All of the following are true about split-thickness skin grafts EXCEPT:
Many of the characteristics of a split-thickness graft are determined by the amount of dermis present. Less dermis translates into less primary contraction (the degree to which a graft shrinks in surface area after harvesting and before grafting), more secondary contraction (the degree to which a graft shrinks during healing), and better chance of graft survival. Thin split grafts have low primary contraction, high secondary contraction, and high reliability of graft take, often even in imperfect recipient beds. Thin grafts, however, tend to heal with abnormal pigmentation and poor durability compared with thick split grafts and full-thickness grafts. Split grafts may be meshed to expand the surface area that can be covered.
Which of the following definitions is INCORRECT?
The composition of a flap describes its tissue components. The contiguity of a flap describes its position related to its source. Distant flaps are transferred from a different anatomic region to the defect. They may remain attached to the source anatomic region (pedicled flaps) or may be transferred as free flaps by microsurgery. These are completely detached from the body, and their blood supply is reinstated by microvascular anastomoses to recipient vessels close to the defect. The term pedicle was originally used to describe a bridge of tissue that remains between a flap and its source, similar to how a peninsula remains attached to its mainland. However, as knowledge of flap blood supply and (micro )vascular anatomy has improved over the years, the term pedicle has increasingly become reserved for describing the blood vessels that nourish the flap.
Factors influencing the development of cleft lip/palate include all the following EXCEPT:
The cause of orofacial clefting is felt to be multifactorial. Factors that likely increase the incidence of clefting include increased parental age, drug use and infections during pregnancy, and smoking during pregnancy.
Principles of reconstructive surgery include all of the following EXCEPT:
The reconstructive surgeon aims to restore lost anatomic components adequately. Residual deficits, seemingly inconsequential, may progress to psychological morbidity, societal malacceptance, and social withdrawal. Uncomplicated and timely wound healing is important to allow adjuvant therapies when indicated and smooth discharge to home and occupation. Each defect can be addressed by a number of methods, but the technique must be decided for each individual patient. Although a more complex reconstruction might offer improved outcomes, it may bring an increased risk of complications. Some patients may therefore benefit from use of a simpler method with more acceptable anesthetic and operative risk rather than a gold-standard reconstruction.
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