Surgery 5th year, 1st lecture (Dr. Ari Raheem Qader)

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The lecture has been given on Apr. 14th, 2011 by Dr. Ari Raheem Qader.

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Surgery 5th year, 1st lecture (Dr. Ari Raheem Qader)

  1. 1. <ul><li>Plastic Surgery </li></ul>
  2. 2. What is Plastic Surgery? <ul><li>the term plastic surgery comes from the Greek word &quot;plastikos,&quot; which means to mold or to shape </li></ul><ul><li>branch of surgery, dealing with the remodelling of any portion of the human body that has been damaged or deformed </li></ul>
  3. 3. Types of Plastic Surgery <ul><li>Cosmetic Surgery </li></ul><ul><li>Reconstructive Surgery </li></ul>
  4. 4. <ul><li>Cosmetic plastic surgery: Surgery designed primarily to enhance or improve the looks of an individual who may not have a gross deformity or physical impairment </li></ul>
  5. 5. <ul><li>Abdominoplasty (or &quot;tummy tuck&quot;): reshaping and firming of the abdomen </li></ul><ul><li>Blepharoplasty (or &quot;eyelid surgery&quot;): Reshaping of the eyelids </li></ul><ul><li>Rhinoplasty (or &quot;nose job&quot;): Reshaping of the nose </li></ul>
  6. 6. <ul><li>Mammoplasty </li></ul><ul><ul><li>Breast augmentation (or &quot;breast enlargement&quot; </li></ul></ul><ul><ul><li>Breast reduction : Removal of skin and glandular tissue. </li></ul></ul><ul><ul><li>Breast lift (Mastopexy): Lifting or reshaping of breasts to make them less saggy, often after weight loss </li></ul></ul>
  7. 7. Reconstructive Surgery <ul><li>involves the restoration of function to a damaged body part and the rebuilding of normal physical contours when parts of the body—such as the nose, jaw, ears, or fingers—are missing or disfigured </li></ul>
  8. 8. Obtaining A Fine-Line Scar <ul><li>The final appearance of a scar is dependent on many factors: </li></ul><ul><li>(1) the type of skin and location on the body. </li></ul><ul><li>(2) the tension on the closure. </li></ul><ul><li>(3) the direction of the wound. </li></ul><ul><li>(4) co-morbid conditions. </li></ul><ul><li>(5) the technique used for closure. Minimizing damage to the skin edges with atraumatic technique, debridement of necrotic or foreign material. </li></ul>
  9. 9. <ul><li>Intrinsic Factors </li></ul><ul><li>1.Age. Loss of elasticity combined with changes in the subcutaneous tissue, produce wrinkling, which makes scars in older individuals less obvious and less prone to stretching. </li></ul><ul><li>2.Type of skin . Skin that is oily or pigmented, or both, produces more unsightly scars. </li></ul><ul><li>3.Certain anatomic areas produce unfavorable scars that tend to become hypertrophic or widened. The shoulder and sternal area are notable examples. On the other hand, eyelid scars almost always heal with a fine-line scar. </li></ul><ul><li>4.Nutritional status can affect wound healing. </li></ul><ul><li>5.Co-morbid conditions such as anemia can retard wound healing. . </li></ul>
  10. 10. Factors determine the severity of suture markers <ul><li>1.Time of removal of stitches . </li></ul><ul><li>2.diameter of the suture . </li></ul><ul><li>3. Relation to wound edges. </li></ul><ul><li>4. Region of the body. </li></ul><ul><li>5.Absence of infection. </li></ul><ul><li>6. Propensity for keloid. </li></ul>
  11. 11. Features of good scar <ul><li>1- Fine line scar </li></ul><ul><li>2- absence of contour irregularities </li></ul><ul><li>3- absence of pigmentary irregularities </li></ul><ul><li>4- no contracture or distortion </li></ul>
  12. 12. Methods of Excision <ul><li>1.Simple Elliptical Excision </li></ul><ul><li>2.Wedge Excision </li></ul><ul><li>Lesions located at or adjacent to free margins can be excised by wedge excisions. </li></ul><ul><li>3.Circular Excision </li></ul><ul><li>When preservation of the skin is required in areas such as the nose or the anterior surface of the auricle, the lesion can be excised in a circular manner and the defect closed with a skin graft or skin flap . </li></ul><ul><li>4.Multiple Excision Technique </li></ul><ul><li>Serial excision is frequently employed for large lesions </li></ul>
  13. 13. Reconstructive Ladder
  14. 14. <ul><li>Secondary Intention </li></ul><ul><li>Primary Suturing </li></ul><ul><li>Delay Primary Suturing </li></ul><ul><li>Secondary Suturing </li></ul><ul><li>Skin Graft </li></ul><ul><li>Flap </li></ul><ul><li>-Local -regional -Distant -Free </li></ul>
  15. 15. Secondary Intention
  16. 17. Primary Suturing
  17. 22. Delay primary suturing
  18. 23. Skin Graft
  19. 26. Flap

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