plastic opd

8/14/2019 Plastic Opd

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The DivisionThe Division

ofof

PlasticPlastic

SurgerySurgery

Outpatient ClinicOutpatient Clinic


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Surgery

Course ObjectivesCourse Objectives

Three (3) week rotation for YearThree (3) week rotation for YearLevel 5 students of the U. P.Level 5 students of the U. P.

College of MedicineCollege of Medicine


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AestheticAestheticReconstructivReconstructive Surgerye Surgery


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Clinic DaysClinic Days

Mondays (1 PM, room 2C06)Mondays (1 PM, room 2C06)

General Plastic Surgery ClinicGeneral Plastic Surgery Clinic


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Tuesdays (1 PM, room 2C05) Tuesdays (1 PM, room 2C05)

Congenital and Cleft lip & palateCongenital and Cleft lip & palate

ClinicClinic


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Fridays (7 AM, Major operating room)Fridays (7 AM, Major operating room)

Cosmetic procedures and minorCosmetic procedures and minorexcisionsexcisions


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What do we do?What do we do?


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Congenital DeformitiesCongenital Deformities


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History & P.E.History & P.E.

Birth & maternal history?Birth & maternal history? Medications?Medications?

Birth trauma?Birth trauma?

Infections?Infections?

Family history of similar anomalyFamily history of similar anomaly

Previous treatment/surgery?Previous treatment/surgery?


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History & P.E.History & P.E. Part affected?Part affected?

Structural?Structural?

Functional?Functional?

Combined?Combined? Associated deformities?Associated deformities?

Isolated defect?Isolated defect?

Syndrome?Syndrome?


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DiagnosticsDiagnostics

Pediatric clearancePediatric clearance CBCCBC CXR APLCXR APL

UrinalysisUrinalysis FecalysisFecalysis

ReferralsReferrals

Speech PathologySpeech Pathology ENT for otologic testingENT for otologic testing DentalDental


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NeoplasmsNeoplasms


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History & P.E.History & P.E. Onset?Onset?

Changes?Changes? Size?Size?

Shape?Shape?

Consistency?Consistency?

Previous treatment/surgery?Previous treatment/surgery?

Exposure to environmental agents?Exposure to environmental agents? Associated symptoms?Associated symptoms?


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Size?Size?

Shape?Shape?

Depth?Depth?

Extension to adjacent areas?Extension to adjacent areas?

Projected margins of defect?Projected margins of defect?

Involvement of other organs?Involvement of other organs?


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Radiologic exam of involved areaRadiologic exam of involved area xraysxrays

CT scanCT scan

MRIMRI

CBCCBC

BUN, Crea, electrolytesBUN, Crea, electrolytes CXRCXR


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History & P.E.History & P.E. Part to be operated on?Part to be operated on?

Size & shape?Size & shape?

Symmetry?Symmetry?

Measurements?Measurements?

Masses or any palpable abnormality in area?Masses or any palpable abnormality in area? Nodularities?Nodularities?

Polyps?Polyps?


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Craniofacial andCraniofacial and

Extremity TraumaExtremity Trauma


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History & P.E.History & P.E. DOI / TOI /POI / MOI?DOI / TOI /POI / MOI? Symptoms?Symptoms?

Headache / vomiting?Headache / vomiting?

Loss of consciousness?Loss of consciousness? Malocclusion? TMJ pain?Malocclusion? TMJ pain? Visual acuity changes?Visual acuity changes? Rhinorrhea / otorrhea ?Rhinorrhea / otorrhea ?

Associated injuries?Associated injuries? Previous treatment / surgery done?Previous treatment / surgery done? Co-morbidities?Co-morbidities?


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Size & shape of defect?Size & shape of defect? Location of injury?Location of injury?

If in extremities, full pulses? Motor/sensory deficits?If in extremities, full pulses? Motor/sensory deficits? Drawers sign?Drawers sign? Associated injuries?Associated injuries?

Extremity fractures?Extremity fractures?

Visual acuity deficits?Visual acuity deficits? EOM limitation?EOM limitation?

Neurologic exam?Neurologic exam?


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RadiographsRadiographs Skull APSkull AP

Townes, Waters viewTownes, Waters view

Mandible APOMandible APO

PanorexPanorex

Facial CT with axial and coronal cutsFacial CT with axial and coronal cuts

CBCCBC

BUN, Crea, electrolytesBUN, Crea, electrolytes


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HandHand


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Traumatic or not?Traumatic or not?

Functional or structural limitations?Functional or structural limitations?

Handedness?Handedness? Associated injuries or lesions?Associated injuries or lesions?

Previous treatment / surgery?Previous treatment / surgery?


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Zones?Zones?

Extent?Extent?

Bony?Bony? Soft tissue?Soft tissue?

Sensory deficits?Sensory deficits?

Motor deficits?Motor deficits? Range of motion?Range of motion?

Neurologic exam?Neurologic exam?


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Hand APOHand APO

b


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Post-burnPost-burn

ReconstructionReconstruction


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DOI / TOI /POI / MOI?DOI / TOI /POI / MOI?

More than 1 month?More than 1 month?

Functional or structural limitations?Functional or structural limitations? Associated injuries?Associated injuries?

Previous treatment / surgery?Previous treatment / surgery?

Co-morbidities?Co-morbidities?


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Part affected?Part affected?

Extent?Extent? Bony?Bony?

Soft tissue?Soft tissue?

Range of motion?Range of motion?


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Xrays of involved areaXrays of involved area

CBCCBC

BUN, Crea, electrolytesBUN, Crea, electrolytes

Referral to RehabReferral to Rehab

Physical therapyPhysical therapy SplintsSplints

Jobst garmentsJobst garments

h kTh k


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The work weveThe work weve

donedone


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Thank youThank you

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