BACKGROUNDAlthough gender disparities for those entering medicine have equalized, the number of women advancing in academia has remained low. Studies have demonstrated that womenʼs representation at ...academic medical conferences has also remained low across multiple fields. Given that conference presentations and national reputation serve as metrics for academic promotion, womenʼs representation at dermatology conferences may provide insight into womenʼs academic productivity.
OBJECTIVETo examine the gender composition of presenters and speaking time at the 2 main national dermatologic surgery conferences.
METHODSSpeakerʼs gender, presentation time, and topics were collected for 2009 to 2017 for the American College of Mohs Surgery (ACMS) and the American Society for Dermatologic Surgery (ASDS) Annual Meetings.
RESULTSWomen had significantly fewer speaking opportunities and speaking minutes at both conferences. This disparity was most pronounced in reconstruction topics and least pronounced in cosmetics topics. The majority of top speakers, repeat speakers, and keynote speakers were men for both conferences. Oral abstracts showed no gender disparity at either conference.
CONCLUSIONWomen spoke less than men at both the ASDS and ACMS annual meetings over multiple years studied. Recently, this disparity in speaking opportunities has decreased. Further studies are needed to evaluate the speaking opportunities for women at other types of dermatology conferences.
Dressings are integrally tied to wound outcomes in dermatologic surgery. Due to the wide range of wound types and dressing options available, dressing selection can be a formidable task. An ...understanding of dressing materials and their unique properties allows for a tailored approach to postoperative wound care. Conventional layered dressings often are suitable for uncomplicated dermatologic surgery wounds. Occlusive dressings and tissue-engineered skin substitutes may be warranted in more complex cases. This review is intended to equip the reader with the knowledge and confidence to successfully manage surgical wounds in dermatology.
The temporal branch of the facial nerve is at risk of damage during Mohs micrographic surgery (MMS). This complication leads to motor deficit in the ipsilateral upper face with resultant functional ...and cosmetic impairment.
To identify patient, tumor, and surgical risk factors associated with temporal nerve damage.
A single-institution, retrospective review of MMS cases involving anatomic sites within the temporal nerve danger zone was performed. Risk factors were compared between cases with and without nerve damage.
Of 616 cases within the danger zone, 28 (4.5%) had postoperative nerve dysfunction. Variables significantly associated with dysfunction included patient immunosuppression, tumor size, aggressive tumor histology, recurrent tumors, high degree of subclinical spread, and greater average number of Mohs stages. Preoperative tumor size and postoperative defect size of ≥3 cm resulted in a ×37 and ×40 increased odds of nerve damage, respectively. Sex, age, and basal versus squamous cell carcinoma were not significantly associated with temporal nerve damage. No patients with a postoperative defect size measuring <2 cm had nerve damage.
The overall risk of damage to the temporal nerve during MMS is low, but there are certain risk factors that warrant increased counseling about this potential complication.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
5.
Mohs Micrographic Surgery Wong, Emily; Axibal, Eileen; Brown, Mariah
Facial plastic surgery clinics of North America,
02/2019, Volume:
27, Issue:
1
Journal Article
Peer reviewed
Mohs micrographic surgery (MMS) is the gold standard for treating various cutaneous tumors. MMS has evolved into a single-day, outpatient procedure. The tumor is excised, mapped, and processed with ...frozen, horizontal sections for immediate histologic evaluation. The process is repeated as necessary until the tumor is completely removed, with maximal conservation of normal tissue. Evaluation of 100% of the surgical margin allows for exceptional cure rates. The Mohs surgeon is trained in tumor excision, histopathology interpretation, and surgical reconstruction. The use of MMS is often part of a multidisciplinary approach to treating cutaneous tumors.
The Ebony series of crepe myrtle ( Lagerstroemia indica ) cultivars includes several (Ebony Embers, Ebony Fire, Ebony Flame, Ebony Glow, and Ebony and Ivory), marketed today under the Black Diamond ® ...brand. These are relatively new crepe myrtle cultivars unique for their dark foliage, but with little information concerning their performance in north-central Texas, especially in low-input landscapes. The study was conducted from 2014 to 2017 at three locations in north-central Texas with three soil types, an acidic fine sandy loam, a neutral pH silt loam, and an alkaline heavy clay. Although soils and environmental conditions caused variations between sites, overall performance among cultivars was consistent across all study sites, with Centennial Spirit having better landscape performance than any of the Ebony cultivars tested. ‘Ebony and Ivory’ and ‘Ebony Blush’ had the overall lowest landscape performance. Ebony cultivars grew more slowly, had fewer blooms, and were more susceptible to powdery mildew than Centennial Spirit. While the trees may perform better in more intensively managed landscapes, the Ebony cultivars did not perform as well as Centennial Spirit in low-input landscapes in north-central Texas.
BACKGROUNDUndermining and hemostasis are basic surgical techniques that can have a significant impact on surgical outcomes.
OBJECTIVETo review the mechanisms and techniques of undermining and ...hemostasis, with an emphasis on the advantages and limitations of each modality.
MATERIALS AND METHODSThe PubMed database was searched for articles with the keywords “undermining,” “hemostasis,” and “electrosurgery.”
RESULTSWhether performing blunt, sharp, or electrosurgical techniques, undermining at the appropriate depth and width is necessary for tissue movement during closures. Both excessive and inadequate undermining can compromise surgical healing. Surgical hemostasis techniques include pressure, suture ligation, topical hemostatic agents, and electrosurgery. Dermatologic surgeons should select the appropriate amount and type of hemostasis for each procedure. Particular care should be taken in performing electrosurgery, given the potential for complications.
CONCLUSIONUnderstanding and optimizing hemostasis and undermining will allow dermatologic surgeons to execute complex closures with minimal complications.
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