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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Tissue expansion is a concept based on the skin's natural ability to stretch in response to an underlying force. ⋯ Many soft tissue changes occur during tissue expansion. Most of these changes return to the pre-expansion state over time following discontinuation of the expansion process.
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J Dermatol Surg Oncol · Dec 1993
Historical ArticleA history of tissue expansion. Concepts, controversies, and complications.
Tissue expansion has become a widely used adjunct in reconstruction of the skin. ⋯ Tissue expansion is becoming widely used and accepted and its continued use under many circumstances is justified by the experimental and clinical results.