Dermatologic Surgery (eBook)

Step by Step

Keyvan Nouri (Herausgeber)

eBook Download: PDF

2012
John Wiley & Sons (Verlag)
978-1-118-41270-1 (ISBN)

Infos

This manual offers detailed, step-by-step guidance to dermatologic surgical procedures. The coverage provides three main sections - General Dermatologic Surgery, Cosmetic Surgery, Lasers and Miscellaneous topics - over 60 chapters with a concise templated format. Each chapter features five sections: pre-operative care, step by step surgical technique, post operative care and follow up, complications, and prevention and management of complications. Filled with clear descriptions and illustrations (5-10 per procedure), this manual and accompanying DVD provides physicians with updated and easy-to-read information for quick review and reference.

CD-ROM/DVD and other supplementary materials are not included as part of the e-book file, but are available for download after purchase.

Edited by
Keyvan Nouri, MD, Department of Dermatology & Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA

Inhalt

Title Page 5
Copyright Page 6
Contents 7
List of contributors 10
Foreword 17
Preface 18
Acknowledgements 19
List of videos 20
PART 1: Dermatologic Surgery 23
CHAPTER 1: Cutaneous anatomy in dermatologic surgery 25
Introduction 25
Scalp and forehead 25
Vasculature 25
Nerves 25
Lymphatic drainage 27
Mid-face 27
Nasal subunit 27
Vasculature 27
Nerves 27
Lymphatic drainage 28
Perioral 28
Vasculature 28
Nerves 28
Lymphatic drainage 28
Chin 28
Vasculature 29
Nerves 29
Lymphatic drainage 30
Periorbital 30
Vasculature 30
Nerves 30
Lymphatic drainage 31
Cheeks 31
Vasculature 31
Nerves 32
Lymphatic drainage 32
Auricular 33
Vasculature 33
Nerves 33
Lymphatic drainage 34
Neck 34
Nerves 35
Lymphatic drainage 35
CHAPTER 2: Surgical equipment and instrumentation 36
Instruments 36
Scalpel handles and blades 36
Forceps 37
Skin hooks 38
Scissors 38
Needle holders 39
Hemostats 40
Curettes 40
Biopsy blades 41
Dermatome/Weck blade 41
Chalazion 41
Summary 41
CHAPTER 3: Anesthesia in dermatologic surgery 42
Local anesthetics 42
Local anesthetic classification 42
Key features 42
Choosing the appropriate anesthetic technique 43
Instruments 43
Step-by-step anesthetic techniques 43
Topical anesthesia 43
Infiltrative anesthesia 43
Nerve blocks 43
Face 44
Hand and wrist 44
Digital nerve block 45
Ankle 45
Complications 46
CHAPTER 4: Suturing techniques 47
Introduction 47
Instruments 47
Choosing appropriate suture materials (Table ) 47
Absorbable 47
Non-absorbable 48
Surgical needles 48
Needle holders 48
Suture scissors 49
Forceps 49
Important points for suturing 49
Step-by-step suturing technique 49
Types of suturing technique 50
Simple interrupted sutures 50
Running sutures 50
Mattress sutures 50
Buried sutures 51
Variations of running sutures 51
Running horizontal mattress sutures 51
Running subcuticular sutures 51
Running subcutaneous sutures 51
Suture removal 51
CHAPTER 5: Electrosurgery 52
Introduction 52
Principles of electrosurgery 52
Cardiac pacemaker and defibrillator interference 55
Radiofrequency ablation system 56
Complications 56
CHAPTER 6: Biopsy techniques 57
Preoperative care 57
Instruments 57
Key techniques 57
Step-by-step surgical techniques 58
Shave biopsy with scalpel 58
Saucerization 58
Punch biopsy (Video 6.1) 58
Incisional biopsy 58
Wedge biopsy 58
Excisional biopsy (Video 6.2) 58
Video list 58
CHAPTER 7: Mohs micrographic surgery 59
Preoperative care 59
Indications for Mohs micrographic surgery 59
Step-by-step surgical procedure 60
Fresh frozen tissue technique 60
Zinc chloride paste technique 60
Equipment for the Mohs micrographic surgery laboratory 61
Limitations of Mohs micrographic surgery 61
Video list 61
CHAPTER 8: Skin grafts 62
Introduction 62
Full-thickness skin grafts 62
Preoperative care 62
Surgical technique (Video 8.1) 63
Postoperative care and follow-up 64
Split-thickness skin grafts 64
