Post on 29-Aug-2019
239
AAbscess
as bacteremia risk factor, 64soft tissue fi llers-related, 199–200, 202stitch, 143wound infection-related, 53–54
Acneas hypertrophic scarring and keloid
cause, 87, 89skin resurfacing-related, 169, 170, 190treatment of, 72, 175, 176, 177
Acquired immunodefi ciency syndrome (AIDS), 47–48
Ala, free margin distortion on, 102–104, 105, 107–108
Alcohol, as antimicrobial agent, 141Alcohol use
effect on surgical outcomes, 6as facelift-related complications risk
factor, 224perioperative discontinuation of, 6, 38as wound infection risk factor, 47
Allergic reactionsto alcohol, 141anaphylaxis, 12–13to collagen injections, 199–200, 201to latex, 13, 14to lidocaine, 14to soft tissue fi llers, 203to sutures, 144
Allergy history, 4Alopecia, facelift-related, 232, 233Alzheimer’s disease, 4American Heart Association, 9, 11, 15,
68–73American Red Cross, 9American Stroke Association, 155-Aminolevulinic acid, 176–177Amoxicillin, 67Anaphylactoid reactions, 12Anaphylaxis, 10, 12–13, 139, 221
Anesthesia, 10nerve injury-related, 30, 33tumescent, 225–226, 227, 230
Angiogenesis, 78Antibiotic prophylaxis, 62–76
in ablative laser skin resurfacing patients, 171
for bacterial endocarditis, 62, 68–73, 74
intraincisional, 65for wound infections, 47, 54, 55, 62–68,
74Antibiotics
allergic reactions to, 12, 14as hemorrhage cause, 5topical
adverse effects of, 65, 141, 142, 170for surgical site infection
prophylaxis, 64–65Anticoagulants, 36–37, 38–39
effect on wound healing, 79as facelift-related complications risk
factor, 224as hemorrhage risk factor, 79, 193–194
Antiplatelet agents, 36–37, 38–39discontinuation prior to face-lifting
procedures, 224effect on wound healing, 79as hemorrhage risk factor, 79, 193–194
Antithrombotic agents, 36–37Antiviral prophylaxis
for herpes simplex virus infections, 170, 171
in laser skin resurfacing patients, 64Anxiety/anxiety disorders, in patients,
13, 14, 162in cosmetic surgery patients, 158–159as hypertension cause, 40
Anxiolytics, drug interactions of, 6Aquamid, 204Artefi ll/Artecoll, 202–203
Asepsis, in surgical site preparation, 52–53
Aspirin, 11discontinuation prior to facelifting
procedures, 224effect on wound healing, 79as hemorrhage risk factor, 36–38, 79
Autologen, 201Axonotmesis, 21
BBacitracin, 64, 65, 141, 142Bacteremia, 64, 68–69
antibiotic prophylaxis for, 69–70, 71–73
occult, 53Bacterial infections, laser skin
resurfacing-related, 170, 171Basal cell carcinoma, 104, 108, 112, 147Basal cell nevus syndrome, 113–114Benzalkonium chloride, 139Beta-adrenergic agents, as anaphylaxis
treatment, 13Bleaching agents, 172, 176Bleeding disorders
as perioperative hemorrhage cause, 36, 38
preoperative evaluation of, 7, 224–225Bleomycin, intralesional, 92Blepharoplasty, 109, 187Blood thinners, as purpura risk factor,
218Body dysmorphic disorder, 159–162,
163–164Botulinum toxin injections, 207–212
action mechanisms of, 207complications of, 23, 207–211
prevention of, 208–209treatment of, 209–211
contraindications to, 209as nerve injury treatment, 35
Index
240 Index
Broken line techniques, for scar revision, 121, 123–126
Buccal nerveinjuries to, 24–26, 33–35, 228, 229location of, 24–25
Burns/burn scars, 87, 88, 92electrocoagulation-related, 227treatment of, 64, 65, 92, 119
CCalcium hydroxylapatite microspheres,
205Cancer, as wound infection risk factor,
47Candidiasis, 57–58, 171Cardiovascular system, preoperative
evaluation of, 6–7Cautery, excessive use of, 79Celecoxib, 37Cellulitis, 58, 59, 197Centers for Disease Control and
Prevention (CDC), 62, 64, 66, 82–83
Central nervous system disorders, preoperative evaluation of, 6
Cervical nerveanatomy of, 22–23, 31, 32injuries to, 31–33
Chemical peels, 64, 184–185Chlorhexidine, 52–53, 62, 63
