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Results for “Dermatologic Surgical Procedures”

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At least 55 records · Page 3Linked to original sources
PubMed2000

Safe and effective conscious sedation administered by dermatologic surgeons.

OBJECTIVE: To review the experience with conscious sedation administered by dermatologic surgeons at an academic medical center. DESIGN: Retrospective medical chart review. SETTING: Outpatient dermatologic surgery unit at an academic medical center. PATIENTS: Fifty episodes of conscious sedation in 37 patients undergoing dermatologic surgical procedures. INTERVENTION: Intravenous and inhaled conscious sedation was administered with strict monitoring during procedures. MAIN OUTCOME MEASURES: Efficacy was subjectively recorded by the administering physician and complications were recorded. RESULTS: Administration of conscious sedation by dermatologic surgeons was associated with good to excellent sedation with minimal complications. Extensive preparation and training were necessary, and strict guidelines devised by a conscious sedation task force were followed. Emergency preparedness was high, although it was not used. CONCLUSIONS: Conscious sedation can be safely and effectively administered by dermatologic surgeons in a hospital-based outpatient surgical unit after extensive training. Emergency preparedness is essential, and conservative guidelines should be followed.

Administration, Inhalation↗
PubMed1981

[A new dermato-surgical therapy for the Favre-Racouchot syndrome (author's transl)].

A new dermato-surgical method for the treatment of the Favre-Racouchot syndrome is introduced. The cysts and comedones are excised in parallel stripes by means of a small electrically driven dermatome. Thus a number of cysts is only partly cut. These remaining lesions are completely repelled with the eschar. This dermatomy gives excellent cosmetic results and should be considered for the therapy of the syndrome.

Dermatologic Surgical Procedures↗
PubMed1995

Thin tangential excision of tattoos.

BACKGROUND: There are many techniques used to remove professional tattoos. Each method can be complicated by hypertrophic scarring, pigmentary changes, and/or insufficient pigment removal. OBJECTIVE: To study the results of precise, thin, tangential excisions of professional tattoos. The posttreatment migration of dermal tattoo pigment was also evaluated. METHODS: Five healthy white males had their professionally placed tattoos excised at a depth of 0.008 in (0.2 mm) using a Brown dermatome. Pre- and posttreatment biopsies were used to measure the depth of the tattoo pigment. RESULTS: At 3 months posttreatment, four patients had no significant scarring and three patients retained only scattered flecks of tattoo pigment. Each patients demonstrated migration of the deeper dermal pigment to a more superficial level. CONCLUSION: A superficial, tangential excision of a professional tattoo by a Brown dermatome is a viable, low-risk, inexpensive procedure.

Adult↗
PubMed1996

Camouflaging techniques and dermatologic surgery.

BACKGROUND: Skin appearance alterations as a result of dermatologic surgical procedures may produce temporary or permanent cosmetic defects. Basic camouflaging cosmetics and techniques can restore self-confidence and allow the surgical patient to resume social contact. OBJECTIVE: This paper presents the dermatologic surgeon with a basic understanding of the principles and techniques employed in cosmetic camouflaging. METHODS: Evaluation of surgical scars and healing tissue in terms of contour and pigmentation defects accompanied by an understanding of complementary colors provides the basis for cosmetic camouflaging. A variety of commercial products are available to meet specific patient needs. RESULTS: Cosmetic camouflaging can merely hide postsurgical erythema following laser resurfacing, dermabrasion, and face peeling or provide a cover for permanent scarring. CONCLUSION: An understanding of cosmetic camouflaging is essential to the dermatologic surgeon.

Cicatrix↗
PubMed2003

Antibiotic use in dermatologic surgery.

Few situations in dermatologic surgery require prophylactic antibiotics. The AHA has decreased the dose for endocarditis prophylaxis from antibiotics before and after the procedure to only 1 hour prior to the procedure. In the 1997 guidelines, fewer procedures are listed as requiring antibiotics compared with prior guidelines. In fact, several authors have questioned the efficacy of prophylactic antibiotics. The sequela of endocarditis or an infected prosthetic joint are certainly serious and possibly life-threatening conditions, yet this should not be a justification for using a therapy that is not proven and has potential serious side effects of its own. The authors suggest not using antibiotics on clean or clean-contaminated wounds regardless of cardiac history. Patients with prosthetic joint replacements probably do not need prophylactic antibiotics in cutaneous surgery unless mucosa is invaded; in such cases the guidelines set by the ADA and the AAOS should be followed. The authors believe that antibiotics should be reserved for contaminated or infected wounds when their application is therapeutic. Table 2 contains a summary of the authors' recommendations for the use of antibiotics in cutaneous surgery. Each patient should be evaluated on an individual basis, and consultation with the patient's primary physician, cardiologist, or orthopedist should be sought when the need arises.

Anti-Bacterial Agents↗
PubMed2005

A retrospective biopsy study of the clinical diagnostic accuracy of common skin diseases by different specialties compared with dermatology.

