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Plastic Surgery STATIONS 6 - 10.

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Presentation on theme: "Plastic Surgery STATIONS 6 - 10."— Presentation transcript:

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.


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