BACKGROUND: Surgical removal and reconstruction in basal cell carcinoma(BCC) located in the face is important both functionally and cosmetically, however, evaluation of clinical and histological characteristics of BCC in view of dermatologic surgery is not enough. OBJECTIVE: To assess the anatomic distribution of primary and recurrent BCCs, and of histological subtypes based on facial aesthetic units and subunits. And to establish their importance and their application to the dermatologic surgery field. METHODS: We reviewed patients' charts to extract clinical data and reexamined their histologic patterns on the excised specimen, classifying then into 5 categories and mapped the anatomical location of the histologic subtype on schematic drawings of the facial the aesthetic unit and subunit. RESULTS: The location of occurrence in BCCs were on the junctional lines, nose, periorbital area respectively. Of 60 cases occurred in H-zone, 48 cases(80%) occurred in T-zone, and of 9 recurrent cancers occurred in H-zone, 7 cases occurred in T-zone. Among the 5 histologic subtypes, the nodular type was the most common on each of the aesthetic units. And in the junctional lines, the nodular type occurred in almost all cases. The nodulomorpheic type occurred relatively more on forehead, nose and infraorbital area of the cheek. CONCLUSION: We confirmed the relationship between the clinical, histological characteristics and facial aesthetic unit and subunit. And we also proved that T-zone was the most dangerous zone.
Carcinoma, Basal Cell* ; Cheek ; Dermatologic Surgical Procedures ; Forehead ; Nose

Nowadays, patients have high expectations when it comes to minimization of postoperative scarring after dermatologic surgical procedures. When an annular lesion is being excised, normal skin should be excised, as well, to prevent a dog ears resulting in a long scar. We introduce a new flap reducing the scar length in annular defects. In order to avoid a long scar, we designed a quadruple fan flap (O-X flap) that is a variation of the rotation flap. It consists of four rotation flaps arranged like fans, with open and closed configuration. We suggest that the quadruple fan flap (O-X flap) is a viable option for treating annular skin defects, because it shortens the scar line, preserves normal tissue, and provides a cosmetically favorable outcome.
Animals ; Cicatrix ; Dermatologic Surgical Procedures ; Dogs ; Ear ; Humans ; Skin

Bariatric surgery, an important treatment modality for pathological obesity, has been increasingly accepted by obese patients. However, the excess skin and the relaxation of muscles and soft tissues after bariatric surgery also bring many troubles and severely affect the quality of life. Body contouring after weight loss surgery can increase the patients satisfaction and self-confidence.
Bariatric Surgery ; Dermatologic Surgical Procedures ; Humans ; Obesity, Morbid ; surgery ; Postoperative Complications ; surgery ; Reconstructive Surgical Procedures

OBJECTIVE: Decompressive craniectomy (DC) is a useful surgical method to achieve adequate decompression in hypertensive intracranial patients. This study suggested a new skin incision for DC, and analyzed its efficacy and safety. METHODS: In the retrograde reviews, 15 patients underwent a newly suggested surgical approach using n-shape skin incision technique (Group A) and 23 patients were treated with conventional question mark skin incision technique (Group B). Two groups were compared in the terms of the decompressed area of the craniectomy, protruded brain volume out of the skull layer, the operation time from skin incision to bone flap removal, and modified Rankin Scale (mRS) which was evaluated for 3 months after surgery. RESULTS: The decompressed area of craniectomy (389.1 cm² vs. 318.7 cm², p=0.041) and the protruded brain volume (151.8 cm³ vs. 116.2 cm³, p=0.045) were significantly larger in Group A compared to the area and the volume in Group B. The time interval between skin incision and bone flap removal was much shorter in Group A (23.3 minutes vs. 29.5 minutes, p=0.013). But, the clinical results were similar between 2 groups. Group A showed more favorable outcome proportion (mRS 0-3, 6/15 patients vs. 5/23 patients, p=0.225) and lesser mortality cases proportion 1/15 patients vs. 4/23 patients, but these differences were not significantly observed (p=0.225 and 0.339). CONCLUSION: DC using n-shaped skin incision was a feasible and safe surgical technique. It may be an easier and faster method for the purpose of training neurosurgeons.
Brain ; Decompression ; Decompressive Craniectomy* ; Dermatologic Surgical Procedures ; Humans ; Methods ; Mortality ; Neurosurgeons ; Skin* ; Skull ; Surgical Flaps ; Surgical Procedures, Operative

OBJECTIVE: To explore the clinical repair value of facial skin and tissue defect caused by tumour, trauma and infection with the axial flap. METHOD: The clinical data of 38 patients with facial skin and tissue defect were analyzed retrospectively. All of them were repaired by the axial flap. RESULT: The axial flap was alive in all patients, and all incision healed in the first stage. All patients had a satisfied result after the second stage of flap surgery. CONCLUSION The method of the axial flap in face can be clinically applied in the facial skin and tissue defects caused by tumour, trauma injury and infection. Because the axial flap cotained named blood vessel, the survival rate of it is high.
Dermatologic Surgical Procedures ; Face ; surgery ; Humans ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Wound Healing

A bolster, simply defined, is any device used to support or cushion. In surgery, bolsters have been used under sutures to reduce skin and subcutaneous tension. Bolsters function to reduce the potential for necrosis and laceration by distributing the wound closure tension over a broader surface area. Pexing stitich is placed between the mobilized tissue and the deep fascia and periosteum to prevent the secondary motion of closure from disrupting anatomic landmarks and moveable structures. The technique aids in obtaining linear closures, prevents distortion of free margins, prevents tenting across concavities, and fixes the closure line at the junction of cosmetic units. Standard treatment of lipoma commonly includes incision with extrication or elliptical excision. Unfortunately, these treatments often elicit a large scar. Using pressure technique, risk of hemorrhage and infection may be minimized secondary to the decreased degree of invasion. In cosmetically sensitive areas, this technique is an effective and aesthetically pleasing method for removal of lipoma.
Anatomic Landmarks ; Cicatrix ; Dermatologic Surgical Procedures* ; Fascia ; Hemorrhage ; Lacerations ; Lipoma ; Necrosis ; Periosteum ; Skin ; Sutures ; Wounds and Injuries