BACKGROUND: With the recent trend for nondermatologists to treat dermatologic disorders, this retrospective biopsy study reviews the accuracy of the clinical diagnosis of physicians of different specialties performing surgical dermatologic procedures. OBJECTIVE: We assessed the diagnostic abilities of nondermatologist physicians who performed various types of skin biopsies and compared them with those of dermatologists. METHODS: The clinical diagnoses of family physicians, plastic, general, and orthopedic surgeons, and internists and pediatricians versus dermatologists were correlated with the histopathologic diagnoses. In total, 4451 cases were analyzed. RESULTS: Dermatologists diagnosed twice the number of neoplastic and cystic skin lesions correctly (75%) than nondermatologists (40%). The clinical diagnosis rendered by family practitioners matched the histopathologic diagnosis in only 26% of neoplastic and cystic skin lesions. Plastic surgeons, who performed the largest number of cutaneous surgical procedures among the nondermatologists, did better in the recognition of skin tumors than family physicians, but still had a diagnostic accuracy rate of only 45%. Inflammatory skin diseases were correctly diagnosed in 71% of the cases by dermatologists but in only 34% of the cases by nondermatologists. LIMITATIONS: A limitation of this retrospective, unblinded study is the use of the clinical data from the pathology requisition form as a surrogate for clinical diagnostic accuracy. CONCLUSIONS: The overall accuracy of the clinical diagnosis depends heavily on the clinicopathologic correlation. Without sufficient clinical data, the histopathologic diagnosis will be limited or restricted. This review concludes that without basic dermatology knowledge, clinicopathologic correlation is compromised.

Biopsy↗
PubMed2006

Pacemakers and implantable cardiac defibrillators in dermatologic surgery.

BACKGROUND: Electrosurgery used during dermatologic surgical procedures can cause malfunction of pacemakers and implantable cardiac defibrillators (ICDs), producing problems with rhythm detection, proper function, or alteration of the device. Well-documented safety data on electrosurgery in patients with cardiac devices are limited. At Mayo Clinic in Rochester, Minnesota, the Pacemaker Clinic manages all patients with pacemakers and ICDs undergoing dermatologic surgery. The preoperative and postoperative evaluations provide a unique opportunity to evaluate the safety of dermatologic surgery with electrosurgery in such patients. OBJECTIVES: The objective was to review the evaluation and management, by an experienced cardiology team, of patients with cardiac devices undergoing dermatologic surgery and to characterize perioperative complications. METHODS: A retrospective chart review of all patients identified with pacemakers or ICDs undergoing Mohs micrographic or dermatologic excisional surgery with electrosurgery at Mayo Clinic 2001 through 2004 were identified. Data were abstracted to identify any possible complications. RESULTS: The 173 patients with pacemakers and 13 with ICDs undergoing dermatologic surgery had no documented complications from electrosurgery. CONCLUSION: The lack of complications associated with pacemakers and ICDs with electrosurgery is reassuring. The authors support published recommendations about techniques and precautions to optimize safety during electrosurgery in patients with cardiac devices. The care of patients with ICDs in particular requires special consideration.

Adult↗
PubMed1987

Complications of cutaneous laser surgery. A survey.

We surveyed a selected group of 139 dermatologists and plastic surgeons about their experience with the complications of cutaneous laser surgery. Reported complication rates varied from 0% to 35%, with means of 3.2% for dermatologists and 6.2% for plastic surgeons using the argon laser, and 4.2% for dermatologists and 2.8% for plastic surgeons using the carbon dioxide laser. Hypertrophic scarring was the complication noted most frequently; 69% of physicians using the argon laser and 64% of physicians using the carbon dioxide laser have seen at least one case of hypertrophic scarring. Complications noted less frequently include infection, pain, atrophic scarring, intraoperative or postoperative hemorrhage, and prolonged wound healing. Environmental accidents were few. No procedure-related deaths, ocular damage, or secondary cutaneous malignant neoplasms were reported. We conclude that cutaneous laser surgery has an acceptable risk profile but that complications are not uncommon.

Argon↗
PubMed2005

[Ambulatory dermatologic surgery].

Outpatient surgery in dermatology is likely to become increasingly important in future, for a number of reasons. Current social legislation favors outpatient surgery, because hospitals must justify performing any procedure in the outpatient catalogue on an inpatient basis. The range of conditions being treated is also broadening, for example due to the growing popularity of aesthetic enhancement procedures. Epidemiological trends in skin cancer will also lead to considerable growth in demand for outpatient dermatological surgery. This article analyses current trends in ambulatory dermato-surgery, taking into account social, legislative, hygienic, legal and economic aspects. Measures to promote quality assurance are also described. The difficult cost situation facing outpatient surgery is creating a need for new forms of cooperation between primary care physicians and hospitals.

Ambulatory Care↗
PubMed2002

Application of local anesthetics in dermatologic surgery.

BACKGROUND: Local anesthesia is an integral aspect of cutaneous surgery. Its effects provide a reversible loss of sensation in a limited area of skin, allowing dermatologists to perform diagnostic and therapeutic procedures safely, with minimal discomfort and risk to the patient. OBJECTIVE: This article discusses the application of local anesthetics in dermatologic surgery through a brief review of the mechanism of local anesthetic activity, classification of local anesthetics, and adverse effects. The discussion will focus on the different methods of administration and techniques that may make the administration less painful to patients. METHODS: An evaluation of the literature, as well as clinical experience in the administration of local anesthetics provide the basis for this review. CONCLUSION: Local anesthesia provides a safe and effective means of decreasing patient's sensitivity to pain. Because of its critical importance to the field of dermatology, a working knowledge of local anesthetics is necessary for optimal use of these agents.

Anesthesia, Local↗