as anaphylaxis cause, 12–13as dermatitis cause, 139–140
Chlorohexylenol, 52Clindamycin, 67, 71
intraincisional, 65Clopidogrel, 36, 37–38Clostridial infections, 49, 58Coagulopathy. See also Bleeding
disordersdrug-induced, 36–39
Collagen, role in wound healing, 77, 78Collagen-based soft tissue fi llers, 199–201Corticosteroids, effects on wound
healing, 47, 79Cosmetic surgery patients
preoperative cosmetic consultations with, 156
preoperative psychiatric consultations with, 156–158
psychological complications and comorbidities in, 4, 155–166
Cosmoderm, 200–201Cosmoplast, 200–201“Crash carts,” 11Cryotherapy, 90–91, 118, 120, 149–150Cultures, bacterial, 52, 54Curettage, as pigmentary change cause,
149Cyclooxygenase-2 inhibitors, 37Cymetra, 201
DDebulking, surgical, for scar revision,
121, 133, 134, 135–136, 219Defi brillation, as ventricular fi brillation
treatment, 9, 10, 11Defi brillators
automatic external, 11–12implanted, 15–17
Dehiscence, of wounds, 53, 77–81management of, 81prevention of, 82–83risk factors for, 6, 78–79
Dementia, 4Depression
in cosmetic surgery patients, 159, 162–163
evaluation of, 157Dermabrasion, 121, 122, 184, 185–190Dermadeep, 204Dermatitis
allergic contact, 139, 144differentiated from wound
infections, 48–49facelift-related, 232–233skin resurfacing procedures-related,
169, 170, 189topical antibiotics-related, 65
atopic, as endocarditis risk factor, 72
contact, 139–142topical antibiotics-related, 83
eczematous, 131erosive pustular, 145immediate contact, 139irritant contact, 139, 140
differentiated from wound infections, 48–49
facelift-related, 232–233laser skin resurfacing-related, 169,
170Dermative, 204Dermatographism, 218Dermologen, 201Dextrose 50% solution, 11Diabetes mellitus
as wound dehiscence risk factor, 78–79
as wound infection risk factor, 8, 47Diabetic patients
preoperative evaluation of, 8wound healing in, 78–79, 82
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), 159, 161
Diastasis recti, 194, 195Diazepam, 11, 15Dietary supplements. See also Herbal
supplementsas hemorrhage risk factor, 5
Diphenylhydramine, 11, 14
Diplopia, botulinum toxin injection-related, 209, 210
Dipyridamole, 36, 37–38“Doctor shopping,” 162“Dog ears,” 102Down’s syndrome, 40–41Drainage, of infected wounds, 53–54,
64Drains, for hemorrhage/hematoma
management, 40, 197Drugs. See also names of specifi c drugs
effects on wound healing, 79Dysesthesia, radiofrequency-related,
177, 178
EEar piercing, 87, 89Ear shape, facelift-related alteration of,
234Ear wound infections, 50–51, 65, 68Ecchymoses, 41, 42, 197, 209, 210Eclabium, 100, 111, 113Ecnasion, 104, 108Ectropion, of the eyelids, 33–34, 110,
173defi nition of, 104differentiated from eyelid retraction,
104Edema, 145–146
chemical peel-related, 185effect on wound healing, 78, 79laser therapy-related, 168, 169,
175–176liposuction-related, 197sclerotherapy-related, 218
Ehlers-Danlos syndrome, 40–41Elastosis, dermal, ablative laser repair
of, 167–168Electrocoagulation, 16
as burn cause, 227for intraoperative hemorrhage
control, 40, 226Electrodessication, 16
for intraoperative hemorrhage control, 40
as nerve injury treatment, 35as pigmentary change cause, 149
Electrofulguration, 16, 40Electrosurgery, in patients with
pacemakers/defi brillators, 15–17Emergencies, in the dermatology offi ce,
9–20emergency plan for, 9–12equipment for, 11–12types of, 12–17
Emergency medical services (EMS), 9, 13, 15
Endocarditiscausal agents of, 60prophylaxis for, 62, 68–73, 74
Index 241
Endocrine disorders, preoperative evaluation of, 8
Enterococcus infections, 66, 67, 68–69
vancomycin-resistant, 51Ephedra, as perioperative hemorrhage
cause, 36, 37Epidermolysis bullosa, as milia cause,
145Epinephrine, 8, 11, 13Erythema
