Tattoo Removal Using Surgical Techniques: Experience With 350 Cases

Introduction: There has been an exponential increase in the number of young adults seeking tattoo removal in recentyears. The main reason is a prohibition of any form of tattoo in recruitment of army, paramilitary force, police, and otherjobs. Most studies done on tattoo removal are either on laser removal or have established results of only one particularsurgical method of tattoo removal. However, almost all known surgical methods of tattoo removal have been performed inthe present study.Aims and Objectives: The aim is to study the clinical outcome of various surgical methods of tattoo removal to search for anideal one.Materials and Methods: A study was conducted in 350 patients. Tattoo removal was done with surgical methods. The varioussurgical techniques used were excision and primary closure, serial excision, tangential split thickness excision, tangentialexcision with dermal over grafting, and excision with grafting. The factors which determined the choice of procedure weresize, site, shape, depth of tattoo, skin laxity, and presence of complication of tattooing or previously attempted tattoo removal.Patients were followed for 3 months.Results: Excision and primary closure were done in 26 tattoos. Serial excision in 9, split thickness tangential excision in 2,tangential excision with dermal over grafting in 179, and excision with grafting in 134 tattoos were done. Scar stretching, minimalcolor changes, and hypertrophy were seen after tattoo removal. Post-operative marginal hypertrophy was seen lesser in tangentialexcision with dermal over grafting (60%) than in excision with grafting (75%) though it could be managed conservatively. Patientsatisfaction levels were well achieved.Conclusion: All procedures resulted in complete tattoo removal, and each had its own application and limitations. It was difficultto label one procedure superior to the other.

Application and advances in the research of animal models in burn research / 中华烧伤杂志

The occurrence, development, and prognosis of burn is a complicated pathophysiological process involving many organs and systems. With the development of science and technology and update of treatment concept, more and more new materials, new equipments, and new methods are applied to the diagnosis and treatment of burn. Animals similar to humans in anatomical structure and physiological function are the ideal models for research of burn. Nowadays, animal models of burn have been developed to simulate different aspects of burn. These models provide important essential support for elucidating the pathophysiological mechanism of burns and exploring new therapeutic interventions and materials for human beings. Understanding the advantages and limitations of these animal models is essential for the research of burn.

Effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn / 中华烧伤杂志

Objective@#To observe the effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn.@*Methods@#Clinical data of 40 children with deep partial-thickness burn wounds on trunk and limbs, admitted to our burn ward from January 2016 to June 2017, conforming to the study criteria, were retrospectively analyzed. They were divided into conventional treatment group (CT, n=19) and minimally invasive tangential excision group (MITE, n=21) according to the different treatments. The patients in group CT were treated with eschar-reserving therapy firstly. When tangential excision was performed, the roller knife was used, and no necrotic tissue left on the wound bed was considered the proper depth of excision. Razor-thickness skin grafting was performed to cover the wound when adipose tissue exposed markedly after tangential excision. Dressing change was performed within 48 h after the operation and repeated every 2 days. Unhealed wounds were covered by razor-thickness skin grafting. The patients in group MITE were treated with tangential excision in the early stage post burn. The tangential excision was operated with electric dermatome, and the thickness was set at 0.1 mm to excise the surface of eschar until the sporadic punctate hemorrhage on wound surface was observed and some necrotic tissue was left on the wound bed. Porcine acellular dermal matrix was applied after tangential excision. The first dressing change was often performed about 1 week after the operation. Razor-thickness skin grafting was performed to cover the unhealed wounds. The length of wound healing, high fever, antibiotic usage, and hospital stay, times of later operation, and hospitalization expenses of patients in the 2 groups were recorded. The excisional eschar and wound bed tissue of patients in group MITE were harvested for pathological observation. Data were processed with t test and Fisher′s exact probability test.@*Results@#(1) There were no statistically significant differences in length of high fever and length of hospital stay and hospitalization expenses between patients in the 2 groups (t=-1.67, -1.93, 0.31, P>0.05). The lengths of wound healing [(24.8±2.5) d] and antibiotic usage [(4.4±0.7) d] of patients in group MITE were significantly shorter than those in group CT [(33.3±2.5) and (7.0±0.7) d, t=-2.44, -2.44, P<0.05], and times of later operation of patients in group MITE [(0.29±0.14) times] were significantly less than those in group CT [(0.79±0.21) times, t=-2.03, P<0.05]. (2) The thickness of the excisional eschar of patients in group MITE was about 150 μm. The eschar has epidermis and upper dermis. Some necrotic tissue was left on the wound bed.@*Conclusions@#The treatment for pediatric deep partial-thickness burn wounds on trunk and limbs with minimally invasive tangential excision using electric dermatome in the early stage post burn can accelerate wound healing, shorten length of antibiotic usage, and reduce times of later operations.