Preoperative care 64
Surgical technique 64
Postoperative care 66
Complications 66
Conclusion 67
Video list 67
CHAPTER 9: Nail unit surgery 68
Preoperative care 68
Preoperative care 68
Step-by-step surgical techniques 69
Punch biopsy 69
Lateral longitudinal excision 69
Matrix shave 70
Nail plate avulsion 71
Postoperative care and follow-up 71
Prevention, and management of complications 72
Video list 72
CHAPTER 10: Cryosurgery 73
Preoperative care 73
Regarding the patient 73
Preparation for cryosurgery 74
Regarding the surgeon 75
Techniques 76
Step-by-step surgical technique 78
Postoperative care and follow-up 78
Immediate 78
After 24–48 hours 78
After 48 hours 78
Complications 78
Prevention and management of complications 78
Video list 79
CHAPTER 11: Dermatologic surgery in ethnic skin 80
Introduction 80
Preoperative care 80
Care during procedure 80
Postoperative care and follow-up 82
Conclusion 82
CHAPTER 12: Complications and emergencies in dermatologic surgery 84
Introduction 84
Interrelated mechanisms of complications: the “terrible tetrad” 84
Hemostasis and anticoagulation 84
Infections 85
Emergency preparedness 87
General considerations 87
Allergy 87
Brain 88
Circulation 88
Conclusion 89
PART 2: Reconstructive Surgery 91
CHAPTER 13: Secondary intention healing 93
Introduction 93
The stages of healing 93
Management of secondary intention wound healing 94
CHAPTER 14: Side-to-side closure 96
Introduction 96
The principles of wound closure 96
Advantages of primary side-to-side closure 96
Contraindications to primary side to side wound closure 96
Preoperative care 97
Step-by-step technique 97
Side-to-side closure using sutures 97
Complications 97
Correction of dog ears 97
Postoperative care and follow-up 97
Care of stitches and advice to patient 97
CHAPTER 15: Skin flaps 99
General 99
Introduction 99
Flap biomechanics 99
Flap vascular supply 100
Flap terminology 101
Flap classification 101
Advancement (Video 15.1) 102
Rotation (Video 15.1) 102
Transposition (Video 15.1) 104
Staged (Video 15.1) 104
Preoperative care 105
Surgical defect analysis 105
Relevant anatomy 105
Adjacent skin and structures 106
Patient factors 106
Step-by-step surgical technique 107
Postoperative care and follow-up 107
Conclusion 107
Advancement flaps 107
Preoperative care 107
Step-by-step surgical technique, crescentic advancement flap 107
Postoperative care and follow-up 109
Prevention and management of complications 109
Rotation flaps 109
Classic rotation flap 109
Rotation flap with a back-cut 110
Dorsal nasal flap 110
Bilateral rotation flap 110
O-Z rotation flap 111
Pinwheel rotation flaps 112
Transposition flaps 112
Introduction 112
Preoperative care 112
Step-by-step surgical technique 112
Rhombic flap 113
Postoperative care and follow-up 114
Prevention and management of complications 114
Subcutaneous island pedicle flap 116
Introduction 116
Cutaneous anatomy pertinent to performing a subcutaneous island pedicle flap 116
Preoperative considerations 116
Subcutaneous island pedicle flap 116
Video list 117
CHAPTER 16: Reconstruction of the nose 118
Introduction 118
Nasal Anatomy 118
Cutaneous layer 118
Subcutaneous layer 119
Muscles 119
External blood supply 119
External sensory nerve supply 120
Nasal skeletal anatomy 120
Internal nasal anatomy 121
Nasal aesthetic units 122
Patient preparation 122
Healing by secondary intention 122
Defect analysis and preparation 123
Anesthesia 124
Reconstructive methods 124
Cutaneous grafts 124
Step-by-step surgical technique: cutaneous grafts 127
Composite grafts 128
Step-by-step surgical technique: composite grafts 128
Primary closure 129
Cutaneous flaps 129
Step-by-step surgical technique: primary closure and cutaneous flaps 130
Interpolation flaps 133
Interpolated forehead flaps 133
Step-by-step surgical technique: interpolated forehead flap 135
Interpolated melolabial flaps 136
Step-by-step surgical technique: interpolated melolabial flap 137
