1. Plastic Surgery
STATIONS

2. STATION 6 STASIE Plastic surgery
1. Name the diagnosis
Gee die diagnose?
2. What other morphological
types of this condition may
be present.
Noem ander morfologiese
tipes van hierdie verskynsel
wat teenwoordig kan wees
3. How would you treat it?
Hoe sal u dit behandel?
Lentigo Maligna melanoma
Superficial spreading
Nodular
Acral Lentiginous
Excisional biopsy.
Sentinel LN biopsy for non-palpable nodes.
Lymphnode discection for palpable nodes.
Chemotherapy, IL 2 and Interferon Beta for mets.

3. STATION 7 STASIE Plastic Surgery
What type of wound is this and name one possible cause?Watter tipe wond is dit en noem ‘n moontlike oorsaak (1)
Name the principles of management/Noem die beginsels van behandeling (4)
Degloving injury
Industrial accident like machinery associated accident. PVA
2) Irigate with normal saline/sterile water.
Initial wound debridement.
Leave unsutured and put dressings on.
Back to theatre in hours for redebridement and closure by suture or skin graft.
Antibiotic cover.

4. STATION 8 STASIE Name the diagnosis/Gee die diagnose
Discuss the treatment/Bespreek die behandeling
What additional workup will be required/Watter bykomende voorbereiding word vereis
SCC
2) Surgical excision with primary closure for small lesion. Skin graft for large lesions.
Cryosurgery, electrocautery, curettage for superficial lesions with no nodal involvement.
Radiation in the elderly.
Block discection for palpable regional nodes
CXR for mets.

5. STATION 9 STASIE
Grade the depth of the burn injury/Watter graad van brandwonde is dit(1)
What are the principles of management/Bespreek die beginsels van behandeling(4)
2nd Degree burns
ABC. Prompt intubation if evidence of inhalation injury.
Fluid administration (Parkland formula)
Pain control, IV antibiotics, tetanus prophylaxis.
Initial cleansing and debridement.
Prevent contamination – sterile dressings.
Relief of constriction if present (escharotomy)
Restoration of epidermal cover (grafting)

6. STATION 10 STASIE
This child has been in a MVA (motor vehicle accident) He is fully conscious and systemically and neurologically normal.
Question:
What are the principals of management (5)
Die kind was in ‘n motorongeluk. Hy is by sy volle bewussyn en sistemies en neurologies is daar geen afwykings.
Vraag:
Noem die beginsels van sy behandeling )
ABC resuscitation.
Look for other injuries.
Analgesia and sedation.
Irrigate wound with normal saline/sterile water.
Debridement, suturing and healing with primary intention.
Antibiotic cover depending on degree of contamination and mode of injury.

7. Station SLIDE J
Name the diagnosis and discuss the management Noem die diagnose en bespreek die hantering.
What other morphological types of this condition may be present Hoe sal u die diagnose bevestig?
How would you treat it/ Hoe sal u dit behandel?
Acro lentiginous melanoma
b) Nodular
Superficial spreading
Lentigo maligna
Excisional biopsy.
Sentinel LN biopsy for non-palpable nodes.
Lymphnode discection for palpable nodes.
Chemotherapy, IL 2 and Interferon Beta for mets.

8. Watter persentasie van die totale liggaamsoppervlakte
STATION 7 SLIDE U
1) What degree of burns are visible?
Watter graad brandwonde is sigbaar?
2) What percentage total body surface is visibly involved?
Watter persentasie van die totale liggaamsoppervlakte
is sigbaar betrokke?
3) What is the management?
Hoe sal u dit hanteer?
Second degree:
+- 18 % According to rule of 9’s. In children the TBSA involved will be more extensive (Lund-Browder diagram)
Mx: Remove pt from source
ABC. Prompt intubation if evidence of inhalation injury.
Fluid administration (Parkland formula) (4ml/kg/%BSA involved. First half over first 8 hours. Rest over next 16 hours)
Monitor urine output (1ml/kg/h in children)
Pain control, IV antibiotics, tetanus prophylaxis.
Nasogastric decompression
Antacids: stress ulceration (Curling’s)
Initial cleansing and debridement.
Prevent contamination – sterile dressings (Flamazine).
Relief of constriction if present (escharotomy)
Restoration of epidermal cover (grafting)

9. Station 8 slide 101/ 2010 a) What is the diagnosis?
Wat is die diagnose? (1) b)
Wat is generally the number one priority in the management and name the principles involved
Wat is algemeen gesproke die nommer een prioriteit in die hantering , en benoem die beginsels betrokke ( 3) c)
What will be a surgical time protocol to correct this abnormality
Beskryf ‘n chirurgiese tyds -protokol om hierdie abnormaliteit te herstel (1)
Cleft lip and palate
Feeding problems: Special bottles, spoon feeding, feeding tube if needed.
Ear infection and hearing loss: Grommets
Speech and language delays: Speech therapy
Dental problems: Orthodontic involvement.
Repair lip at 0-3 months
Repair cleft palate at 5-12 months.
Small lip adjustment up to 5 years where needed.
Pharyngoplasty for nasal escape at 6-9 years.
9-11 years alveolar bone transplant and maxillary osteotomies
15-18 years small nasal adjustments.

10. Station SLIDE A
1) What are the possible aetiological reasons for this problem? Wat is die moontlike etiologiese oorsake van die probleem
2) Name the principles of management Noem die beginsels van hantering
Extrinsic factors: Pressure, friction, shear force
Intrinsic factors: Immobility, malnutrition, moisture, sensory loss.
Reduce pressure.
Mobilize
Maintain nutrition.
Wound debridement (mechanical, enzymatic, autolytic) and dressing applications.
Maintain moist wound environment for re-epithelialization)
Treat wound infection (antibiotics)

11. Station 10 Slide 100/2010 a) Wat is die mees algemene oorsaak?
What is the most likely etiological cause? (1) b)
Two other causes in the differetial diagnosis
Noem twee ander oorsake in die gedifferensiёle diagnose (1) c)
Principles of management
Beginsels van hantering?
(3)
SCC
Trauma/laceration
Ulcer: syphilitic underlying
Excise malignancy for biopsy.
Debridement and suturing for trauma.
Antimicrobial treatment for infection.