23 - INFECTIONS IN SKIN SURGERY

Summary

HISTORY

Dermatologic surgery has grown in popularity and stature during the past few decades. Skin surgery is routinely performed by dermatologists and plastic surgeons, mostly using local anaesthesia. Types of skin surgery include, skin biopsy (punch biopsy, shave biopsy, incisional biopsy, and excisional biopsy), excision of the skin lesion, curettage, and cautery, flap, skin grafting, and Mohs microscopically controlled excision (for cancers at high risk of local recurrence). It is common to remove benign tumors. It is even more common to remove malignant tumors such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or melanoma. Skin cancer is the most common malignancy in humans and its incidence, especially that of BCC, has increased over the last decades and is still increasing. Left untreated, these lesions may become locally destructive (BCC) and others (SCC and mostly melanoma) have a potential for metastasis. The primary treatment of cutaneous neoplasms is surgical excision, and dermatologists have expanded their practice to include surgical procedures in response to the epidemic of cutaneous tumors related to an increased elderly population worldwide. Besides the treatment of tumors, dermatologic surgery is used for cosmetic purposes, and in emergency cases to drain abscesses or inflamed cysts.

A survey of the American Society for Dermatologic Surgery found that members performed about 3.9 million procedures a year. Of these procedures, skin cancer surgery was the most common with 1.4 million operations. Surgery performed by dermatologists on an outpatient basis under local anesthesia is less costly than other more complex options and has become the treatment of choice for many cutaneous malignancies.