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In The Name of GOD Principles of Skin Surgery Lecture For Gps

In The Name of GOD Principles of Skin Surgery Lecture For Gps. Behzad Nakhai M.D, FICS Asso, Professor Department of Surgery Tehran University of Medical Sciences Tehran ,Islamic Republic of Iran. General Consideration. The Largest & Most complex organ of the Body

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In The Name of GOD Principles of Skin Surgery Lecture For Gps

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  1. In The Name of GODPrinciples of Skin Surgery Lecture For Gps Behzad Nakhai M.D, FICS Asso, Professor Department of Surgery Tehran University of Medical Sciences Tehran ,Islamic Republic of Iran

  2. General Consideration • The Largest & Most complex organ of the Body • Great Variation from Region to Region of Body • A Protective Barrier with Environment • Palms & Soles Thick for weight Bearing • Finger tips Highest Sensory Innervations • Easy to Observe & Obtain Skin Specimens • Major Organ Responsible for Thermoregulation

  3. Surgical Anatomy of the Skin • Three Layers: The Epidermis The Dermis The Hypodermis

  4. Epidermis: Four Main Layers • The Keratin Layer ( Stratum Corneum) • The Granular Layer( Stratum Granulosuma) • The Prickle Cell ( Stratum Spinosum ) • The Basal Layer ( Stratum Germinal / Melanocyt) Note: Cell Division Normally Occurs only in the Basal Layer

  5. The Dermis :Consists of DenseCollagen Fibers that Determines the lines of tension in the Skin Known As Langer's Lines

  6. Langer's Line of The Face

  7. HypoDermis: Deepest Layer • Loose FibroFatty Tissue • Contain Skin Appendages: Sweets Glands Hair Follicles Sebaceous Glands

  8. Gross Anatomy & Pathology

  9. Pre& Malignant Solar Keratosis Bowen's Disease Squa-Cell Carcinoma Basal-Cell Carcinoma Melanotic Lesions /BA Skin Lesions Epidermal Origin • Benign Papillomas Warts Seborrhoeic Keratosis KeratoAcanthoma

  10. Skin Lesions Dermal Origin • Pyogenic Granuloma • Histiocytoma • Keloid & Secondary Carcinoma • Kaposi's Sarcoma

  11. Skin Lesions Appen Origin • Sebaceous Cyst • Dermoid cyst • Pilonidal Sinus • Benign Appendage Tumors

  12. Skin Lesions Hypodermal Origin • Lipoma & LipoSarcoma • NeuroFibroma & Sarcoma • NeuroFibromatosis • Schwannoma • Deeper Lesions, e.g. Lymph nod , Ganglion

  13. Skin Lesions Vascular Origin • Spider Naevi • All Kind of Angioma • Glomus Tumors ( Digits) • Vascular Spots ( Morgan)

  14. Symptoms & Signsof The Skin Lesions • Lump in the Skin ( Size, Shape, Surface, Depth , Margin, Consistency, Pulsatility, Emptying & Refilling, Transilluminancy, Temperature ) • Pain, Tenderness, Discomfort • Ulceration ( Behavior of the Ulcer) • Color & Pigmentation • Rapidly Developing Lesions • Site of the Lesion • Age when Lesion Detected

  15. Principles of Management • Simple Excision • Physical Methods ( Cautery, Laser, Cryo, Rf) • Excisional Biopsy • Incisional Biopsy • Wide Local Excision ( Skin Grafting) • Lymph Node Clearance ( Dissection ) • Radiotherapy & Chemotherapy

  16. Use of Scalpel

  17. Face Skin Lesions Excision

  18. Dog Ear Removing

  19. Skin Closure Techniques

  20. Methods of Skin Suture

  21. Approximating of Subcutaneous

  22. Exicional Biopsy

  23. Incision & Excision of Skin Lesions

  24. Ligature of the Vessels

  25. Proper Skin Surgery

  26. References • Schwartz's Textbook of Surgery • Grabb & Smith's Plastic Surgery • Essential of Surgery • Farquharson,s Operative Surgery • Sabiston Textbook of Surgery • ACS, Surgery

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