ablative laser skin resurfacing-related, 168, 169, 170, 172, 173
chemical peel-related, 185, 187dermabrasion-related, 184, 187–188keloid-related, 87nonablative laser skin remodeling-
related, 174, 175–176radiofrequency-related, 177, 178scarring-related, 87, 115, 173sclerotherapy-related, 218soft tissue fi llers-related, 199, 200, 201,
202Erythema ab igne, 196Erythromycin, 67Erythromycin sterate, as contact allergy
cause, 141Erythromycin sulfate, as contact allergy
cause, 141Escherichia coli infections, 66, 67Estrogen, 217Ethyl alcohol, 63Exercise, as anaphylaxis cause, 12Extravasation, of sclerosing agents,
219–221Eyebrows
cocked, 210, 211ptosis of, 209, 211
Eyelidsectropion of. See Ectropionfree margin distortion of, 104,
109–111, 112lymphedema of, 145–146ptosis of, 209, 210retraction of
differentiated from eyelid ectropion, 104
postoperative transient, 95–96Eye surgery, as edema cause, 145–146
FFace
asymmetry ofbotulinum toxin injection-related,
210facelift-related, 234–235
free margin distortion on, 95–114Facelifting procedures, 224–237
complications of, 225–235contour irregularities, 226–227
facial asymmetry and premature sagging, 234–235
intraoperative, 225–229postoperative, 229–234
operative phase of, 225preoperative phase of, 224–225
Facial artery, palpation of, 27Facial nerves. See also specifi c facial
nervesmotor nerve anatomy and injuries,
22–28sensory nerve anatomy and injuries,
28–31Facial surgery, as edema cause, 146Fascian, 201Fasciitis, necrotizing, 54–55, 58, 59,
197–198Fat grafting, autologous, 196, 197Fibrinolytic disorders, as perioperative
hemorrhage cause, 36, 38Flaps. See Skin fl apsFluids
extracellular, complications of, 145–147intravascular, administration during
liposuction, 1925-Fluorouracil, 92, 118, 119, 120Freckles, removal of, 187Free margins
distortion of, 95–114regional considerations in, 102–113revision techniques for, 100–102self-correction of, 96
perioperative considerations regarding, 95–96
second intention healing of, 96–99, 100
Fungal infections, ablative laser skin resurfacing-related, 170, 171
Fusiform ellipse, 100
GGangrene
gas, 58, 59hemolytic streptococcal. See Fasciitis,
necrotizingGeneral anesthesia, liposuction under,
192–193Genodermatodoses, 36, 37–38Geometric broken lines (GBL), 121,
123, 124, 125–126Glabella, collagen injection-related
necrosis in, 200Glycerin, chromated, 216, 218, 220Grafts. See Skin graftsGranulation tissue, excessive, 144–145Granulomas, soft tissue fi ller-related,
199, 202, 203, 204Great auricular nerve
anatomy of, 28, 32injuries to, 31–33, 228
HHair removal, from surgical sites, 47, 48,
62Head. See also Face
anatomic “danger zones” of, 22, 23–33
Hematomas, 36, 40, 42–44, 193–194differentiated from wound infections,
48, 49effect on wound healing, 78, 79expanding, 43–44, 197
facelift-related, 230as necrosis cause, 80
facelift-related, 225–226, 229–230, 231
small, indolent, 43soft tissue fi llers-related, 202symptoms of, 48as wound dehiscence cause, 79, 81
Hemodialysis patients, 7Hemorrhagic complications, 36–45. See
also Hematomas; Hemostasiscauses of, 5, 6, 36–41, 225–226types of, 41–44
Hemosiderin, 215, 216–217Hemostasis
inadequate intraoperative, 36, 39–40in wound healing, 77
Hepatic function, preoperative evaluation of, 7
Herbal supplementsas contact dermatitis cause, 170as hemorrhage cause, 5, 36, 37, 39, 41,
193–194Hernias, in liposuction patients, 194Herpes simplex virus infections, 58, 101,
169, 170–171Herpes virus infections, 174, 183–184,
188–189Hexachlorophene, 139Human immunodefi ciency virus (HIV)
infections, 47–48, 204–205Hyaluronic acid fi llers, 201–202Hyperemia, skin resurfacing-related,
187–188Hyperpigmentation
liposuction-related, 197postoperative, 149, 150sclerotherapy-related, 213–217skin remodeling-related, 174, 175, 176skin resurfacing-related, 168, 169,
