS Jr. The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol 2001;22(10):607–612
PREOPERATIVE ASSESSMENT OF NUTRITION
2.When assessing a patient’s preoperative nutritional status before major surgery by monitoring blood albumin levels, which one of the following is correct?
E.A low preoperative level is a strong predictor for postoperative mortality risk.
Albumin can provide a useful indication of nutrition. Its half-life is 20 days, and a normal value is 3.6–5.4 g/dL. A value of 2.8–3.5 g/dL suggests mild malnutrition, 2.1–2.7 g/dL suggests moderate malnutrition, and less than 2.1 g/dL indicates severe malnutrition. A large study published in 1999 involving more than 50,000 patients showed that as preoperative albumin levels decreased, early postoperative mortality and morbidity increased exponentially.1 The authors concluded that albumin was a useful predictor of outcome in major surgical procedures.
Prealbumin, rather than albumin, has a half-life of 3 days and can be assessed by the rule of fives. A normal value is greater than 15 mg/dL, mild...
