The Journal of dermatologic surgery and oncology
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J Dermatol Surg Oncol · Mar 1990
ReviewTumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction.
The tumescent technique for local anesthesia permits regional local anesthesia of the skin and subcutaneous tissues by direct infiltration. The tumescent technique uses large volumes of a dilute anesthetic solution to produce swelling and firmness of targeted areas. This investigation examines the absorption pharmacokinetics of dilute solutions of lidocaine (0.1% or 0.05%) and epinephrine (1:1,000,000) in physiologic saline following infiltration into subcutaneous fat of liposuction surgery patients. ⋯ The associated vasoconstriction is so complete that there is virtually no blood loss with liposuction. The tumescent technique can be used with general anesthesia or IV sedation. However, with appropriate instrumentation and surgical method, the tumescent technique permits liposuction of large volumes of fat totally by local anesthesia, without IV sedation or narcotic analgesia.
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J Dermatol Surg Oncol · Jan 1990
Case ReportsIntraoperative tissue expansion using a Foley catheter following excision of a basal cell carcinoma.
Chronic tissue expansion has gained an accepted role in reconstructive surgery. Recently, intraoperative tissue expansion (rapid expansion) has been introduced as an alternate technique for recruitment of additional tissue to aid in wound closure. At the present time, the available expanders are designed for single use and then must be discarded; thus they are relatively expensive. We present the use of the readily accessible Foley catheter as a suitable, inexpensive, safe, and practical device for intraoperative tissue expansion.
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J Dermatol Surg Oncol · Jun 1989
Anesthesia for outpatient dermatologic cosmetic surgery: midazolam--low-dosage ketamine anesthesia.
Cardiovascular, respiratory, CNS, and postoperative effects of using low-dose ketamine and midazolam combined with local anesthesia during 40 outpatient cosmetic procedures are reviewed. This method of anesthesia is safe, effective, and well-tolerated by patients.
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More complex methods of outpatient anesthesia, including I. V. sedation and general anesthesia, have become commonplace. ⋯ Appropriate outpatient facilities and monitoring are reviewed. The authors' favorite methods of anesthesia, caveats, and suggestions are presented, as well as prevention and treatment of anesthesia problems and emergencies.
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J Dermatol Surg Oncol · Jul 1988
Review Case ReportsZosteriform metastasis: case presentation and review of the literature.
In contrast to benign tumors, malignant tumors, by definition, are characterized by the potential of giving rise to metastases. Albeit infrequently, skin metastases do occur, and their clinical appearance varies over a wide morphologic spectrum. We present the case of a 65-year-old male with zosteriform metastasis secondary to bronchogenic adenocarcinoma. A review of cutaneous metastasis is presented with emphasis on dermatomal distribution and possible mechanisms of dissemination.