BACKGROUND: Glomus tumor is a small encapsulated tumor that is derived from the subcutaneous glomus body. Treatment of subungual glomus tumor is the complete removal of the tumor. However, the surgical method is not familiar to us. OBJECTIVE: The aim of this study is to introduce surgical treatment results of subungual glumus tumor in dermatologic surgery clinic of Seoul National University Hospital and Seoul City Boramae Hospital from 1995 to 2002. METHOD: We reviewed the medical records and checked clinical aspects, surgical methods and results. RESULTS: All patients, 10, were female. Pain was elicited by contact in 80% and occurred spontaneously in 60%. Temperature hypersensitivity occurred in 50%. 90% of tumors were located in fingers. 70% of tumors revealed just blue or erythermatous discoloration of nail plate. Nail deformity was found in 30%. Post-operative mild distal nail splitting had developed in 2 cases. In 8 cases nails showed normal growth. Nobody complained of a recurrence of pain. CONCLUSION: Careful dissection and complete removal of the tumor almost offered permanent relief and it is thought that appropriate education of surgical skills should be needed and offered.
Congenital Abnormalities ; Dermatologic Surgical Procedures ; Education ; Female ; Fingers ; Glomus Tumor* ; Humans ; Hypersensitivity ; Medical Records ; Recurrence ; Seoul

BACKGROUND: As the number of dermatologic surgical procedures increases, home care wound management is growing in frequency. OBJECTIVE: The aim of this study was to evaluate the efficacy and surgical site infection rate of home care wound management according to the use of oral antibiotics and the characteristics of the wound and of the patient. METHODS: Our study included 207 patients that had undergone a dermatologic surgical procedure and the subsequent management of their wounds in the home. We checked overall infection rate of home care wound management and compared the result according to the use of oral antibiotics. We evaluated surgical site infection rate after we classified each surgical wound based on age, sex, surgical method, site, size, and depth. In addition, we surveyed efficacy of home care wound management. RESULTS: Overall surgical site infection rate was 1.86%, and the infection rate was not significantly different between the group that utilized home care wound management without oral antibiotics and the group with oral antibiotics (p>0.05). There was no statistically significant difference of surgical site infection rate according to sex, age, wound's size and depth (p>0.05). However, patients with younger age, male sex, greater size, and depth of wounds showed a numerical increase in surgical site infection rate. Staged partial excision for nevus sebaceous in scalp showed significantly higher rate of surgical site infection (p<0.05). In our survey, most patients preferred home care wound management after dermatologic surgical procedures and patients were able to perform the wound care well. CONCLUSION: We expect to utilize home care wound management after dermatologic surgical procedures, provided that physicians appropriately educate patients and their caretakers on proper dressings.
Anti-Bacterial Agents ; Bandages ; Dermatologic Surgical Procedures ; Home Care Services ; Humans ; Male ; Nevus ; Scalp

The pinch graft is one type of skin graft and is indicated in small, chronic stubborn wounds or ulcers where cosmetic results are not paramount. It is a common procedure for the rapid healing of leg ulcers in countries where these are very common, such as in western society. However, it is an unfamiliar procedure to dermatologists in Korea where leg ulcers are quite rare. We treated a case of leg ulcer in systemic sclerosis using pinch grafts with satisfactory results. The pinch graft may be a useful treatment method for skin ulcers in dermatologic surgery under adverse conditions.
Dermatologic Surgical Procedures ; Korea ; Leg Ulcer* ; Leg* ; Scleroderma, Systemic* ; Skin ; Skin Ulcer ; Transplants* ; Ulcer ; Wounds and Injuries

BACKGROUND: Recently, increasing attention in the field of dermatological surgery has been paid to treating skin cancers, including both premalignant and malignant lesions. The rhombic flap, one of the transposition flaps, is an outstanding method for reconstructing small- to medium-sized defects after skin surgery. OBJECTIVE: The aim of this study was to evaluate our clinical results with the rhombic flap for reconstruction after Mohs micrographic surgery (MMS), including the cosmetic aspects, complete surgical excision, and recurrence. METHODS: Between June 2010 and September 2013, 37 patients who were diagnosed with premalignant and malignant lesions on the face and extremities were treated with rhombic flaps for the reconstruction of primary cutaneous defects following lesion excisions. We reviewed the medical records and evaluated the clinical aspects and surgical treatment outcomes, and the cosmetic results were scored as excellent, good, fair, or poor. In addition, we assessed the surgical treatment outcomes using the Vancouver Scar Scale (VSS). RESULTS: Thirty-seven patients received 37 rhombic flaps. The cosmetic results of the reconstructions were gratifying, and 28 of 37 patients (75.7%) showed good to excellent results. Specifically, the cosmetic results of the modified rhombic flaps were great, and 27 of 30 patients (90.0%) showed good to excellent results. The cosmetic results on the VSS showed a high mean score (2.9). CONCLUSION: Our study showed that the rhombic flap is a simple reconstruction method and provides aesthetically pleasing results. Therefore, it could be a useful option for reconstructing defects of the face and extremities.
Cicatrix ; Dermatologic Surgical Procedures ; Extremities ; Humans ; Medical Records ; Mohs Surgery* ; Recurrence ; Skin Neoplasms*