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At least 37 records · Page 2Linked to original sources
PubMed2005

The cutaneous surgery experience of multiple specialties in the Medicare population.

BACKGROUND: There has been tremendous growth in the performance of ambulatory surgical procedures. Traditional forms of peer review, commonplace for hospital-based procedures, are not typically performed in the office-based setting. Hospital credentialing of physicians has been suggested to be a means of assuring patient safety. Credentialing committees may be unaware of the level of experience of typical office-based physicians who perform cutaneous surgery. PURPOSE: To compare the levels of cutaneous surgery experience of dermatologists and other surgical specialists. METHODS: Medicare claims data on number of cutaneous surgery procedures performed by various medical disciplines, including dermatologists, plastic surgeons, general surgeons, and others, were obtained from the 1998-1999 Medicare Current Beneficiary Survey (MCBS) and analyzed. The number of physicians in each specialty was used to normalize the data to a per physician basis. RESULTS: Dermatologists performed half (50%) of the complex repairs and most of the excisions (58%) and intermediate repairs (62%). Dermatologists performed more flaps (40% of all flaps) than any other specialty, while plastic surgeons performed more total grafts (38%) than any other specialty. Dermatologists and plastic surgeons performed similar numbers of full-thickness skin grafts, while plastic surgeons performed more split-thickness skin grafts. CONCLUSION: As dermatologists seek hospital credentials for performing cutaneous surgery procedures, these data should help surgical colleagues understand the typical level of experience of their dermatologist colleagues.

Clinical Competence↗
PubMed2005

Self-warming lidocaine/tetracaine patch effectively and safely induces local anesthesia during minor dermatologic procedures.

BACKGROUND: Dermatologic procedures often cause some degree of pain. A self-warming patch containing lidocaine and tetracaine (L/T) was developed to provide topical local anesthesia prior to painful procedures. OBJECTIVES: To evaluate the safety and efficacy of a self-warming L/T patch to provide anesthesia in adult patients undergoing minor dermatologic procedures. METHODS: An active or placebo study drug was placed on adults 30 minutes prior to minor dermatologic surgical procedures in a prospectively randomized, double-blinded manner. Subcutaneous lidocaine injection was available during the procedure as a rescue medication if requested by the subject. Immediately following the procedure, the subjects, the investigator, and an independent observer rated pain intensity and adverse events were recorded. RESULTS: Patient-reported pain intensity was significantly lower in the L/T patch group (p<.001). Investigators and an independent observer rated the pain in the L/T patch group to be less than in the placebo patch group (p = .004 and p<.001, respectively). Forty-nine percent of patients in the placebo group required rescue subcutaneous lidocaine compared with 22% in the L/T patch study group (p = .008). One patient in the L/T patch group reported a transient moderate burning sensation. CONCLUSION: The self-warming L/T patch was effective in providing clinically useful local anesthesia for minor dermatologic procedures in adult patients.

Administration, Cutaneous↗
PubMed1988

[Wound dressings].

The wide variety of dermatologic surgical procedures has resulted in a corresponding choice of wound dressings. Considering the chemical and physical properties as well as the function of the dressings, standardized dressing techniques can be performed with relatively few materials. This saves both time and money.

Bandages↗
PubMed1997

Intraoperative and postoperative bleeding problems in patients taking warfarin, aspirin, and nonsteroidal antiinflammatory agents. A prospective study.

BACKGROUND: Many patients who undergo cutaneous surgery take medications that can affect bleeding. The role of these medications in postoperative bleeding complications is unclear. Dermatologists have no clear guidelines regarding the need to discontinue these medications preoperatively. OBJECTIVE: We designed a prospective study to evaluate the incidence of postoperative bleeding complications in patients taking aspirin, warfarin, or nonsteroidal antiinflammatory agents. METHODS: Data were collected from patients undergoing Mohs surgery regarding preoperative medication history, operative bleeding, and postoperative bleeding. Frequency of postoperative bleeding complications was then evaluated. RESULTS: There was no statistically significant difference in postoperative bleeding complications between patients on aspirin, warfarin, or nonsteroidal antiinflammatory agents, when compared with controls. CONCLUSION: It may not be necessary to discontinue aspirin, warfarin, or nonsteroidal antiinflammatory agents in patients undergoing many common dermatologic surgical procedures, such as Mohs surgery.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1986

Blood pressure as a parameter in dermatologic surgery.

Elevated blood pressure is a major cause of perioperative bleeding and postoperative hematoma. Seventy-five patients scheduled for dermatologic surgical procedures were prospectively asked if they were aware of any personal history of hypertension. If patient response alone is relied on as a preoperative screen for hypertension, over half of the individuals affected with this disease will be missed. Epinephrine-containing local anesthetics were found not to increase blood pressure in doses commonly employed by dermatologists; in fact, they lowered blood pressure in hypertensive individuals.

Adolescent↗
PubMed1988

Comparison of preoperative skin preparations for the face.

