The demand for outpatient cutaneous surgery procedures has increased at a rapid rate over the last several decades. Cosmetic, oncology, and reconstructive procedures are being performed by primary care physicians and a variety of specialists in different disciplines such as dermatology, plastic surgery, ophthalmology, and otolaryngology. As the number of cutaneous surgery procedures rises, so will the rate of complications, which are inevitable and occur even with the most skilled, careful, and meticulous surgeons. In the practice of medicine, we often learn more from our complications than our triumphs. The authors of each chapter of Complications in Cutaneous Surgery were recruited to contribute based on their experience and respective areas of expertise. As of this writing, no other book specifically addresses complications in cutaneous surgery. The goal of this volume is to provide a comprehensive text that will enable the practicing physician to formulate a preoperative strategy to not only prevent complications before they occur but also to properly diagnose and manage complications when they arise, allowing the physician to provide optimal care to the patient. 0387731512......Page 1 Title Page ......Page 3 Copyright Page ......Page 4 Preface......Page 5 Table of Contents ......Page 6 Contributors......Page 8 Section I Acute Surgical Complications......Page 10 Orientation......Page 11 Allergies......Page 12 Medications and Supplements......Page 13 Cardiovascular......Page 14 Renal......Page 15 References......Page 16 Level of Training......Page 17 The Office Team......Page 18 Automatic External Defibrillators......Page 19 Anaphylaxis......Page 20 Vasovagal Syncope......Page 21 Acute Stroke......Page 22 Electrosurgery and Pacemakers/Defibrillators......Page 23 References......Page 25 Avoiding Nerve Injury: “An Ounce of Prevention Is Worth a Pound of Cure”......Page 29 The Spinal Accessory Nerve (Cranial Nerve 11)......Page 30 Management of Temporal Nerve Injury......Page 31 Course of the Zygomatic and Buccal Nerves and Location of the Anatomic Danger Zone......Page 32 Management of Zygomatic and Buccal Nerve Injuries......Page 33 Course of the Marginal MandibularNerve and Location of the Anatomic Danger Zone......Page 34 Consequences of Marginal Mandibular Nerve Injury......Page 35 Course of the Supraorbital and Supratrochlear Nerves and Location of the Anatomic Danger Zone......Page 36 Management of Supraorbital and Supratrochlear Nerve Injuries......Page 37 Course of the Mental Nerve and Location of the Anatomic Danger Zone......Page 38 Avoidance of Spinal Accessory Nerve Injury......Page 39 Avoidance of Great Auricular Nerve Injury......Page 40 Different Locations Require Different Approaches......Page 41 Suggested Further Readings......Page 43 Drug-Induced Coagulopathy......Page 44 Inadequate Intraoperative Hemostasis......Page 47 Less Common Causes of Bleeding and Hematoma......Page 48 Hemorrhagic Complications......Page 49 References......Page 52 Immunocompromised Patients......Page 54 Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome......Page 55 Contact Dermatitis......Page 56 Spitting Sutures......Page 57 Ear Flora......Page 58 Gastrointestinal and Urinary Flora......Page 59 Commercial Chlorhexidine Preparations......Page 60 Management of Established Wound Infection......Page 61 Methicillin-Resistant Staphylococcus aureus......Page 63 Prevention of Hospital-AssociatedMethicillin-Resistant Staphylococcus aureusand Community-Acquired Methicillin-ResistantStaphylococcus aureus Wound Infection......Page 64 Candida......Page 65 Life-Threatening Wound Infections......Page 66 Conclusion......Page 67 References......Page 68 Preoperative Condition of the Skin......Page 70 Wound Characteristics......Page 71 Topical Antibiotics......Page 72 Patient Characteristics that Increase the Risk of Surgical Site Infection......Page 73 Wound Infection Pathogens and Prophylactic Antibiotics......Page 74 Endocarditis......Page 76 Procedures that Require Endocarditis Prophylaxis According to the American Heart Association Guidelines......Page 77 Surgical Procedures Involving Infected Tissue......Page 78 Bacteremia after Dermatologic Procedures......Page 79 Conclusion......Page 81 References......Page 82 Normal Wound Healing......Page 85 Dehiscence......Page 86 Wound Necrosis......Page 88 Necrosis......Page 89 Prevention......Page 90 References......Page 91 Section II Chronic Surgical Complications......Page 92 8 Hypertrophic Scars and Keloids......Page 93 Intralesional Steroids......Page 95 Cryotherapy......Page 96 Interferon Therapy......Page 97 Others......Page 98 References......Page 99 Free Margins: Perioperative Considerations......Page 101 Second Intention Healing......Page 102 Z-Plasty......Page 106 Grafts......Page 108 Eyelid......Page 110 Lip......Page 116 Linear Repair......Page 118 Conclusion......Page 119 References......Page 120 Observation......Page 121 Silicone......Page 122 Steroids......Page 125 Nonsurgical Laser......Page 126 Surgical Lasers......Page 127 Geometric Broken Lines (GBL) and W-Plasty......Page 129 Z-Plasty......Page 132 Subcision®......Page 138 References......Page 143 Chlorhexidine......Page 145 Iodophors......Page 146 Diagnos is and Wound Care Implications......Page 147 Extrusion of Buried Sutures......Page 148 Railroad Tracking......Page 149 Excessive Granulation Tissue......Page 150 Edema......Page 151 Seroma......Page 152 Reflex Sympathetic Dystropy......Page 153 Nasal Valve Compromise......Page 154 Cryosurgery......Page 155 References......Page 156 Section III Complications of Cosmetic Procedures......Page 159 12 Preoperative Cosmetic Consultation and Psychological Complications of Cosmetic Surgery......Page 160 The Psychiatric Exam......Page 161 Anxiety Disorders......Page 163 Epidemiology......Page 164 Body Dysmorphic Disorder......Page 166 Depression......Page 167 Treatment Options......Page 168 Conclusion......Page 169 References......Page 170 Ablative Laser Skin Resurfacing......Page 172 Normal Healing Process......Page 173 Prolonged Erythema......Page 174 