Postoperative care and follow-up 138
Complications 138
Summary 140
CHAPTER 17: Reconstruction of the lips 144
Introduction 144
Anatomy and function 144
Step-by-step surgical techniques 145
Upper lip reconstruction 145
Lower lip reconstruction 146
Vermilion reconstruction 147
Prevention and management of complications 149
CHAPTER 18: Reconstruction of the eyelids 151
Preoperative care 151
Step-by-step surgical technique 151
Primary closure 151
Deficient anterior lamella 152
Deficient posterior lamella 152
Postoperative care and follow-up 155
Complications 155
Video list 156
CHAPTER 19: Reconstruction of the ears 157
Introduction 157
Principles of ear closure 157
Suture techniques 157
Second intention healing 158
Skin grafts 159
Primary closure 160
Single stage flaps 160
Staged flaps 163
Perioperative care 164
Conclusion 164
Video list 167
CHAPTER 20: Reconstruction of the cheeks 168
Introduction 168
Preoperative care 168
Choosing a reconstructive technique 169
Repair by cheek subunit 169
Medial cheek 169
Anterior cheek 170
Infraorbital cheek 170
Malar cheek 170
Buccal cheek 170
Pre-auricular cheek 171
Mandibular cheek 171
Complications 171
Conclusions 172
Video list 172
CHAPTER 21: Reconstruction of the forehead and temples 173
Introduction 173
Preoperative care 173
Patient considerations 173
Informed consent 173
Tissue reservoirs 173
Step-by-step surgical techniques 174
Second intention healing (granulation) 174
Primary (linear) closure 174
M-plasty 175
Local flaps 175
Regional flaps 176
Distant/free flaps 176
Skin grafting 176
Prevention and management of complications 177
Nerve/muscle injury 177
Conclusion 177
Video list 178
CHAPTER 22: Reconstruction of the scalp 179
Primary closures of the scalp 179
Preoperative care 179
Surgical site preparation 179
Step-by-step surgical technique (Video 22.1) 179
Postoperative care and follow-up 181
Small local flaps to repair scalp wounds 181
Step-by-step surgical technique 181
Small local flaps to repair scalp wounds 186
Small local flaps to repair scalp wounds 189
Small local flaps to repair scalp wounds 191
Video list 193
CHAPTER 23: Reconstruction and soft-tissue management of the trunk 194
Introduction 194
Chest reconstruction 194
Abdominal wall reconstruction 195
Upper extremity reconstruction 196
Lower extremity reconstruction 196
CHAPTER 24: Reconstruction of the hand 199
Introduction 199
Hand anatomy, arteries, and nerves 200
Soft-tissue reconstruction of hand 201
Primary closure 201
Dermal regeneration template 201
Skin grafts 201
Flaps 201
Defect reconstruction by anatomic region 201
Fingertip 201
Defects of dorsum or palm 203
CHAPTER 25: Treatment of Dupuytren’s contracture by needle fibrotomy 205
Introduction 205
Definitions 205
Guillaume Dupuytren 205
Normal anatomy 205
The anatomy of Dupuytren’s contracture 205
Clinical findings in DC 205
DC and malignancy 209
Associated factors & diseases
Proposed pathophysiological mechanism: the vasodilatation hypothesis 209
Progression or recurrence 209
The treatments of DC 209
Rationale of needle fibrotomy 210
Preoperative care 210
Step-by-step surgical technique 210
Method of NF 210
Results of NF treatment 211
Postoperative care and follow-up 211
Postoperative care 211
Postoperative exercises 212
Intralesional corticosteroids 213
Prevention of disease progression 213
Complications 213
Prevention and management of complications 214
Advantages of NF over surgery 215
Conclusions 216
Video list 216
PART 3: Cosmetic Surgery 217
CHAPTER 26: Treatment of acne scars 219
Introduction 219
Preoperative care 220
Step-by-step surgical technique and postoperative care (Video 26.1) 223
Complications and management of complications 227
Video list 228
CHAPTER 27: Dermabrasion 229
Introduction 229
Indications 229
Preoperative care 229
Step-by-step surgical technique 230
Equipment 230
Anesthesia 230
Surgical technique 231
Postoperative care and follow-up 232
Healing course 232
