Chapter Summary Physiologic hemostasis occurs in three interrelated phases: initiation (thrombin formation); amplification (platelet aggregation and activation); and propagation (fibrin formation and clot stabilization). In general, anticoagulation prescribed for secondary thrombotic prophylaxis should not be discontinued for dermatologic surgery procedures.…
Chapter Summary Facial skin is divided into discrete cosmetic subunits whose aesthetic characteristics are derived from regional variations in the composition of the underlying tissue layers. Careful attention to restoring these subunits during reconstruction is critical. The human face is…
Chapter Summary Choice and placement of wound closure materials play critical roles in the outcome of incisional surgery. The properties of suture materials combine to give each suture unique characteristics. Sutures must be placed at the same vertical level across…
Chapter Summary Preoperative planning includes the following methods to confirm and define the extent of the condition: using palpation, ultrasonography (US), computed tomography (CT) or magnetic resonance imaging (MRI). Be mindful of the regional anatomy. Previously removed cysts may be…
Chapter Summary The skin biopsy is essential to dermatologic surgery both in diagnosis and planning therapy. Several biopsy techniques are available, including shave, saucerization, curettage, scissors “snip,” punch, and scalpel excision, or incisional biopsy. Complications are infrequent but can be…
Chapter Summary A surgical treatment option for benign and malignant lesions Excellent safety profile and relatively easy to perform A low-cost procedure of short duration Less invasive and has a lower morbidity than some other surgical procedures Usually performed as…
Chapter Summary Electrosurgery refers to thermal tissue damage resulting from tissue resistance to the passage of high-frequency, alternating electric current as in electrocoagulation, electrofulguration, electrodesiccation, and electrosection. Electrocautery refers to thermal damage from heat generated by an electric current. The…
Chapter Summary Dressings cover the wound, absorb drainage, and provide a moist environment. Dressings should be selected to keep the wound moist, but not too wet nor too dry. Moist wound healing enhances epithelial migration, stimulates angiogenesis, helps in retention…
Chapter Summary Wound healing occurs in orderly, overlapping phases: the inflammatory, the proliferative, and the remodeling phases. The depth of the wound determines the degree of contraction and the location and source of keratinocytes that serve as a reservoir for…
Chapter Summary In general, the rate of wound infections in dermatologic surgery is extremely low. Given the frequency with which cutaneous procedures are performed, an understanding of skin microflora and risks of infection with procedures ranging from biopsies to liposuction…