can you send a punch biopsy piece to pathology?
no, it burns the sample
when would you use a punch biopsy?
large surface area without a dx (can take samples from several areas)
OR unresponsive to txment
what could you do a shave biopsy on?
seborrheci keratosis, verrucous, molluscum, BCC, acrochordons (skin tags), pedunculated nevi
when would you excise a skin thing?
melanomas, epidermal inclusion cysts, lipomas, larger BCC or SCC, dermal lesions > 1cm
how much blood should you get from a shave bx?
not much
where do you silver nitrate when doing a shave bx?
only where the bleeders are (otherwise it will create a scar)
how do you rotate the punch instrument?
In one direction only
what do you have to be concerned about with tape?
old ppl with delicate skin will have skin tears when its removed
who should you not put neosporin on?
lower extremities of ppl with DM, smokers or other vascular deficiency
where can necrotic wounds be debrided?
at bed side, bc they have lost feeling there
what is the wound healing schedule?
coagulation
proliferation
maturation
what is the time frame for maturation?
21 dys to what it will look like, 1 yr to get strength back (will be 80% of pre event strength)
why do we use sutures?
- controls bleeding
- makes healing faster
- decrease likelihood of infection
- decrease scar tissue and make it more cosmetically pleasant
how many ppl should you use to put in staples?
2
when would a staple be preferred?
scalp wounds