Prevention and management of complications 232
Infections 232
Pigmentation changes 232
Scarring 232
Other complications 232
Summary 233
CHAPTER 28: Hair transplantation 234
Introduction 234
Hair loss: who, when, and “why me?” 234
Preoperative care 234
The consultation 234
Candidate selection 235
Day of surgery 236
Step-by-step surgical technique 236
Harvesting the donor area 236
Hairline design and graft site creation 237
Graft creation and placement 237
Postoperative care and follow-up 238
Conclusion 238
CHAPTER 29: Chemical peeling 239
Introduction 239
Preoperative care 239
Step-by-step surgical technique 240
Glycolic acid 240
Salicylic acid 241
Lipo-hydroxy acid 241
Jessner’s solution 241
Tretinoin peel 242
Trichloroacetic acid 242
Phenol peels 243
Postoperative care and follow-up 243
Prevention and management of complications 243
Video list 244
CHAPTER 30: Liposuction 245
Introduction 245
Preoperative care 245
Step-by-step surgical technique 246
Marking 246
Infiltration 246
Homogenizing time 247
Liposuction 247
Postoperative care and follow-up 247
Complications 247
Future directions 249
Video list 249
CHAPTER 31: Upper eyelid blepharoplasty 250
Preoperative care 250
Step-by-step surgical technique 250
Postoperative care and follow-up 252
Prevention and management of complications 252
Summary 254
Video list 254
CHAPTER 32: Facelifts 255
Indications 255
Preoperative care 255
Step-by-step surgical technique 256
Ancillary procedures 261
Postoperative care and follow-up 261
Prevention and management of complications 261
Video list 261
CHAPTER 33: Sclerotherapy 262
Introduction 262
Varicose veins 262
Diagnostic approaches 262
Type I 262
Type II 263
Type III 263
Type IV 263
Preoperative care 263
Step-by-step surgical techniques 263
Treatment techniques 264
Compression sclerotherapy 264
Duplex ultrasound-guided sclerotherapy 266
Practice of duplex sclerotherapy 267
Points to consider when treating varicose veins 267
Keys to success when treating varicose veins 267
Reticular veins 267
Preoperative care 268
Appropriate sclerosant concentrations for treating reticular veins 268
Step-by-step surgical technique 268
Treatment technique for reticular veins 268
Postoperative care and follow-up 269
Post-treatment follow-up visits 270
Pearls and pitfalls: reticular veins 270
Keys to success: reticular veins 270
Telangiectasias 270
Choosing the appropriate sclerosant concentration for treating telangiectasias 271
Step-by-step surgical technique: sclerotherapy for telangiectasias 271
Postoperative care and follow-up 273
Treating approaches to resistant telangiectasia 273
Conclusion 273
CHAPTER 34: Botulinum toxin 275
Introduction 275
Preoperative care 275
Step-by-step surgical technique 275
Reconstitution 275
Syringe 276
Setting 276
Injection point, dose, and technique 276
Glabellar lines 276
Periorbital wrinkles 276
Horizontal forehead lines 277
Mid- and lower face 277
Postoperative care and follow-up 277
Prevention and management of complications 278
Complications 278
Final considerations 279
Video list 280
CHAPTER 35: Temporary fillers 281
Autologous fat transfer 281
Introduction 281
Preoperative care 282
Step-by-step surgical technique 282
Adipocyte harvesting 282
Isolation of adipocytes 282
Injection of fat 283
Postoperative care and follow-up 283
Prevention and management of complications 284
Collagens 284
Introduction 284
Bovine collagen 284
Human collagen 285
Porcine collagen 285
Patient selection 285
Preoperative care 285
Injection techniques 286
Indications 286
Postoperative care and follow-up 286
Tolerability and contraidications 286
Closing remarks 287
Poly-l-lactic acid 287
Introduction 287
Composition and mechanism of action 288
PLLA reconstitution 288
Injection techniques 288
The mid-face 288
Correcting the cheek 289
The upper face 289
The temple 289
The lower face 289
Indications 289
Complications 289
Contraindications 289
