BACK TO CORE CURRICULUM TOPICS PAGE
1. Is an end-to-side anastomosis better than an end-to-end? (PRS 1997; 99:1109)
2. What happens to vein grafts? Do patency rates change with length? Does the use of a vein graft with two anastomoses decrease patency?
3. Should we cool the free flap until it is removed? Should we perfuse it with any solution such as heparin or the Wisconsin formula that is used with kidneys?
4. Review the histopathology regarding microvascular anastomosis. What does cautery do to the epithelium? What does stripping the adventitis tissue do? What do repeated needle punctures do? What do unequal sutures do?
5. How do you feel about laser-assisted microvascular anastomoses? Do vessels, staplers, and couples work? What is their patency rate? How much does a coupler cost?
6. Review the microvascular clamps available. How much pressure do they put on the vessel? Are the same ones used for arteries and veins? What happens on the histological level to clamped endothelium?
7. Can you plug into irradiated vessels? What is the patency? (PRS 1993; 92: 628 PRS 1979; 63:525 BrJPS 1982; 35:328)
8. Should you give your patient heparin, aspirin, or dextan post-operatively? SHould you use heparin solution intra-op to irrigate?
9. Are interrupted sutures better than continuous sutures? How many sutures are needed for an anatomosis?
10. How should we monitor our free flap once it is done?
11. Should you use loupes or a microscope? (PRS 1995; 95:261,270)
12. Why do free flaps fail? (Ann PS 1981; 6:215)
13. Describe the anatomy of a free fibula.
14. Describe the anatomy of a scapular and parascapular flap (with and without bone).
15. Describe the anatomy of a radial forearm flap (with and without bone).
16. How do you do an iliac crest free flap?
17. How do you harvest omentum for a free flap?
18. Your flap has no reflow. Should you give streptokinase? How is it given? What about recombinant tissue plasminogen activator? (PRS 1995; 96:1215)
19. Describe: the posterior wall technique (BrJPS 1981; 34:47), the cuff technique (BrJPS 1981; 34:50), the sleeve technique (Ann PS 1984; 13:145).
20. Does smoking affect a free flap? (PRS 1992; 89:490, Ann PS 1983; 11:206)
21. Do free flaps work in the elderly? (PRS 1992; 90:87, PRS 1991; 87:1074, PRS 1991; 88:259, PRS 1996; 98:1234)
22. What happens to legs with failed free flaps? (PRS 1996; 98:834)