Infection......Page 175 Pigmentary Alteration......Page 176 Ectropion Formation......Page 178 Mid-Infrared Lasers......Page 179 Short-Contact Photodynamic Therapy......Page 181 Nonablative Radiofrequency......Page 182 Fractional Photothermolysis......Page 183 References......Page 184 Patient Evaluation......Page 188 Medium and Deep Chemical Peels......Page 189 Pigmentary Changes......Page 190 Scarring......Page 192 Infection......Page 193 Acne/Milia......Page 194 Inherent Errors during the Procedure......Page 195 References......Page 196 Liposuction under General Anesthesia......Page 197 Preoperative Assessment......Page 198 Infection......Page 202 References......Page 203 Collagen-Based Products......Page 204 Hyaluronic Acid Fillers......Page 206 Artefi ll/Artecoll......Page 207 Silicone......Page 208 Semipermanent Fillers......Page 209 References......Page 210 Mechanisms of Complications......Page 212 Avoiding Complications......Page 213 Treating Complications......Page 214 Conclusion......Page 216 References......Page 217 Postsclerotherapy Hyperpigmentation......Page 218 Telangiectatic Matting......Page 222 Purpura......Page 223 Cutaneous Necrosis......Page 224 Rare but Major Complications......Page 226 References......Page 227 Preoperative Phase — Minimizing Complications......Page 229 Bleeding......Page 230 Alterations in Contour......Page 231 Nerve Injury......Page 232 Motor Nerves......Page 233 Hematoma......Page 234 Infection......Page 235 Flap Necrosis and Slough......Page 236 Allergic and Irritant Contact Dermatitis......Page 237 Hypertrophic and Keloid Scars......Page 238 Facial Asymmetry and Premature Sagging......Page 239 References......Page 240 Index......Page 243
The demand for outpatient cutaneous surgery procedures has increased at a rapid rate over the last several decades. Cosmetic, oncology, and reconstructive procedures are being performed by primary care physicians and a variety of specialists in different disciplines such as dermatology, plastic surgery, ophthalmology, and otolaryngology. As the number of cutaneous surgery procedures rises, so will the rate of complications, which are inevitable and occur even with the most skilled, careful, and meticulous surgeons.
In the practice of medicine, we often learn more from our complications than our triumphs. The authors of each chapter of Complications in Cutaneous Surgery were recruited to contribute based on their experience and respective areas of expertise. As of this writing, no other book specifically addresses complications in cutaneous surgery. The goal of this volume is to provide a comprehensive text that will enable the practicing physician to formulate a preoperative strategy to not only prevent complications before they occur but also to properly diagnose and manage complications when they arise, allowing the physician to provide optimal care to the patient.
Doody Review Services
Reviewer:Jon C Starr, MD(Stanford University Medical Center)
Description:This useful book outlines the common complications that can occur in cutaneous surgery.
Purpose:This information can be found in other books, but not in such a focused and concentrated style.
Audience:The audience includes surgeons from residents to experienced practitioners. The author is a respected dermatologic surgeon and he has gathered an excellent group of contributing authors.
Features:The book is particularly useful in explaining how to avoid common complications and is unique in that many surgeons avoid discussing complications. This is a refreshing and honest presentation of a topic we would all prefer not to discuss.
Assessment:This book is great -- useful, complete, and discussing a topic not well covered in the literature. It should be required reading for all residents expecting to practice cutaneous surgery.
The demand for outpatient cutaneous surgery procedures has increased at a rapid rate over the last several decades. Cosmetic, excisional, and reconstructive pro- dures are being performed by primary care physicians and a variety of specialists in different disciplines, such as dermatology, plastic surgery, ophthalmology, and otolaryngology. As the number of cutaneous surgery procedures rises, so will the rate of complications, which are inevitable and occur even with the most skilled, careful, and meticulous surgeons. In the practice of medicine, we often learn more from complications than t- umphs. The authors of the chapters in this book were recruited based on their experience and respective areas of expertise. To my knowledge, no book exists that summarizes the medical literature regarding complications in cutaneous surgery. The goal of this book is to provide a comprehensive text that will enable the pr- ticing physician to formulate a preoperative strategy to prevent complications before they occur and to properly diagnose and manage complications when they arise in order to provide a better service to the patient. This book is divided into three sections: acute surgical complications, chronic surgical complications, and complications of cosmetic procedures. Each chapter discusses a different complication and outlines proper preventative, diagnostic, and management strategies based on the medical literature and the experience of the author. Acute complications, some of which may be associated with serious morb- ity and mortality, are those experienced within the ? rst few weeks of surgery. This comprehensive volume examines the possible complications that can arise in cutaneous surgery. The demand for outpatient cutaneous surgery procedures has increased at a rapid rate over the last several decades. As the number of cutaneous surgery procedures rises, so will the rate of complications, which are inevitable and occur even with the most skilled, careful, and meticulous surgeons. This work will help the practicing physician to formulate a preoperative strategy that will prevent complications before they occur as well as properly diagnose and manage complications if they arise, allowing the physician to provide optimal care to the patient.
