Removal Of Benign Skin Lesions Research Articles

Effectiveness of hypnoanalgesia for dermatological surgery in children: Randomised clinical trial

Background and Objective. Diagnostic or therapeutic procedures may generate pain, fear or anxiety. The aim of this paper is to assess whether hypnosedation in children undergoing dermatological surgery is effective in reducing the doses of sedation and analgesia during the periprocedure. Patients and methods. Clinical trial in which paediatric patients scheduled for removal of benign skin lesions in a hospital were randomised to receive hypnosis (intervention group) or attention-distracting techniques (control group). The outcome measures used were doses of sedation (propofol) during surgery, and the need for analgesia (paracetamol and others) and pain assessment by visual analogue scale (VAS), post-surgery and at 24 hours. Results. Thirty patients between 5 and 16 years of age were selected consecutively, two of them being excluded because they did not meet the criteria; 15 patients were assigned to the hypnosis group and 13 to the control. Patients treated with hypnosis as an adjuvant to conscious sedation showed a lower need for propofol (median 1.8 mg/Kg; P25-75 1.6 - 2.0) than those treated with distraction (2.9; 2.5 - 3.0; p=0.001). Eighty percent of the children in the hypnosis group needed post-surgical paracetamol versus 100% in the control (p=0.226); after 24 h after discharge the difference in need of ibuprofen was 6.7% versus 38.5% (p=0.041) and of analgesics in general 46.7% versus 84.6% (p=0.082). The VAS of pain during the procedure in the hypnosis group was VAS 0 (0-0) vs 0 (0-5.5) (p=0.142). Conclusions. Hypnosis as an adjuvant to sedation in children undergoing major outpatient surgery

Hold firmly, coagulate indirectly, and pull gently: A simple and swift technique for radiofrequency-assisted removal of small benign skin lesions

Removal of small benign lesions, such as common warts and skin tags, is a common outpatient procedure, and patient turnover remains high. Cold excision using a surgical blade or scissors is associated with bleeding. Conventional radiofrequency (RF) excision requires cutting from one end of the base of the lesion until it reaches to the other end. It is time consuming and also leads to smoke generation because of prolonged contact of the RF probe with the lesion. RF probes are expensive and, if touched to the patient, can be reused only after sterilization. We describe the more economical use of Allis forceps combined with RF to crush and coagulate for the swift removal of benign skin lesions.

EXPERIENCE OF REMOVING BENIGN NEOPLASMS OF SKIN IN CERVICOFACIAL AREA USING THE METHOD OF PLASMA ABLATION

Choosing appropriate methods for removal of benign skin lesions (BSL) in the cervicofacial area has always been an important and challenging issue. Removal of the BSL is indicated and performed for medical and aesthetic reasons. A method with less painful procedures, a short healing period, without noticeable long-lasting traces (such as scars, dyschromia) and, predictably, fewer repeat procedures is preferred. Objectives. Evaluation of the effectiveness, safety and convenience of BSL plasma ablation using Plexr® (GMV, Italy); Comparison of the reparative processes speed after the BSL removal in the cervicofacial area applying the Plexr® device with other instrumental methods (based on literature reviews). Materials and Methods. We identified a group of patients wishing to remove papilloma, xanthelasma, dermal nevi, dermatofibroma on their face and body. Neoplasms (skin lesions) were assessed visually and by means of the Dermlite 3DN dermatoscope. Patients with atypical skin lesions were excluded from the study and referred to a medical oncologist for consultation. Each patient, having been fully briefed on the nature and course of the medical procedure, as well as required aftercare, submitted their written informed consent. Plasma ablation of BSL was performed using Plexr® device. Re-examination of patients was carried out after the scab from the treated area of the skin had fallen off. Results. We have performed 373 BSL removal procedures, including 212 (57%) — in the cervicalfacial area, among which there have been 47 (13%) cases of acrochordoni, papilloma, xanthelasma, syringoma and upper and lower eyelid milia removals. Complete healing has been recorded in 98% of all cases, with repeated corrective procedure being required only for one patient due to insufficiently deep tissues destruction in the course of multiple syringoma removal in the lower eyelid area. Conclusion. The results obtained allow to consider the method of BSL tissues plasma ablation applying Plexr® device effective, safe, non-traumatic, inexpensive, with a short period of tissue healing (7—10 days). BSL removal with the help of Plexr® — is a good alternative to conventional surgical and laser methods, which can be introduced into medical practice.

A new technique for aesthetic removal of benign skin lesions, the “North Star” procedure

Many types of local flaps are commonly used for the repair of circular skin defects. In this paper, we described that the “North Star” design is useful for aesthetic removal of benign skin lesions.

Evaluation of the long-term outcome of wounds closed with ”Indermil" adhesive

”Indermil” is a new formulation of n-Butyl-2- Cyanoacrylate used for securing skin grafts and surface wound closure. We report a prospective randomized trial, comparing the use of ”Indermil” adhesive with suture in wound closure. A total of 30 patients underwent 37 procedures for the removal of benign skin lesions under local anaesthesia. ”Indermil” was used in the skin closure in 18 procedures and sutures were used in 19 procedures. Scar quality, patient satisfaction and complications were recorded at a period between 8 and 18 months (median 12.2) following the procedure. The study showed no difference between the two groups in terms of scar quality and patient satisfaction. We conclude that long term outcome of wounds closed with ”Indermil” are no different from sutured wounds.

Minor Surgery at Primary Care Centers in Riyadh, Saudi Arabia

This study was conducted to review the present situation with regard to training, facilities and performance of minor surgical procedures in primary care, and to look at the way doctors perceive various minor surgical procedures in primary care. Randomly selected primary care doctors working in Riyadh health centers completed a predesigned confidential questionnaire, which was then mailed to the researchers. The questionnaire of data on health centers, such as geographic location, size of catchment area population and number and gender of doctors working there. In addition, demographic data of doctors who completed the questionnaire, as well as their exposure to minor surgery training and performance, were recorded. The doctors were then asked about their perception of the necessity of performing various minor surgical procedures in primary care centers. The study was conducted from June through December of 1994. The completed questionnaires were entered into a personal computer for statistical analysis using the chi-squared test. Of the 231 doctors who participated in the present study, 74% performed some sort of minor surgery during their day-to-day work in the health center. Doctors living in remote areas performed more minor surgery (MS) compared to other areas and male doctors performed more MS than female doctors (P = 0.05). As doctors gained confidence in certain skills such as resuscitation, venous cut-down and handling of trauma and fractures, they performed more MS compared to those who were not confident. A room allocated for MS only was available to 27.7% of doctors, but instruments and equipment were available for over 76% of doctors. The doctor's perception of the necessity for MS was statisticaly higher among MS performers only in cases of removal of benign skin lesions, sebaceous cysts and treatment of burns, compared with non-MS performers. There is a great need for provision of facilities and organized training courses in minor surgical procedures for primary care doctors and nurses.