171–172, 185–187soft tissue fi llers-related, 202
Hypersensitivity reactions. See also Allergic reactions
to bovine collagen injections, 199–200, 201
delayed-type, 202Hypertension, 7, 36, 37, 78–79Hypochondriasis, 159
242 Index
Hypopigmentationcryotherapy-related, 91dermabrasion-related, 121, 122postoperative, 149–150skin resurfacing-related, 169, 172–173,
187, 189Hypoxia, smoking-related, 6
IImiquimod, 92Immunosuppression, as wound infection
risk factor, 46–47Immunosuppressive drugs, effect on
wound healing, 6Impetigo, 183, 184Implanted cardiac devices (ICD), 7,
16–17Incisions, surgical
as hypertrophic scaring and keloid cause, 87, 89
as pigmentary change cause, 149Infections. See also Wound infections
botulinum toxin injection-related, 211
facelift-related, 230–231liposuction-related, 197–198skin resurfacing-related, 169, 170–171,
188–189as wound dehiscence risk factor, 79
Informed consent, 183Infraorbital defects, 96, 109, 111Infraorbital nerve
anatomy of, 28injuries to, 30
Insect bites, 87Insight, lack of, 4Interferon therapy, for scars, 91, 117,
119International normalized ratio (INR),
39Iodophors, 52, 62, 63
adverse reactions to, 140–141Ischemic heart disease, as mortality
cause, 9Isopropyl alcohol, 52, 53Isotretinoin, 184, 187
JJudgment
evaluation of, 157lack of, 4
KKeloids, 115, 116, 118
burn-related, 92comparison with hypertrophic scars,
87, 88facelift-related, 232–234as facelift-related complications risk
factor, 224
isotretinoin-related, 184prevention of, 87, 89, 90, 116, 232–234as pruritus cause, 148recurrence of, 119treatment of, 87–94, 116, 120, 232–234
Keloid surgery, as hematoma cause, 43Kenalog, 120, 184, 226Klebsiella infections, 67
LLacerations, as scar and keloid cause, 87,
88Laser therapy, 167–182
ablativefor scar revision, 121, 123, 124for skin resurfacing, 167–173,
178–179for hyperpigmentation, 216–217for hypopigmentation, 187for keloids, 91nonablative
for scar revision, 120–121for skin remodeling, 174–176, 178
as pigmentary change cause, 150preoperative patient evaluation for,
167for scars, 91, 118, 120–121, 173side effects of, 91technical basis for, 167
Latex allergy, 13, 14Lentigines, 167–168, 187Lidocaine
allergic reactions to, 12, 14hepatic dysfunction and, 7intraincisional, 65toxicity of, 193use in liposuction patients, 193, 194
Linezolid, 56Lip
free margin distortion on, 95, 111–113soft tissue fi ller injections into,
201–202, 203Lipoatrophy, 204–205Liposuction, 192–198
in combination with facelifting procedures, 224, 226, 227, 229
under general anesthesia, 192–193under local anesthesia, 192, 193tumescent
as infection cause, 197–198local complications of, 195–197preoperative assessment for,
193–195ultrasonic, 193
Liver disease, 7Local anesthesia, use in liposuction
patients, 192, 193Local anesthetic injections, patients’
tolerance to, 147Lorazepam, 11, 15
MMalnutrition, as wound infection risk
factor, 47Mandibular nerve, marginal
injuries to, 26–28, 33–34, 228–229location of, 228
Mania, evaluation of, 157Manic-depressive disorders, 162Marfan’s syndrome, 40–41Massage therapy, for scars, 117, 118–119Medical and surgical histories, 4–8Melanocytes, cold sensitivity of, 149Mental nerve
anatomy of, 28, 30–31injuries to, 31
Mental status examinations, 157Microscopic epidermal necrotic debris
(MEND), 178–179Milia, 145, 169, 170, 189–190Minnesota Multiphasic Personality
Inventory, 155Mitral valve prolapse, 69Mohs’ micrographic surgery
as alar crease defect cause, 108as ear wound infection cause, 50–51,
68endocarditis prophylaxis in, 71, 72free margin distortion associated with,
99as herpes simplex virus infection risk
factor, 58infection rate in, 64intraincisional antibiotic prophylaxis
