The Journal of dermatologic surgery and oncology
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J Dermatol Surg Oncol · Jun 1994
Comparative StudyDecrease in skin-closing tension intraoperatively with suture tension adjustment reel, balloon expansion, and undermining.
The biomechanical and viscoelastic properties of the skin enable it to be significantly stretched within a relatively short period of time. This property, called mechanical creep, is exploited in various surgical maneuvers for intraoperative closure of large surgical defects. The recently introduced Miami Suture Tension Adjustment Reel (S.T.A.R.) device permits both the precise sutured attachment of a linear cycled load to approximate the edges of widened surgical defects, and the easy measurement of wound edge tension across the defects. ⋯ Our data showed that all three techniques were effective in lowering the tension required to approximate surgically created defects, with the S.T.A.R. device proving to be most effective. Undermining and the S.T.A.R. device also worked synergistically to decrease skin-closing tension.
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There is little written in dermatologic literature on bipedicle advancement flaps. ⋯ We believe the bipedicle flap to be a much under-used flap in superficial soft tissue reconstruction. We suggest that this flap be actively considered as a reconstructive option for a variety of defects on multiple body sites.
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J Dermatol Surg Oncol · Feb 1994
Randomized Controlled Trial Clinical TrialA double-blind placebo controlled study of a 5% lidocaine/prilocaine cream (EMLA) for topical anesthesia during thermolysis.
Electrolysis and thermolysis are commonly used electrosurgical methods for the permanent destruction of unwanted hair. However, patient fear of pain during treatment may interfere with or even prevent desired treatment of hirsutism on sensitive areas such as the upper lip. ⋯ EMLA cream may have multiple applications to the practice of dermatologic surgery, including topically achieved local anesthesia during thermolysis and electrolysis.
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Chronic tissue expansion is an extremely useful addition to the dermatologic surgeon's skills. ⋯ Chronic tissue expansion provides an excellent means for obtaining extra tissue for cosmetic and reconstructive surgery.
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J Dermatol Surg Oncol · Dec 1993
Case ReportsPrimary reconstruction of congenital facial lesion defects with tissue expansion.
Congenital facial lesions may require surgical intervention to correct deformity or to decrease the potential for malignant degeneration. ⋯ Tissue expansion has a role in surgical management of congenital facial lesions. Staged excision, skin grafting and nonintervention are also options which must be individualized to the case at hand.