Postoperative care and follow-up 290
Conclusion 290
An overview of the dermal filler calcium hydroxylapatite (Radiesse) 290
Introduction 290
Composition and mechanism of action 290
CaHA in clinical literature 291
CaHA and collagen 292
CaHA and hyaluronic acids 292
CaHA and Fitzpatrick skin types IV–VI 292
CaHA and the aging hand 292
FDA-approved indications 292
Patient counseling and evaluation 292
Preoperative care 293
Step-by-step injection technique 293
Common applications of CaHA 294
Complications 295
Conclusion 297
Acknowledgements 297
Hyaluronic acid fillers 298
Introduction 298
Hyaluronic acid 298
Aging face 298
Differences between aging face proportions 299
Preoperative care 299
Step-by-step injection technique 300
Patient evaluation 300
Product choice 300
Needle choice 300
Injection technique 300
Upper face 301
Glabellar lines 301
Forehead lines 301
Brow ptosis 301
Mid-face 302
Lower face 302
Complications 303
Prevention and management of complications 304
Video list 307
CHAPTER 36: Permanent fillers: liquid silicone and polymethylmethacrylate 308
Liquid silicone 308
Mechanism of action 308
Indications 308
Efficacy and safety 308
Technique (Video 36.1) 309
Prevention and management of complications 312
Polymethylmethacrylate 312
Mechanism of action 313
Indications 313
Efficacy and safety 313
Technique 313
Video list 314
CHAPTER 37: Cosmetic dermatologic surgery in ethnic skin 315
Introduction 315
Evaluation of the ethnic patient 315
Preoperative care 315
Postoperative care and follow-up 315
Complications 316
Dimpleplasty 316
Postoperative care and follow-up 316
Complications 316
Sebaceous cyst 316
Narrow hole excision technique (NHET) 316
Postoperative care 316
Xanthelasma 316
Step-by-step surgical technique (upper and lower eyelids) 316
Postoperative care 317
Complications 317
Ephelides/lentigenes 317
Step-by-step surgical technique 317
Syringomas 317
Acrochordons 317
Vitiligo 318
Indications 318
Grafts 318
Non-grafting techniques 318
Punch grafting 319
Split-thickness grafting 319
Suction blister technique 319
Recipient site 320
Complications 320
PART 4: Lasers 321
CHAPTER 38: Laser for treatment of vascular lesions 323
Preoperative care 323
Anesthesia 323
Laser safety 323
General considerations 323
Step-by-step procedure for port wine stains 324
Step-by-step procedure for telangiectasias and spider angiomas (Videos 38.1 and 38.2) 324
Step-by-step procedure for hemangiomas 324
Postoperative care 325
Video list 325
CHAPTER 39: Laser treatment for pigmented lesions 326
Introduction 326
Preoperative considerations 326
Anesthesia 327
Laser safety 327
Step-by-step procedure for epidermal pigmented lesions 327
Step-by-step procedure for dermal pigmented lesions 327
Postoperative care for pigmented lesion patients 327
CHAPTER 40: Laser treatment of tattoos 329
Introduction 329
Choosing the appropriate laser 330
Preoperative care 330
Anesthesia 330
Laser safety 330
Step by step procedure for tattoo removal (Video 40.1) 331
Postoperative care and follow-up 331
Other considerations 331
Video list 331
CHAPTER 41: Lasers for hair removal 332
Introduction 332
Preoperative care 332
Anesthesia 332
Laser safety 333
General consideration before treatment 333
Step-by-step procedure surgical technique (Video 41.1) 333
Postoperative care and follow-up 334
Complications 334
Video list 334
CHAPTER 42: Laser and light treatment for hair transplantation and growth induction 335
Introduction 335
Medical therapy for hair loss 335
Hair transplantation 335
Laser-assisted hair transplantation 336
Low-level light therapy and hair loss 337
Clinical application of the devices 337
Peer-reviewed evidence 337
Current role of LLLT in treating male and female pattern hair loss 338
Future challenges 338
CHAPTER 43: Laser treatment for keloid, hypertrophic, and surgical scars 340
Introduction 340
Video list 341
CHAPTER 44: Laser for treatment of leg veins 342
Introduction 342