for, 65as nerve injury cause, 24, 26, 229in patients with implantable cardiac
devices, 17preoperative questionnaire for, 5
Molecular mimicry, 201Mood, evaluation of, 157Mupirocin, 64
as contact allergy cause, 141intranasal application of, 66
Muscle twitching, botulinum toxin injection-related, 211
Mycobacterial infections, 57, 197, 198, 230
Myonecrosis, clostridial, 58, 59
NNares, Staphylococcus aureus
colonization of, 66Nasal tip, ptosis of, 96Nasal valve, compromise of, 148–149Neck
anatomic “danger zones” of, 22, 23–33excessive liposuction of, 196, 197
Necrosis, cutaneous tissuecollagen injection-related, 200defi nition of, 81
Index 243
differentiated from dehiscence, 80prevention of, 82–83sclerotherapy-related, 219–221smoking-related, 6of surgical wounds, 53, 80, 81–82treatment of, 81–82
Neomycin, as contact allergy cause, 141, 142
Neomycin sulfate, 64–65Nerve injuries, 21–35. See also specifi c
nervesin anatomic “danger zones,” 22, 23–33facelift-related, 227–229management of, 33–35
Neurofi bromatosis, 15Neuromas, 147, 234Neuropraxia, 21Neurosurgery, complications of, 147–148Neurotmesis, 21Nitroglycerin tablets, 11Nonsteroidal anti-infl ammatory drugs,
38discontinuation prior to facelifting
procedures, 224effect on wound healing, 79as hemorrhage risk factor, 5, 36, 37,
38, 39, 79as purpura risk factor, 218
Nose, free margin distortion on, 95, 96, 97, 98, 99, 102–104, 105–108
OObsessive-compulsive disorder, 159, 161,
162Organ transplant patients, 7Orientation, to person, time, and place,
3–4, 156–157Osteoporosis, 148
PPain
botulinum toxin injections-related, 208postoperative, 82, 147–148
facelift-related, 234scarring-related, 115, 118
sclerotherapy-related, 218Para-aminobenzoic acid (PABA), 14Paraesthesia, liposuction-related, 197Paranoia, in cosmetic surgery patients,
159Patent foramen ovale, 221Penicillin, allergic reactions to, 54, 65, 71Personality, types of, 159Petrolatum
as alternative to antibiotic ointment, 142
effect on wound healing, 83as postoperative wound dressing, 64,
81, 169use in scar massage therapy, 118
Phenol, as chemical peel agent, 187, 190Phlebology, 213Photodamage, ablative laser repair of,
167–168Photodynamic therapy, short-contact,
176–177Photographs, as preoperative
documentation, 183Photorejuvenation
with laser therapy, 175with short-contact photodynamic
therapy, 177Photothermolysis, fractional, 178–179Phototoxic reactions, 177Physical examination, preoperative, 8Pigmentation. See also
Hyperpigmentation; Hypopigmentation
postoperative changes in, 149–150“Pixie ear” deformity, 234Polidocanol, 214, 216, 218, 220Polyacrylamide gels, 204Poly-L-lactic acid, 204–205Poly(methy methacrylate) microspheres,
202–203Polymyxin B, 64, 141Pores, enlarged, 189, 190Porphyria, as milia cause, 145Posttraumatic stress disorder, 162Povidone-iodine, 140Preoperative evaluation, 3–8Pressure, for intraoperative hemorrhage
control, 226Pressure dressings, for hemorrhage/
hematoma control, 40, 197Pressure therapy, for keloids and
hypertrophic scars, 90, 117, 118–119
Prodigiosin, 51Propionibacterium infections, 50Prosthetic joint infections, prophylaxis
for, 68, 73Prosthetic valves, endocarditis of, 68, 69Proteus, 67Protoporphyrin IX, 176–177“Proud fl esh,” 144–145Pruritus
keloid-related, 87postoperative, 115scar-related, 118, 148skin resurfacing-related, 169, 170, 171,
189Pseudomonas infections, 51, 64–65,
67–68, 171, 188Psychological profi les, of patients, 3–4Psychotherapy, 163–164Ptosis, 96, 209, 210Pulmonary system, preoperative
evaluation of, 7Purpura, sclerotherapy-related, 218, 219
RRadiation therapy, for keloids and
hypertophic scars, 91, 118, 120Radiofrequency treatment, nonablative,
177–178Refl ex sympathetic dystrophy, 147–148Renal function, preoperative evaluation
