Improving quality of dermatologic surgery: from different points of view

Abstract

This thesis showcases multiple aspects to improve dermatologic surgery and is divided in three parts. In the first part, research is conducted measuring forces in dermatologic surgery such as suturing techniques and skin tension. Various devices are used to examine the pulling force needed to close sutures and to determine the most ideal skin orientation for an excision. In the second part, results from perioperative topics are shown. Circular excisions are made on the lower limb to determine the effect on dog-ear formation which regress spontaneously. A review is conducted on which tie-over technique for full-thickness grafts has the best graft take. Both tie-over and no tie-over techniques show high success rates. Risk factors for incomplete excision of cutaneous squamous cell carcinomas are analyzed and tumor depth beyond the dermis is an important risk factor. In the last part, the impact of facial skin surgery has been investigated using patient-reported outcome measurements. Facial skin surgery does not affect quality of life after a 1-year follow-up period.