What's new in instrumental dermatology?

• Published in: Annales de dermatologie et de vénéréologie Vol. 144 Suppl 4; pp. IVS10 - IVS15
• Main Author: Chaussade, V
• Format: Journal Article
• Language: French
• Published: France 01-12-2017
• Subjects: Chirurgie cutanée; Cancers cutanés; Erreur de site opératoire; Transposition flap; Wrong-site surgery; Greffe de peau; Antithrombotiques; Anti-thrombotics; Cutaneous surgery; Skin graft; Lambeau de transposition; Infection du site opératoire; Skin cancers; Surgical site infection
• ISSN: 0151-9638
• DOI: 10.1016/S0151-9638(17)31060-8

This "What's new in instrumental dermatology" dedicated skin surgeryis based upon a 2015-2017 literature analysis. The excision of skin cancers is an important part of surgical dermatology. Will artificial intelligence and new drug be able to face the increasing need for therapy? Wrong-site surgery is due to multiple factors. Photographs of biopsy site and short time between biopsy and surgery decrease postponement of surgery and wrong-site surgery. Noninvasive imaging technologies are improving and help to delineate skin tumors and increase the probability of complete tumor removal. They are beginning to be an essential tool for skin surgery. The 2005 recommendations for the management of melanoma stages I to III have been updated in 2016. The Slow-Mohs technique is the better way to treat dermatofibrosarcoma protuberans whose sub-clinical invasion is often asymmetric and unpredictable. Wide local excision for the treatment of severe hidradenitis suppurativa improves the quality of life and decreases recurrence rate. Cutaneous surgery is considered as safe procedures with a low risk of complications. Postoperative bleedings are the most frequent. Anti-thrombotics enhance the risk, but must not be stopped or bridged, except the novel oral anticoagulants which can be interrupted 24h before surgery and started again a few hours after. The risk of surgical site infections is low in dermatologic surgery. Most recommended measures to prevent them have been extrapolated from other types of surgery and the level of evidence is low. The reconstruction of skin defect must be adapted on size and location. A birhombic transposition flap is reliable in case of a defect too large to be repaired by a single flap. Full-thickness skin graft is a safe option to repair defect on the external ear.