of, 7Resurfacing procedures. See also
Chemical peels; Dermabrasionas herpes simplex virus infection risk
factor, 58laser-based, 167–173
ablative, 167–173, 178antibiotic prophylaxis for, 64as fractional photothermolysis,
178–179nonablative, 178
as pigmentary change cause, 150preoperative consultations for,
183–184Retinoids, effect on wound healing, 6Rhytidectomy
complications of, 225, 228, 230, 232as nerve injury treatment, 35
Rhytideslaser therapy for, 167–168, 175lateral orbital, 209
Rosacea, 148
SSaline, hypertonic, as sclerosing agent,
214, 218, 220“Saturday night palsy,” 21Scalp, erosive pustular dermatitis of, 145Scalpel sculpting, of scars, 133, 136–137Scars
ablative laser skin resurfacing-related, 169
atrophic, 175, 176evaluation of, 115, 116–117excision of, 121, 133hematoma-related, 42hypertrophic, 115, 116, 118
comparison with keloids, 87, 88facelift-related, 232–234isotretinoin-related, 184liposuction-related, 197prevention of, 116, 119, 232–234revision of, 119skin fl ap sloughing-related, 231skin resurfacing-related, 169, 173,
187–188treatment of, 87–94, 116, 119, 121,
134, 232–234pigmentary changes in, 149–150preoperative evaluation of, 8revision and camoufl age of, 115–138
of hypertrophic scars, 87–94, 116, 119, 121, 134, 232–324
244 Index
Scars (cont.)nonsurgical options for, 115,
117–121surgical options for, 121–137
suture-related, 143–144Scar tissue, postoperative pain in, 147Schizophrenia, 157, 158Sclerosing agents, 214
extravasation of, 219–221inadvertent arterial injections of,
221–222Sclerosis, 213
tuberous, 15Sclerotherapy
complications of, 150, 213–223contraindications to, 213defi nition of, 213
Scrubbing solutions, aseptic, 52–53Sculptra, 204–205Sedation, conscious, 6Sedation agents, drug interactions of, 6Seizures, 6, 10, 15Seromas
differentiated from wound infections, 48, 49
effect on wound healing, 78, 79facelift-related, 226, 230, 231liposuction-related, 197–198as necrosis cause, 80symptoms of, 48treatment of, 48as wound dehiscence cause, 79of wounds, 146–147
Serosanguinous discharge, 53Serous discharge, 168, 169Serratia marcescens infections, 51Shaving, of surgical sites, 47, 48, 62Silicone, as soft tissue fi ller, 203–204Silicone dressings, for scar revision, 117,
119Silicone gel sheets, 90, 119Silver nitrate, as excessive granulation
tissue treatment, 144–145Skin, preoperative evaluation of, 8Skin fl aps
antibiotic prophylaxis for, 64hinged turnover, 104, 107meliolabial interpolation, 104, 105nasolabial transposition, 104, 106necrosis and sloughing of, 80, 82,
231–232perforation of, 227rhombic transposition, 96, 97two-staged, for alar rim defect repair,
104use in facelifting, 225
Skin graftsfor alar distortion free margin
revision, 102–103antibiotic prophylaxis for, 64
for eyelid defects, 110, 111necrosis of, 80, 81as pigmentary change cause, 150for wound contraction prevention, 98
Skin picking, 161–162Skin remodeling, nonablative laser,
174–176Smoking
effect on surgical outcomes, 6effect on wound healing, 82as facelift-related complications risk
factor, 224, 225as wound dehiscence risk factor, 79as wound infection risk factor, 47
Smoking cessation, perioperative, 6, 82Snap test, 110Sociopaths, 159Sodium tetradecyl sulfate, 214, 218, 220,
222Soft tissue fi llers, 199–206
permanent, 199, 202–204semipermanent, 199, 204–205temporary, 199–202
Sotradecol, 214, 218“Spider veins,” 213Spinal accessory nerve
anatomy of, 22–23, 31injuries to, 31–32, 229
Squamous cell carcinoma, perineural, 147
Staphylococcus aureus infections, 48as endocarditis cause, 68, 69methicillin-resistant, 55–57, 65, 66, 67,
71, 143of prosthetic valves, 73of surgical sites, 50, 51, 53, 64, 66–67,
68, 69, 171as toxic shock syndrome cause, 197
Staphylococcus epidermidis infections, 50, 73
