The Failing Free Flap

Chapter 4 of Volume 3, Skin, Burns & Surgical Principles. Revision notes and examiner-style viva questions with model answers for the FRCS (Plast).

16 viva questions in this chapter

1. This is the flap on the first postoperative day. What do you see?
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2. What are you going to do about it?
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3. Take me through the re-exploration.
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4. Tell me about thrombolysis. Would you use it?
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5. What is the no-reflow phenomenon?
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6. When would you not take a flap back?
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7. What anticoagulation do you use?
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8. The flap is congested, the vein will not stay open, and you have no other recipient vein. What now?
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9. How would you monitor this flap postoperatively?
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10. How does a microvascular anastomosis heal?
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11. What increases the risk of anastomotic thrombosis?
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12. Would you perform a free flap in a smoker? After radiotherapy? In the very elderly?
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13. How would you manage severely irradiated recipient vessels if there were no alternative?
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14. How do aspirin and heparin work?
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15. How would you handle a size discrepancy?
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16. What is a venous coupler, and is it better?
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