You are on page 1of 36

The Division

of
Plastic
Surgery
Outpatient Clinic
Course Objectives

 Three (3) week rotation for Year


Level 5 students of the U. P.
College of Medicine
Aesthetic
Reconstructiv
e Surgery
Clinic Days
 Mondays (1 PM, room 2C06)
General Plastic Surgery Clinic
Clinic Days
 Tuesdays (1 PM, room 2C05) –
Congenital and Cleft lip & palate
Clinic
Clinic Days
 Fridays (7 AM, Major operating room)

Cosmetic procedures and minor
excisions
What do we do?
Congenital Deformities
History & P.E.
 Birth & maternal history?
 Medications?
 Birth trauma?
 Infections?
 Family history of similar anomaly
 Previous treatment/surgery?
History & P.E.
 Part affected?
 Structural?
 Functional?
 Combined?
 Associated deformities?
 Isolated defect?
 Syndrome?
Diagnostics
 Pediatric clearance
 CBC
 CXR APL
 Urinalysis
 Fecalysis
 Referrals
 Speech Pathology
 ENT for otologic testing
 Dental
Neoplasms
History & P.E.
 Onset?
 Changes?
 Size?
 Shape?
 Consistency?
 Previous treatment/surgery?
 Exposure to environmental agents?
 Associated symptoms?
History & P.E.
 Part affected?
 Size?
 Shape?
 Depth?
 Extension to adjacent areas?
 Projected margins of defect?
 Involvement of other organs?
Diagnostics
 Radiologic exam of involved area
 xrays
 CT scan
 MRI
 CBC
 BUN, Crea, electrolytes
 CXR
Aesthetic
History & P.E.

 Patient expectations & objectives for surgery?


 Previous surgery?
 Allergies & co-morbidities?
 Psychological concerns?
 Realistic goals?
History & P.E.
 Part to be operated on?
 Size & shape?
 Symmetry?
 Measurements?
 Masses or any palpable abnormality in area?
 Nodularities?
 Polyps?
Craniofacial and
Extremity Trauma
History & P.E.
 DOI / TOI /POI / MOI?
 Symptoms?
 Headache / vomiting?
 Loss of consciousness?
 Malocclusion? TMJ pain?
 Visual acuity changes?
 Rhinorrhea / otorrhea ?
 Associated injuries?
 Previous treatment / surgery done?
 Co-morbidities?
History & P.E.
 Part affected?
 Size & shape of defect?
 Location of injury?
 If in extremities, full pulses? Motor/sensory deficits?
 Drawer’s sign?
 Associated injuries?
 Extremity fractures?
 Visual acuity deficits?
 EOM limitation?
 Neurologic exam?
Diagnostics
 Radiographs
 Skull AP
 Towne’s, Water’s view
 Mandible APO
 Panorex
 Facial CT with axial and coronal cuts
 CBC
 BUN, Crea, electrolytes
Hand
History & P.E.
 Traumatic or not?
 Functional or structural limitations?
 Handedness?
 Associated injuries or lesions?
 Previous treatment / surgery?
History & P.E.
 Part affected?
 Zones?
 Extent?
 Bony?
 Soft tissue?
 Sensory deficits?
 Motor deficits?
 Range of motion?
 Neurologic exam?
Diagnostics
 Hand APO
Post-burn
Reconstruction
History & P.E.
 DOI / TOI /POI / MOI?
 More than 1 month?
 Functional or structural limitations?
 Associated injuries?
 Previous treatment / surgery?
 Co-morbidities?
History & P.E.
 Part affected?
 Extent?
 Bony?
 Soft tissue?
 Range of motion?
Diagnostics
 Xrays of involved area
 CBC
 BUN, Crea, electrolytes

 Referral to Rehab
 Physical therapy
 Splints
 Jobst garments
The work we’ve
done…
Thank you