Status epilepticus, 10, 15Steroids
as contraindication to collagen injections, 199
effect on wound healing, 6as hemorrhage cause, 36, 38intralesional
as keloid and hypertrophic scar cause, 89–90, 91, 92
as scar treatment, 119, 120as postoperative infection risk factor,
6Stomatitis, alcohol-related, 141Streptococcus infections, 50, 67, 68Strias, 194, 195Stroke, 14–15, 221Sturge-Weber syndrome, 15Subcision®, of depressed scars, 133, 137Sudden cardiac death, 9Sudeck’s atrophy, 148
Suicide, 162, 163Sunscreens, 171–172Superfi cial musculoaponeurotic system
(SMAS), 21–22, 23, 25, 27, 28, 35in facelifting procedures, 224, 225, 227,
228–229, 234Supraorbital nerve
anatomy of, 28–29injuries to, 29–30
Surgical history, 4, 5, 8Surgical prepatory agents, as dermatitis
cause, 139–141Surgical sites
aseptic preparation of, 52–53infections of. See Wound infections
Suturesburied, 49, 79, 82, 87, 89, 142–143complications of, 49, 87, 89, 142–144excessively tight, 79in facelifting procedures, 225plication, 226removal of
in contact dermatitis, 141–142from infected wounds, 53, 54
spitting, differentiated from wound infections, 49
stainless steel, 144for wound dehiscence prevention, 79,
82for wound necrosis prevention, 82
Syncope, vasovagal, 10, 13–14Systemic lupus erythematosus, 15
TTacrolimus, as keloid treatment, 92“Talkesthesia,” 13Tape, surgical, cutaneous reactions to,
141, 142, 197Telangiectactic matting, 217–218Telangiectasia, 148, 213
effect of skin resurfacing on, 189hereditary hemorrhagic, 40–41sclerotherapy-related, 217–218steroids-related, 188
Temporal nerve, injuries to, 23–24, 229Thought processes
disordered, 4evaluation of, 157
Thromboembolitic complications, 39Thrombolytic (fi brinolysis) therapy, 37Thrombophlebitis, sclerotherapy-related,
221Thrombosis, deep venous, 221Thyroid disease, preoperative evaluation
of, 8Ticlopidine, 36, 37–38Toxic shock syndrome, 189, 197Trauma, as hypertrophic scars and
keloid cause, 87, 88Trendelenberg position, 9, 13
Index 245
Triamcinolone acetonide, intralesional, 90, 91, 92
Trichloracetic acid (TCA), 185, 187, 190Trigeminal nerve
anatomy of, 28injuries to, 28–31
Trimethoprim-sulfamethoxazole, 67–68
Tumors, recurrence of, as pain cause, 147
UUlcers, 82, 220–221Urticaria, 139, 141, 218
VVaccinations, as hypertrophic scarring
and keloid cause, 87, 89Vancomycin resistance, 51Varicose veins, 213Verapamil, 92Visual disturbances, sclerotherapy-
related, 221Vitamin E, as perioperative hemorrhage
cause, 36, 37, 39, 41, 193–194V to Y repair, of eclabium, 113
WWarfarin, 5, 38Wound care, 52–53, 82–83Wound contraction, 96–99, 101Wound dehiscence. See Dehiscence, of
woundsWound healing
delayed, 81, 188in diabetic patients, 8normal, 77–78phases of, 77, 184pruritus during, 148by secondary intention, 96–99, 100,
110, 113Wound infections, 46–61
classifi cation of, 46, 47in diabetic patients, 8, 47diagnostic criteria for, 47differential diagnosis of, 48–49as keloid cause, 87life-threatening, 58–59management of, 53–55methicillin-resistant Staphylococcus
aureus-related, 55–57microbiology of, 50–51prevention of, 52–53
prophylaxis for, 62–68, 74risk factors for, 46–48, 65–66risk of, 62, 63unusual causes of, 57–58
Wound margins. See also Free marginscontact dermatitis at, 141–142
Wounds, surgical. See also Wound care; Wound healing; Wound infections
classifi cation of, 63–64seroma of, 146–147tensile strength of, 79
W-plasty, 121, 123, 124, 125–126Wrinkles. See Rhytides
ZZ-plasty
for eclabium revision, 112–113for ecnasion revision, 104, 108for free margin distortion revision,
100–102, 110–111for scar revision, 121, 124, 126–129,
130–133Zyderm collagen implants, 199–200Zygomatic nerve, injuries to, 24–26,
33–35Zyplast collagen implants, 199, 200