Antiseptic preparation of the skin before dermatologic surgical procedures should provide maximal reduction of cutaneous microflora for the duration of the operation. No data currently exist concerning the efficacy of topical antimicrobials on the most common site of cutaneous surgery, the face. In this study the potency and temporal characteristics of three antimicrobials were tested on the faces of 14 volunteers. A 10-second wipe of 70% isopropyl alcohol was as effective in reducing aerobic microflora at the 5-minute postoperative period as a 60-second alcohol wipe or a 60-second povidone-iodine or chlorhexidine tincture application. At 60 minutes after the application, aerobic bacterial reduction possibly was better maintained by the povidone than by the 10- or 60-second alcohol preparation. None of the antiseptics tested were capable of a profound reduction of the anaerobic flora present on the sebaceous facial regions.

1-Propanol↗
PubMed1989

Scarring following herpes simplex infection of postsurgical cutaneous sites.

Herpes simplex type 1 produces a perilabial vesicular eruption that normally resolves without scarring. Three cases of herpetic infection associated with different dermatologic surgical procedures are presented. Those procedures involving reduction of cutaneous macrovascular blood supply via undermining or flap creation were followed by clinical scarring. None of the recognized etiologies of tissue compromise (bacterial infection, tension, host vascular disease, excessive inflammation, or edema) could be identified. It is speculated that in the immunocompetent host, small vessel injury secondary to herpes simplex may eventuate in scarring if the subdermal vascular network is significantly compromised. Prophylactic oral acyclovir may be useful in select instances where tissue blood supply is judged clinically tenuous and the frequency of herpetic infection at the surgical site judged worrisome.

Adult↗
PubMed2001

The apical angle: a mathematical analysis of the ellipse.

BACKGROUND: The elliptical excision is a common surgical procedure. The dermatologic literature predominantly describes an excisional geometry with a 3:1 length:width ratio and an apical angle of 30 degrees. OBJECTIVE: To analyze the elliptical excision by applying mathematical principles and define the apical angle and its relationship to the length:width ratio. METHODS: We examined numerous examples of elliptical excisions as presented in the dermatologic literature. We analyzed the geometry of the excisions and defined it mathematically. RESULTS: The apical angle of a 3:1 elliptical excision is not 30 degrees. The true apical angle varies from 37 degrees to 74 degrees depending on excisional geometry. CONCLUSION: The commonly presented apical angle of 30 degrees is incorrect and does not reflect the true apical angle of elliptical excisions.

Dermatologic Surgical Procedures↗
PubMed1988

Safety of liposuction: a review of 9478 cases performed by dermatologists.

Complications and methods of anesthesia were reviewed in 9478 patients who had undergone liposuction surgery often in several areas. Seventy-one percent of the patients were treated under local anesthesia and the overall level of complications was extremely low. The results of the survey reflect the large number of liposuction procedures that are being performed by dermatologists with a high degree of patient safety.

Adolescent↗
PubMed1989

Instrumentation.

Explore the source record for details and available documents.

Dermatologic Surgical Procedures↗
PubMed1990

Special considerations in pediatric dermatologic surgery.

Dermatologic surgical procedures can be performed in the pediatric patient in an outpatient setting. Although the surgical techniques involved are the same as those used in adult medicine, special attention must be given to anesthesia and patients' fears when dealing with pediatric patients. In this communication, some insights relating to pediatric surgical procedures performed at Duke University Medical Center's Dermatologic Surgery Unit are presented.

Anesthesia↗
PubMed1996

[Effectiveness of dermatologic minor surgery in the office of the family physician and patient satisfaction in relation with ambulatory surgery].

BACKGROUND: The minor surgery by family physicians increase the primary care competences. The purpose of this work is to prove patients' satisfaction and minor surgery effectiveness practiced by family physicians in health centers with respect to ambulatory's general surgeon. MATERIAL AND METHODS: Case-control retrospective study, comparing dermatological surgical procedures performed by 4 family physicians and 8 3rd-year Family Physician residents with surgical procedures wade made by a surgeon over one a year period. Variables analysed include: descriptive samples homogeneity, surgery effectiveness (waiting time, esthetic results, healing time and number of visits, and histopathologic correlation) and patients' satisfaction (with the waiting time, with the results of surgery and with the physician). RESULTS: Minor surgical procedures carried out by 146 family physicians and 61 general surgeons were compared, in congruence with the analyzed descriptive homogeneity's parameters. Family physicians average waiting time was the lower, with a mean of 45 days less than the surgeon. Patient's satisfaction with the physician was higher when family physician were involved (p < 0.001); the same could be applied for the waiting time (p < 0.001). There were no significant differences over the effectiveness and patients' satisfaction. CONCLUSION: The dermatologic minor surgery by family physician is effective, satisfactory for patients, and has less waiting time. This results justify the introduction of minor surgery in the family physicians office.

Adolescent↗