ABD Dermatologic Surgery 3 — Questions and Answers
Question 1: Which flap moves tissue by pivoting around a fixed point to fill an adjacent defect?
- Advancement flap
- Rotation flap (Correct answer)
- Full-thickness graft
- Split-thickness graft
Correct answer: Rotation flap
A rotation flap pivots curvilinearly around a fixed point to close a defect.
Question 2: A bilobed flap is most commonly used to reconstruct defects of which anatomic site?
- Scalp
- Nasal tip and ala (Correct answer)
- Lower eyelid
- Dorsal hand
Correct answer: Nasal tip and ala
The bilobed flap is classically used for distal nasal (tip/ala) reconstruction.
Question 3: Full-thickness skin grafts differ from split-thickness grafts by including?
- Only epidermis
- Epidermis and full dermis (Correct answer)
- Subcutaneous fat
- Fascia
Correct answer: Epidermis and full dermis
Full-thickness grafts contain the entire epidermis and dermis but no subcutaneous fat.
Question 4: What is the initial phase of skin graft survival before revascularization?
- Inosculation
- Imbibition (Correct answer)
- Neovascularization
- Contraction
Correct answer: Imbibition
Plasmatic imbibition nourishes the graft by diffusion during the first 24-48 hours.
Question 5: Which relaxed skin tension line orientation minimizes scar visibility?
- Perpendicular to RSTLs
- Parallel to RSTLs (Correct answer)
- Diagonal at 45 degrees
- Orientation is irrelevant
Correct answer: Parallel to RSTLs
Incisions placed parallel to relaxed skin tension lines heal with less noticeable scars.
Question 6: A dog-ear deformity at the end of an elliptical closure is best corrected by?
- Leaving it to resolve
- Excising the redundant standing cone of tissue (Correct answer)
- Adding more deep sutures
- Applying pressure dressing
Correct answer: Excising the redundant standing cone of tissue
Dog-ears are corrected by excising the redundant tissue as a small triangle or M-plasty.
Question 7: A Z-plasty is primarily used to?
- Remove a tumor
- Lengthen and reorient a contracted scar (Correct answer)
- Harvest a graft
- Reduce infection
Correct answer: Lengthen and reorient a contracted scar
Z-plasty transposes triangular flaps to lengthen and redirect scar contractures.
ABD Dermatologic Surgery 3
Which flap moves tissue by pivoting around a fixed point to fill an adjacent defect?