Simpson A, Graham ME, Williams J.
J Wound Care. 2011 Nov;20(11):540, 542.
Congenital indifference to pain (CIP) is a rare condition characterised by painless injuries beginning in early life, with normal sensory exam findings. Young people with inexplicable, painless chronic wounds may present to the plastic surgeon for surgical management. Given the young age of onset and high likelihood of postoperative failure, alternative options for closure of non-healing wounds should be considered. We present the case of a 17-year-old boy with congenital indifference to pain and successful management of his longstanding plantar ulcer.
Michael SG Bell
Can J Plast Surg. 2009 Autumn; 17(3): e13–e14.
Facial cysts are a common complaint. They often appear in the central cheek and eyelid areas where there are few facial expression lines, leading to a somewhat unfavourable scar if they get infected and drain, or require surgical intervention.
Minimizing the incision line to deal with them is always a challenge.
Under local anaesthesia, it may be possible to simply tease out the capsule through a small stab incision. This allows a primary closure, with a short incision directed as chosen by the surgeon.
Unfortunately, in many cases the capsule is ill-defined. There may have been previous infections, such that only the contents can be expressed adequately and curetted out. In that circumstance, painting the lining with silver nitrate is a time-honoured technique. In many of these situations the capsule will spontaneously extrude over the next five to seven days, leaving a cavity that contracts and closes. A secondary procedure may then be required to revise the scar, and hopefully pull adjacent soft tissues centrally to eliminate the contour deformity.
The author has been pleased with the use of a new dynamic tape to deal with the circumstance of the open cavity after the capsule of the cyst has sloughed following silver nitrate application
Doumit J1, Vale R, Kanigsberg N.
J Cutan Med Surg. 2013 Jan-Feb;17(1):62-5.
A punch biopsy is a common therapeutic and diagnostic procedure that is routinely performed by dermatologists. A thin cylinder of tissue is removed with abiopsy punch, which creates a full-thickness wound. Sutures are used for primary closure as part of standard practice and are removed in follow-up 5 to 14 days later. Thebiopsy site heals with a small linear scar. In the past, punch biopsies were often left to heal by secondary intention, but given the extended healing time, this has fallen out of practice among dermatologists.
The purpose of this case report is to introduce a new quick and cost-effective approach to accelerate secondary intention healing following punch biopsies in busy dermatology clinics.
We present a case where Dynaclose tape (Canica Design Inc, Almonte, ON) was used as an alternative to sutures for biopsy site closure.Dynaclose tape is a strip with adhesive ends and a clear center composed of silicone elastomer. The silicone elastomer promotes wound closure by pulling the opposing margins together. The tape maintains excellent adhesion and follows the natural shape of the skin to maximize patient comfort and mobility.