Anatomy of venous system 342
Patient selection 343
Clinical outcomes of laser and light treatment 344
Considerations for treatment strategy 345
Treatment approach 345
Key determinants 345
Patient interviews 347
Treatment techniques 347
Patient selection 347
Available laser technologies 347
Treatment algorithm 351
Complications 353
Conclusion 353
Video list 354
CHAPTER 45: Laser treatment for acne 355
Introduction 355
Suggested procedure for use of the photopneumatic device (Video 45.1) 356
Side effects of the photopneumatic device 357
Video list 358
CHAPTER 46: Laser treatment of psoriasis, vitiligo, and alopecia areata 359
Introduction 359
Psoriasis 359
Vitiligo 359
Alopecia areata 360
Preoperative care 360
Patient selection checklist 360
Favorable patient characteristics 360
Unfavorable patient characteristics 360
Supplies needed 360
Step-by-step surgical technique 360
Preprocedure checklist 361
Low- or medium-dose UVB treatment advised for some psoriasis, and all vitiligo and alopecia areata (AA) patients (adapted from the Clinical Reference Guide for the Xtrac excimer laser) 361
High-dose excimer laser treatment (8–16× MED): psoriasis only 361
Postoperative care and follow-up 361
Complications 362
Prevention and management of complications 362
Video list 362
CHAPTER 47: Lasers for skin resurfacing 363
Introduction 363
Ablative resurfacing 363
Non-ablative resurfacing 363
Preoperative care 364
Step-by-step surgical technique 365
Anesthesia 365
Safety 365
Intraoperative considerations 366
Postoperative care and follow-up 367
Complications 368
Prevention and management of complications 368
Conclusions 370
CHAPTER 48: Fractional resurfacing lasers: ablative and non-ablative 371
Introduction 371
Fractional ablative resurfacing 371
Fractional non-ablative resurfacing 372
Preoperative care 375
Step-by-step surgical technique 376
Anesthesia 376
Safety 376
Intraoperative considerations 376
Postoperative care and follow-up 378
Complications 378
Prevention and management of complications 378
Conclusions 379
CHAPTER 49: Non-invasive devices for fat removal 381
Introduction 381
Preoperative care 382
Step-by-step surgical technique 383
Complications 383
Conclusion 383
CHAPTER 50: Laser and light treatment for wound healing 385
Introduction 385
General wound care considerations 385
Clinical application of phototherapy 387
Discussion 388
CHAPTER 51: Laser for in vivo skin cancer diagnosis. Reflectance confocal microscopy 390
Introduction 390
Reflectance confocal microscopy. Basic principles. Confocal features of normal skin 390
Skin tumors 391
Squamous neoplasia 391
Basal cell carcinoma 393
Acquired melanocytic tumors 394
Melanoma 394
Clinical applications 394
Acknowledgments 397
Video list 397
CHAPTER 52: Intense pulsed light 398
Preoperative care 398
Choose technology: Intense pulsed light versus lasers 398
IPL device 398
Selection of parameters and indications 398
Patients: selection, contraindications, and pretreatment 398
Step-by-step surgical technique 399
Hair removal (photoepilation) 400
Pigmentation 400
Lentigines and tattoo removal 400
Melasma 401
Vessels 401
Photorejuvenation and skin tightening 401
Medical indications 401
Postoperative care and follow-up 401
Complications 402
Prevention and management of complications 402
Patient selection and compliance 402
Video list 403
CHAPTER 53: Light-emitting diodes 404
Introduction 404
Mechanism of action 404
Indications 405
Photorejuvenation 405
Acne 406
Preoperative care 407
Parameters 407
Procedure 407
Postoperative care and follow-up 407
Safety 407
Complications 408
Video list 408
CHAPTER 54: Photodynamic therapy 409
Introduction 409
Photosensitizers 409
Light source 409
Laser PDT 409
Non-coherent light sources 410
Instruments and items required 410
Step-by-step surgical technique (Video 54.1) 410
Variation in the technique when using MAL for the treatment of AK 411
Postoperative care and follow-up 411
