Tuesday, October 11, 2016

Plastic surgery Syndactltaly repair


   
Repair of Syndactylism
Objective
In cases of congenital fused fingers:
•   Separation of webbed fused digits.
Position
Supine.
Anesthesia
General.
Procedure
1.  Zig-zag or Z-plasty incisions are made in the interdigital space(s).
2.  The neurovascular bundles are protected.
3.  Bony and ligamentous defects if present are corrected.
4.  The incisions are closed.
5.  Full thickness grafts (e.g. skin from the abdomen or the medial aspect of the arm or the thigh) may be required to close defects.
6.  Stents are sutured over the grafts.
7.  A bulky dressing and splint are applied.
Instruments
•   Minor orthopedic procedure set 
•   Basin set 
•   Sheet wadding 
•   Esmarch bandage 
•   Blades (2) No. 15 
•   Bulb syringe 
•   Marking pen 
•   Stents.

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Wednesday, October 5, 2016

Plastic Surgery Dermoabrasion

Dermabrasion
Ovjective
In cases of minor scars of face:
•   Abrasion of the skin to smooth scars and surface irregularities.
Position
Supine.
Anesthesia
Local.
Procedure
1.  Skin is stretched by hand.
2.  The epidermis is abraded by means of a motor-driven sanding cylinder and/or a wire brush.
3.  The area is irrigated copiously with saline during (and following) the procedure.
4.  The wound may be dressed with nonadherent gauze (e.g. Owens gauze).
5.  Compression bandage may be applied.
Instruments
•   Adson forceps 
•   Straight Mayo scissors 
•   Dermabrader (with wire brush and sanding cylinder) and cord, for example, Stryker 
•   Basin set 
•   Marking pen or methylene blue 
•   Syringes (2) Luer-Lok control, and needles (2) 25 or 27 gauge
•   Local anesthetic with epinephrine

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Repair 

Tuesday, September 27, 2016

Plstic Surgery mentoplasty

Mentoplasty Augmentation
Objective
In cases of micrognathia (small chin):
•   Correction of cosmetic defect with the insertion of a chin prosthesis.
Position
Supine.
Anesthesia
Local.
Procedure
1.  A short transverse incision in the submental region or in the labial sulcus.
2.  A supraperiosteal pocket is created just large enough to accommodate the prosthesis.
3.  Implant may be fixed with a deep mattress suture.
4.  Wound is closed.
5.  A bulky pressure dressing is applied.
Instruments
•   Limited plastic procedure set 
•   Basin set 
•   Bipolar electrocoagulating forceps 
•   Blades (2) No. 15 
•   Marking pen or methylene blue 
•   Syringes (2) Luer-Lok control, and needles (2) 25 or 27 gauge 
•   Local anesthetic with epinephrine implant (e.g. silicone).

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Tuesday, September 20, 2016

Plastic surgery Otoplasty

Otoplasty
Objective
Correction of bat ears.
Position
Supine.
Anesthesia
General.
Procedure
1.  Mark incisions.
2.  Incise and raise flaps.
3.  Reshape the cartilage.
4.  Closure.
Instruments
Limited plastic procedure set.
Suture
•   6‘0’ Prolene on curved cutting needle 
•   5‘0’ Vicryl on curved cutting needle 
•   Crepe bandage 4" 2 rolls.

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Wednesday, September 14, 2016

Plastic surgery Abdominoplasty

Abdominoplasty
Objective
Excision of excessive fatty tissue over the lower abdomen.
Position
Supine with pillow under the knees.
Anesthesia
General.
Procedure
1.  Mark incisions.
2.  Excise excess skin and fat.
3.  Plicate abdominal muscles.
4.  Closure in layers over suction drains.
Instruments
•   Limited plastic procedure set 
•   General surgery set.
Sutures
•   2‘0’ Prolene on curved round body needle 
•   1‘0’ Catgut/Vicryl on curved cutting needle 
•   5‘0’ Prolene on curved cutting needle.

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Tuesday, September 6, 2016

Blepheroplasty

Blepharoplasty
Objective
Correct of Baggy eyelids.
Position
Supine. 
Anesthesia
Local.
Procedure
1.  Mark incisions.
2.  Infiltrate local anesthesia.
3.  Incise.
4.  Remove excess fat.
5.  Trim excess skin.
6.  Hemostasis.
Instruments
•   Limited plastic procedure set 
•   Sutures 
     6‘0’ Prolene on curved cutting needle.

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Tuesday, August 30, 2016

Face lift surgery

Face Lift
Objective
To improve the appearance of facial ageing by correcting laxity of the skin of face and neck.
Position
Supine, head extended with a pillow under the shoulders and ring under the head. Head end elevated 15°.
Anesthesia
General or local with deep sedation.
Procedure
1.  Mark incisions. 
2.  Infiltrate xylocaine 0.5% with adrenaline 1 in 200,000.
3.  Incise and develop flaps.
4.  Excise redundant skin and subcutaneous tissues.
5.  Closure in layers.
Instruments
•   Limited plastic procedure set 
•   Metzenbaum scissors 8" long 
•   Crepe bandage 4" rolls.


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