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Dermatologic surgery

Aesthetic dermatology

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	Routine procedures
	Patient information
	Opening hours
	Indications and procedures
		General information
		Acne inversa
		Methods for anesthesia
		Simple closure
		Dermabrasion
		Simple excision
		Electrodesiccation/ electrocaustic
		Hair transplantation
		Incision and drainage
		Transplantation of keratinocytes
		Cryotherapy and cryosurgery
		Curretage
		Surgical flaps
		Liposuction
		Operations on the nail
		Phlebosurgery
		Skin biopsy
		Sentinel-Lymph-Node-Dissection (SLND)
		Transplants/ Skin grafts
	Impressum

	Suche

Preparation before surgical procedures

Surgical procedures are part of the routine in any dermatologic practice. They comprise a broad spectrum, ranging from diagnostic biopsies and smaller procedures, such as incision/drainage (e.g. of abcesses), removal of superficial skin tumors (via curettage, dermabrasion, cryotherapy, electrocautery or excision) to more extensive surgical interventions for tumors -- followed by transplantation of the skin for covering of large defects.

Also cosmetic procedures, such as hairtransplantation and liposuction are carried out by dermatologists. In addition to this, phlebo-surgical procdures such as stripping of varicose veins and also lymph node removal (e.g. sentinel lymph node dissection or therapeutic lymph node removal) for assessing the potential for metastasis in malignant melanoma, are performed.

Below you can find the general preparations before surgical procedures and also find a short description of the individual procedures and methods. For more detailöed information on the surgical techniuqes, please consult dermatologic surgery textbooks.

 

Informed consent

Before any surgical procedure, it is required to inform the patient about the planned operation (in laymen's terms) in detail and obtain consent, otherwise any surgical intervention is considered a criminal assault that may be prosecuted.

The following topics should be addressed:

 

• the procedure itself
• the kind of anesthesia: local, regional or general anesthesia
• general surgical risks, e.g. adverse reactions to anesthetics, risk of bleeding, nerve damage, wound infection, scarring, risk of thrombosis.
• specific surgical risks (these should be added in writing to the consent form), e.g. special risks due to anatomic localisation (e.g. nerve damage), multi-session surgical procedures (wound closure after histological examination of the borders), risk of necrosis of transplants, recurrence (of tumors), keloid formation or dehiscence of fresh scars (in case of individual predisposition or due to peculiar traction forces).

Diagnostics

Before any more extensive surgical procedure, a detailed history should be taken, assessing specific internal risk factros, such as, hypertension, current medication, allergies, blood clotting defects, circulation alterations (chronic venous insufficiency, peripheral arterial disease, diabetes, neuropathias, paralysis), immunosuppression, infectious diseases (hepatitis, HIV, etc.) and lab tests should be initiated accordingly. Minimal lab exams should include blood count and blood clotting parameters.