Desired phototoxic reaction 411
Complications 411
Prevention and management of complications 411
Contraindications 411
Video list 412
CHAPTER 55: Laser for skin tightening 413
Introduction 413
Non-invasive skin tightening with laser and light sources 413
The use of fractional resurfacing for skin tightening 415
Laser-assisted lipolysis for skin tightening 416
Video list 417
CHAPTER 56: Radiofrequency for skin tightening 418
Introduction 418
Facts about radiofrequency 418
Mechanism of action for skin tightening 418
Comment about lasers and radiofrequency 419
Types of radiofrequency devices 419
During the consultation 419
Preparation for radiofrequency procedure 419
Achieving predictable and reproducible results 420
Tips for monopolar radiofrequency with Thermacool 420
Treatment pearls for devices without disposable treatment tips 420
Contraindications to the use of radiofrequency 421
Video list 421
CHAPTER 57: Lasers for treatment of ethnic skin 422
Introduction 422
Preoperative care 422
Freckles and lentigines 422
Nevus of ota 424
Acquired bilateral nevus of Ota-like macules (ABNOM or Hori’s macules) 425
Melasma 426
Skin rejuvenation 427
Video list 429
PART 5: Topics Pertinent to the Practice of Dermatologic Surgery 431
CHAPTER 58: Wound dressings 433
Introduction 433
Types of dressings 433
Low adherent dressings 433
Gauze dressings 434
Transparent film dressings 434
Hydrogel dressings 434
Foam dressings 434
Hydrocolloid dressings 434
Alginate and hydrofiber dressings 435
Antimicrobial dressings 435
Conclusion 436
CHAPTER 59: Medicolegal aspects 437
Introduction 437
Medical malpractice 437
Duty 437
Breach of duty 438
Damages 438
Causation 439
Consent/refusal for treatment 439
Informed consent 439
Medical records 439
Adverse events and complications in dermatologic surgery 440
Trust building 440
Remedying the adverse event 440
Summary 441
CHAPTER 60: Ethical aspects 442
Introduction 442
Core values 442
Autonomy 442
Beneficence 442
Non-maleficence. 442
Justice 443
Medical necessity: blending economics with patient needs 443
Cosmetic procedures: rhetoric versus reality 444
Lasers 444
Credentials and training 445
Conclusion 445
CHAPTER 61: Psychiatric aspects of cutaneous surgery 0
Introduction 0
Patients who exaggerate their cosmetic defects 0
Monosymptomatic hypochondriacal psychosis 0
Body dysmorphic disorder 0
Somatization of depression 0
Anxiety disorder 0
Borderline personality disorder 0
Alternative psychiatric diagnoses 0
Schizophrenia 0
Schizoaffective disorder 0
Bipolar disorder 0
Gender identity disorder 0
Management 0
General concepts 0
Monosymptomatic hypochondriacal psychosis 0
Somatization of depression 0
Chronic anxiety disorder 0
Borderline personality disorder 0
Other psychiatric disorders 0
Psychiatric disorders resulting from disfigurement 0
Social phobia 0
Summary 0
CHAPTER 62: New frontiers in photodynamic therapy 447
Introduction 447
Daylight-mediated PDT 447
Fractional laser-assisted PDT 448
Complications 450
Final thoughts 450
Index 452

Rezensionen

"Brief but accurate discussions on preoperative and
postoperative care, complications, and a general outline for
performing the procedures provide an introduction to many different
avenues for procedure-oriented dermatologists to
explore." (Doody's, 26 July 2013)

Produkt-Details

• Erscheint lt. Verlag: 6.9.2012
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizinische Fachgebiete ► Chirurgie ► Ästhetische und Plastische Chirurgie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Dermatologie
• Schlagworte: dermatologic surgery • Dermatologie • Dermatologische Chirurgie • Medical Science • Medizin • oncological procedures, cosmetic procedures, laser procedures, skin surgery, skin surgeries, dermatologic surgical procedures, plastic surgery, surgical treatment of skin conditions, melanoma, melanoma surgery
• ISBN-10: 1-118-41270-2 / 1118412702
• ISBN-13: 978-1-118-41270-1 / 9781118412701