This new reference covers the top 100 pearls in cutaneous oncologic, nail and cosmetic dermatologic surgery, giving you at-a-glance access to some of the best know-how in the field. Organized in a consistent format, and illustrated with full color photographs and explanatory line drawings, this is the perfect tool to help you improve the level of care you offer your patients. Whether you're new to the field or you've been practicing dermatologic surgery for years, you'll consider this book one of your most valuable resources.
Fills a gap in the field by bringing together material that is rarely gathered in one book.
Includes expert hints and tips on avoiding common pitfalls in cosmetic and dermatologic surgery.
Illustrates each pearl with line drawings and photographs to put it into clinical context.
Pearl 1: Surgical Assistant: Counter-Traction and a Clear Visual Field Pearl 2: Placement of the Simple Interrupted Stitch Pearl 3: Surgical Assistant: Help with Surface Sutures Pearl 4: Surgical Assistant: Twisted Knot and Cutting Suture at Correct Length Pearl 5: Surgical Assistant: Help with the Subcuticular Stitch
Section 2: Suture Techniques
Pearl 6: How to Break the Memory of Suture Material without Breaking the Suture Pearl 7: Hemostasis: Suture Ligature Pearl 8: Proper Placement of the 3-Cornered Stitch Pearl 9: Delayed Closure of Buried Sutures When Closing Small Excisions Pearl 10: Percutaneous Buried Vertical Mattress Suture Pearl 11: The Running Locked Suture as an Aid for Hemostasis Pearl 12: Maximal Skin Edge Eversion with the Running Hybrid Mattress Suture Pearl 13: The Short String Tie off
Section 3: Closures and Procedures
Pearl 14: Circular Incisions as a Guide for Optimal Aesthetic Removal Pearl 15: The Crescentic Ellipse for Curving Relaxed Skin Tension Lines Pearl 16: Serial Excision Pearl 17: S-Plasty for Excision on Convex or Concave Pearl 18: Pruning the Proud Flesh Pearl 19: Hydro-Dissection (Hydroplaning) with Anesthetic Fluid Pearl 20: Second Intention Healing Over Bare Cartilage Pearl 21: A User-Friendly Surgical Dressing Pearl 22: Minimizing the Dogear Pearl 23: In Pursuit of the Perfect Punch Biopsy Pearl 24: The Split Punch Biopsy: The power of two Pearl 25: Saucerization Biopsy Pearl 26: "Off-Set Bias Suturing" to Favorably Alter the Tension Vector of Closure Pearl 27: Have I Cut the Temporal Nerve or Just Anesthetized It? Pearl 28: Electrodesiccation and Curettage for Warts Pearl 29: Cysts and Lipomas, Oh My Pearl 30: Drainage of Inflamed/Liquefied Cyst Pearl 31: Transection of Pigmented Lesion Pearl 32: The Retraction Suture for Cyst Removal
Section 4: Flaps
Pearl 33: Flap Components Pearl 34: The Tension Vector of Closure Pearl 35: Tension Vector of Rotation/Advancement Flaps Pearl 36: Determining the Final Scar Lines and Tension Vector of the Rhombic Flap Pearl 37: The Suspension Suture: Partial Closure of Defect Near Free Margin Pearl 38: Contour Maintenance with Suspension Sutures Pearl 39: Reconstruction of the Alar-Facial-Lip Sulcus Pearl 40: "Mercedes Flap": Multiple Flap Closure of Large Defects
Section 5: Grafts
Pearl 41: Trimming Fat Off of Full-Thickness Skin Grafts Pearl 42: Free Hand Harvesting of a Small Split-Thickness Skin Graft Pearl 43: Basting Suture for FTSG under Direct Visualization Pearl 44: Continuous Tie-Over Bolster Dressings for Skin Grafts Pearl 45: M-Plasty FOR Dog Ear Pearl 46: Dog-Ear as Graft; Don't Throw That Tissue Away Pearl 47: Dermabrasion for Surgical Scars and Grafts Pearl 48: Manual Dermabrasion of Full-Thickness Grafts Pearl 49: Post-surgical dermabrasion
Section 6: Safety
Pearl 50: Maintaining an Orderly Surgical Tray Pearl 51: Surgical Waste Disposal Pearl 52: Safety: The Medicine Cup: Behold the Lowly cup Pearl 53: Safety: Corneal Eyeshield Pearl 54: Safety: The Sheathed Syringe Pearl 55: Geometric Pattern Excision for Histological Margin Control of Tumors Pearl 56: Control of the Surgical Lamp: In the Best Light Pearl 57: Electrosurgical Unit Safety
Section 7: Instruments
Pearl 58: Instruments for Special Occasions: The Mini-Scalpel System Pearl 59: Razor Blade Surgery for Benign Lesions Pearl 60: Razor Blade Excision for Shallow Basal Cell Carcinomas of the Nose Pearl 61: Alternate Use of a Forceps: A Freeze With a Squeeze Pearl 62: Towel Clamp Assisted Closure for Wounds under Significant Tension Pearl 63: The Cotton-Tipped Applicator (CTA): The Ever-Ready, Multi-Purpose Superstar Pearl 64: The Tongue Depressor: More than say "Ah" (Sept pearls) Pearl 65: The Universal Paper Clip: There's always one in the desk drawer Pearl 66: The Hyfrecator: Low-Tech, Yet Efficient Benign Lesions Pearl 67: The Punch Used as a Curette
Section 8: Nail
Pearl 68: Nail Matrix Exploration and Retraction Suture for Exposure of the Proximal Nail Groove. Pearl 69: Obtaining an Adequate Biopsy of the Nail Matrix/Bed Pearl 70: Compressive Dressing for the Nail Unit Pearl 71: Use of a Sterile Surgical Glove to Create a Sterile Field Pearl 72: The Proximal Nail Plate Avulsion Pearl 73: Post-phenol Matricectomy Injection to Prolong Anesthesia and Prevent Lymphangitis Pearl 74: Decompression of a Subungual Hematoma
Section 9: Regional Tips
Pearl 75: Pinwheel flap for the scalp vertex and direct galeotomy Pearl 76: Tips for Scalp Surgery: Keeping Hair Out of the Field Pearl 77: Tips for Scalp Surgery: Collodion Dressing Pearl 78: Pearls Around the Mouth Pearl 79: Suturing on the Lip to Minimize Patient Discomfort Pearl 80: Labial Mucocele Removal Pearl 81: Dental Roll for Nasal Packing Pearl 82: Cotton Plug in the Ear Canal Pearl 83: Testing Lower Eyelid Strength Pearl 84: Second Intention Healing of Ear Defects
By Stuart Salasche, MD, Clinical Professor, University of Arizona Health Sciences Center, Research Scientist, University of Arizona, Cancer Center, Tucson, AZ; Ida F. Orengo, MD, Director of Dermatologic Surgery, Associate Professor, Department of Dermatology, Baylor College of Medicine, Houston, TX, USA; and Ronald J. Siegle, MD, Center for Surgical Dermatology, Columbus, OH, USA