Skin Surgery Flashcards
What are the basic points to skin surgery?
- make a diagnosis – need before surgery
- use best treatment option – not necessarily surgery
- keep within your limits
- send all specimens to pathology
What would indicate a skin biopsy?
Assist in diagnosis
remove malignancy
remove unwanted skin growth
Describe a dermatofibroma?
Firm to touch
often increased pigment around rim
Why may a biopsy of a rash not provide a diagnosis?
- different skin conditions may have same histology eg different types of eczema
- one cause of a skin condition can have several histology patterns (drug eruption)
Give some presentations of skin disease due to adverse reaction to amoxicillin.
Morbilliform eruption urticaria angiodema fixed drug eruptions generalised pustulosis
After diagnosis of a skin tumour give some examples of what therapy can be used.
Surgery photodynamic therapy cryotherapy chemo/radio therapy 5-fluroacil solaraze Imiquimod
What is involved in pre-operative planning?
Nature of procedure PMH DH bleeding disorder Allergies Other - pacemaker, valve defect, epilepsy, diabetes
What is “tiger country”?
around temples, pre-auricular, over jaw to lips, Erb’s point
What are the 5 layers of the scalp?
S- Skin C- connective tissue A- aponeurosis L- loose connective tissue P- periosteum
Give some methods of local anaesthesia
topical
local infiltration
nerve block
field block
What is the role of adrenaline in skin surgery?
Prolongs anaesthesia and reduces bleeding
What are the potential complications of skin surgery?
Bleeding wound dehiscence infection scarring motor or sensory nerve damage loss of function
What are the basic methods of skin surgery?
electrosurgery snip excision curettage shave excision punch biopsy elliptical excision
Give the advantage of a punch biopsy?
Produces good wound edges
Are there any disadvantages to punch biopsy?
difficult to judge depth
round holes do not always heal well
pathology sample may be too small
