By George B. Winton (auth.), M. D. Marwali Harahap (eds.)
The scope of dermatologic surgical procedure is so huge that unavoidably a multitude and diversity of problems come up. after all nearly all of problems should be avoided by means of cautious preoperative education, meticulous surgical process, and correct postoperative care, but if they do take place, they are often famous and controlled with ability and competence. This ebook offers a invaluable resource of reference for the prevention, recogni tion, and administration of issues in dermatologic surgical procedure. warding off seasoned blems is no less than as vital as facing them, and so all of the chapters during this ebook take care of either prevention and administration. This ebook addresses dermatologic surgeons in perform or in education and to surgeons in different specialties who might be required to adopt fix of pores and skin defects. Many ofthe authors permitted the accountability of contributing to this paintings as well as their many different duties. For this, i'm tremendous thankful to them. MARwALI HARAHAP Contents neighborhood Anesthesia and neighborhood Anesthesia George B. Winton ...................................................... 1 Electrodesiccation and Curettage Harvey Finkelstein and Robert Jackson. . . . . . . . . . . . . . . . . . . . . .. . . . sixteen . . . . . . . .
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Extra resources for Complications of Dermatologic Surgery: Prevention and Treatment
Alternative therapies should be considered for these cases. In the extensive solar-induced poikilodermatous skin the white atrophy of the slightly thickened scar can stand out against the background of yellow elastosis, red telangiectasia, and brown hyperpigmentation. Hypertrophic scars are estimated to occur in 10%-15% of cases after removal of basal cell carcinomas by electrodesiccation and curettage. Keloids are much rarer, in approximately 1% of cases [9, 17]. Hypertrophic scars occur most often on the upper chest and lateral arms, but the face, back, and abdomen can also be affected (Figs.
Surgery in these patients is best postponed, if possible, until the effect of the drug has been reversed. Even if adequate hemostasis seems to be achieved in the office, much bleeding may occur later. Consultation with the patient's family physician or internist is indicated before these drugs are discontinued or their action reversed with vitamin K or plasma factor concentrates. When curettage and electrodesiccation is undertaken in patients in whom anticoagulant-types of medications cannot be stopped, meticulous care needs to be taken to make sure that good hemostasis has been achieved before the patient leaves the office.
A pressure dressing is helpful. The patient should be instructed on the appropriate use of pressure to a bleeding wound if problems arise at home and to limit physical activity for 24 h following surgery. The patient should be reassured and be prepared for some bleeding that might occur when the initial crusted electro coagulum separates. Bleeding may occur, usually from some minor trauma, any time up to 2-3 weeks. It is particularly common on the red lip about 7-10 days after the initial procedure.
Complications of Dermatologic Surgery: Prevention and Treatment by George B. Winton (auth.), M. D. Marwali Harahap (eds.)