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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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Clinic DaysClinic Days
Tuesdays (1 PM, room 2C05) Tuesdays (1 PM, room 2C05)
Congenital and Cleft lip & palateCongenital and Cleft lip & palate
ClinicClinic
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Clinic DaysClinic Days
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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History & P.E.History & P.E. Part affected?Part affected?
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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DiagnosticsDiagnostics
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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History & P.E.History & P.E. Part affected?Part affected?
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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DiagnosticsDiagnostics
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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History & P.E.History & P.E.
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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History & P.E.History & P.E. Part affected?Part affected?
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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DiagnosticsDiagnostics
Hand APOHand APO
b
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Post-burnPost-burn
ReconstructionReconstruction
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History & P.E.History & P.E.
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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History & P.E.History & P.E.
Part affected?Part affected?
Extent?Extent? Bony?Bony?
Soft tissue?Soft tissue?
Range of motion?Range of motion?
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DiagnosticsDiagnostics
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