Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
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Comparative Study
Sterile versus nonsterile gloves during Mohs micrographic surgery: infection rate is not affected.
Mohs micrographic surgery (MMS) is an outpatient procedure that has become the treatment of choice for certain cutaneous malignancies. Although the major steps in this procedure are relatively standardized, one difference involves the use of sterile or nonsterile, clean gloves during the tumor removal phase. ⋯ Our study lends support to the contention that clean, nonsterile gloves are safe and effective for use in the tumor extirpation phase of MMS, at a significant cost savings.
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Randomized Controlled Trial
Treatment of surgical scars with the cryogen-cooled 595 nm pulsed dye laser starting on the day of suture removal.
Cosmetic results after skin surgery are a key component of patient satisfaction and self-image. Various lasers have been used to attempt scar improvement, without consistent results. The optimal time to initiate laser treatment has not been determined. A recent study using a noncooled 585 nm pulsed dye laser starting on the day of suture removal demonstrated substantial improvement in scar appearance. ⋯ The cryogen-cooled 595 nm pulsed dye laser is a safe and effective option to improve the cosmetic appearance of surgical scars in skin types I to IV starting on the day of suture removal.
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Randomized Controlled Trial Comparative Study
A randomized, double-blind comparison of two topical anesthetic formulations prior to electrodesiccation of dermatosis papulosa nigra.
Liposomal lidocaine 4% (L.M.X.4 cream, Ferndale Laboratories Inc., Ferndale, MI, USA) has been proposed as a more rapidly acting topical anesthetic than the eutectic mixture of lidocaine 2.5% and prilocaine 2.5% (EMLA cream, AstraZeneca LP, Wilmington, DE, USA) for venipuncture and laser procedures. However, their anesthetic efficacy has not been previously compared for electrosurgical destruction of superficial skin lesions. ⋯ EMLA and L.M.X.4 provide comparable levels of anesthesia after a single 30-minute application under occlusion prior to electrodesiccation of superficial skin lesions.
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Randomized Controlled Trial
Pilot study of imiquimod 5% cream as adjunctive therapy to curettage and electrodesiccation for nodular basal cell carcinoma.
Curettage and electrodesiccation (C&D) is a widely used method to treat nodular basal cell carcinoma (BCC). However, residual tumor is present immediately after the procedure in approximately 20 to 40% of cases. Imiquimod, a topical immune response modifier that targets Toll-like receptor 7, is currently approved for superficial BCC. ⋯ Imiquimod 5% cream once daily for 1 month as adjunctive therapy after C&D substantially reduced the frequency of residual tumor and improved the cosmetic appearance compared with C&D alone. These preliminary results suggest that further studies to investigate imiquimod adjunctive therapy are warranted.
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The nasal trumpet has been used in emergency resuscitation, anesthesia, and facial burns to maintain nares openings. The dermatologic surgery literature is not as familiar with this device to improve respiratory function during the postoperative period after reconstruction of large defects on the nose. ⋯ We present a novel way of using a modified nasal trumpet orthosis after a melolabial interpolation flap procedure. For large defects involving the nares and/or nasal valve of the nose, the nasal trumpet is well tolerated by the patient and can lead to increased postoperative respiratory function while acting as a "bolster" for the closure.