Flaps & Grafts

Flaps & Grafts

Question 1 - The difference between a skin graft and skin flap is:

There is no difference

Blood supply

Nerve supply

Epidermal involvement

Question 2 - What are the stages of the graft “take”?

Imbitition, inosculation, neovascular ingrowth

Inosculation, imbitition, neovascular ingrowth

Hemostasis, inflammatory phase, proliferative phase, maturation

Imbition, neovascular ingrowth, inosculation

Question 3 - Which of the following is NOT a local flap?

Transpositional

Rotational

Advancement

Pedicle

Question 4 - A 45-year-old woman undergoes a deep inferior epigastric perforator (DIEP) flap procedure for reconstruction of her right breast after a masectomy for breast cancer. Which of the following is an indication of poor flap health?

Warm to touch and pink in colour

Moderate Doppler strength and increased signal when flap is compressed

Rapid capillary refill

Slow bleeding on needle puncture

Question 5 - Which of the following statements is CORRECT regarding split thickness skin grafts?

They require subsequent closure of the donor site

They have less primary contraction but more secondary contraction compared to FTSG

They have more primary contraction but less secondary contraction compared to FTSG

They are often used to cover facial deficits due to their favorable cosmetic result

Question 6 - The features of a split thickness skin graft include all of the following except:

The graft includes the epidermal layer as well as a portion of the dermis of variable thickness

The graft donor site heals via reepithelialization from the edges of the wound as well as from the epithelium-lined dermal appendages (ie. Hair follicles) that are remaining in the base of the wound

The graft donor site cannot heal via reepithelialization, but rather must be closed by primary intention or be grafted using a split-thicknes skin graft

A thinner split thickness graft is more successful to take than a thicker graft because less vascular ingrowth is required to maintain viability of the graft

The secondary contraction that occurs during the healing phase is greater in a graft that contains a lesser thickness of dermis

Question 7 - Which of the following is NOT a cause of graft loss

Hematoma and/or seroma under the graft

Poorly vascularized recipient site

Plasmatic imbibition

Shearing forces between graft and recipient site

Infection/colonization

Question 8 - The difference between a split-thickness graft (STSG) and a full-thickness skin graft is:

A FTSG covers more surface area than a STSG

A FTSG has its own blood supply whereas a STSG does not

A STSG contains epidermis and part of the dermis whereas a FTSG contains epidermis and all of the dermis

Question 9 - The definition of an allograft is:

Graft from one place to another on same individual

Graft from one individual to another of same species

Graft from one individual to another of a different species

Artificial graft

Question 10 - The difference between a free flap and a graft is:

A free flap has veins and arteries intact

A graft has veins and arteries intact

A graft may consist of bone, but a flap consists only of soft connective tissues

A flap may consist of bone, but a graft consists only of soft connective tissues

Question 11 - Which of the following regarding split-thickness versus full-thickness skin grafts is FALSE?

STSG has the advantage of more sites

There is lower rate of survival with FTSG

There is greater secondary contraction with FTSG

The aesthetic result of STSG is usually poor

12 Full thickness skin graft can be taken from the following sites except  ?
a) Elbow b) Back to neck
c) Supraclavicular area d) Upper eyelids

answer a

13Free skin graft is rejected on   ?
a) Muscle b) Fat
c) Deep fascia d) Dermis

answer b 

14 Skin graft for facial wounds is taken from
a) Medial aspect of thigh b) Cubital fossia
c) Groin d) Post auricular region

15 The best skin graft for open wounds is –
a) Isograft b) Homograft
c) Allograft d) Autograft

16 The organism causing destruction of skin grafts is
a) Streptococcus b) Staphylococcus
c) Pseudomonas d) Clostridium

17 For on open wound of leg with exposure of bone, treatmen of choice
a) Partial skin graft b) Complete skin graft
c) Pedicle graft d) Reverdin graft

18 Graft is not taken up on the following
a) Fat b) Muscle
c) Deep fascia d) Skull bone

19 Man sustained an injury with loss of skin cover exposing bone of 10×10 cms. The best treatment is –
a)Full thickness graft
b)Pedicle graft c)Amnion
d)Split thickness skin graft

20 Skin graft survival in the first 48 hrs is dependent on
a)Random connection between
host & donor capillaries
b)Plasmatic imbibition
c)Saline in dressing
d)Development of new blood vessels

21 Skin grafting is not done in infection with
a)Pseudonmonas aeroginosa
b)Staph. Aureus
c)Beta hemolytic streptococci d)E. coli

22vSplit skin graft can be applied over
a) Muscle b) Bone
c) Cartilage d) Eyelid

23 Best procedure to be done after an injury to leg associated with exposure of underlying bone and skin loss
a) Pedicle flap b) Split skin grafting
c) Full thickness grafting d) Skin flap

24 Dacron vascular graft is
a) Nontextile synthetic b) Textile synthetic c) Nontextile biologic d) Textile biologic

25 Which one of the following statements about Mesh Skin Grafts is not correct?
a)They permit coverage of large areas -True
b)They allow egrees of fluid collections under the graft) -True
c)They contract to the same degree as a grafted sheet of skin
d)They "take" satisfactorily on a granulating bed

26 Split skin grafts in young children should be harvested from
a) Buttocks b) Thigh
c) Trunk d) Upper limb

27 Wolfe grafts is
a)Full thickness -skin grafts b)Partial thickness skin grafts
c)Split-skin grafts
d)Pedicled flap

28 Deep skin burns is treated with
a)Split thickness graft
b)Full thickness graft
c)Amniotic membrane
d)Synthetic skin derivatives

29 Skin flap is used in all except
a) Bone b) Tendon
c) Burn wound d) Cartilage

30 The subdermal plexus forms the vascular basis for –
a)Randomised flaps
b)Axial flaps
c)Mucocutaneous flaps
d)Vasciocutaneous flaps

31 full thickness loss of middle one third of the upper lip is best reconstruted by
a) Naso labial flap b) Cheek flap
c) Abbey flap d) Estlander’s flap

32 In the reconstruction following excision of previously irradiated cheek cancer, the flap will be –
a)Local tongue
b)Cervical
c)Forehead
d)Pectoralis major myocutaneous

33 Reconstruction of the breast following total mastectomy for cancer is done ideally by using –
a)Distant tube pedicvle
b)Opposite breast
c)Trapezius myocutaneous flap
d)Latissmus dorsi myocunaneous flap

34 Flap commonly used in breast reconstruction is

 -a) Serratus anterior b) TRAM 
c) Flap from arm d) Delto pectoral flap