Clinical study of tangential excision within 24 hours after burn with massive deepⅡdegree in treatment for eld-erly patients / 局解手术学杂志

Objective To observe the clinical efficacy and inflammation of tangential excision within 24 hours after burn with massive deep Ⅱdegree burn wounds for elderly patients. Methods From Jan. 2010 to Dec. 2013, a total of 82 elderly patients with massive deepⅡdegree burn wounds were divided into the observation group ( giveing tangential excision within 24 hours after burn) and the control group ( giveing tangential excision within 3~5 d after burn) according the time of tangential excision treatment. The amount of infused fluid, u-rine, levels of serum inflammatory factors, survival rate of skin grafts, wound healing time, hospitalization time and the complications were compared between the two groups. Results There was no significant difference in the amount of infused fluid, plasma and urine between the two groups in the first day and fifth day (P>0. 05). The levels of TNF-αsignificantly decreased after 3 days of therapy compared with the control group (P<0. 05). The levels of IL-6 significantly decreased and IL-10 significantly increased from the first day of therapy in the ob-servation group compared with the control group (P<0. 05). The survival rate of skin grafts in the observation group was significantly higher than that in the control group, and time of wound healing and hospitalization in the observation group was significantly shorter than that in the control group (P<0. 05). The complication rate of the observation group was 11. 1% which was significantly lower than that in the control group 29. 7% (P<0. 05). Conclusion To treat burn with massive deepⅡdegree burn wounds for elderly patients with tangential excision within 24 hours which can effectively reduce the inflammatory, reduce wound infection and improve the success rate of skin grafting.

Aesthetic Improvement of Burn Scar by Tangential Excision and Thin Split Thickness Skin Graft

BACKGROUND: Burn injuries of the extremity can result in cosmetically offensive appearance. Postburn scar can improve by the combination of tangential excision and thin split-thickness skin graft. METHODS: From January 2005 and December 2012, 17 patients (10 males and 7 females) with postburn scar of the extremity underwent the combined techniques. The median time from initial injury to surgery was 66.2 months (range: 11-288 months). In the operation, burn scar was excised until viable dermis could be observed using electrical dermatome, after which thin split thickness skin graft was performed. RESULTS: Tangential excision and thin split thickness skin graft gave excellent grafting results without the need of reoperation. Depigmentation in the majority of patients were recovered within a year by the operation of thin split thickness skin graft. Recovery of range of motion and cosmetic results were good in all patients. CONCLUSIONS: Tangential excision and thin split thickness skin graft are a good way of the reconstruction of deformed and depigmented skin from burns on extremity.

Tangential excision and dermabrasion in treatment of superficial giant congenital melanocytic nevus / 中华医学美学美容杂志

ObjectivePresent treatment in plastic surgery on giant congenital melanocytic nevus has always been a tough practice because it is difficult to achieve balance between effects and costs of treatment.This paper aimed to explore the concrete procedure of tangential excision and dermabrasion in treatment of adult giant congenital melanocytic nevus. Methods Taking into consideration pathological examination results before surgery,diseased regions,psychological expectancy and other factors,we used a humby knife or globe grinding head to remove giant congenital relanocytic nevus by wiping off the surface of it in 10 cases.After operation,the operated area of the skin underwent a process of healing in a moisturized state.In each case,surgical procedure was carried out by 1 2 sta ges,with the interval period ranges from 3 months to 6 months.ResultsOne to 3 years follow-ups showed that among those cases,5 cases obtained good results in which skin color of surgical area turned to normal and pathological examination showed that nevus cells disappeared,4 cases achieved improvement,and 1 case was relapsed.ConclusionsThe two alternative methods for treatment of giant congenital melanocytic nevus,either tangential excision or dermabrasion,with combination of pathological examination results,diseased regions,and psychological expectancy should be taken into consideration,which can remain a maximum balance between effects and costs of treatments.Tangential excision and dermabrasion are effective in some cases of giant congenital nevus where traditional methods do not work,or in order to reduce the cost of body appearance in treatment.Therefore,these two methods deserve to be adopted extensively in clinical therapy.But it still needs further accumulation of experience in practice and longer period of follow-up after operation.

A Case of Tuberous Sclerosis with Multiple Fibroma on Scalp and Extremity

PURPOSE: Tuberous sclerosis is an autosomal dominant multisystemic neurocutaneous syndrome characterized by the development of multiple hamartoma distributed through the body, skin, brain, heart, kidney, and lung. The classic triad is seizure, mental retardation, and facial angiofibroma. We experienced a case of a tuberous sclerosis associated with the facial lesion and multiple masses on scalp, forehead, and right lower extremity. METHODS: This a 34-year-old male patient had subependymal giant cell astrocytoma in brain and multiple angiomyolipoma in both kidneys. Tangential excision with razor blade and dermabrasion were done on the centrofacial area. We excised other lesions and the mass on scalp was excised and covered with split thickness skin graft. RESULTS: The histopathological finding revealed that the facial lesion was angiofibroma and the others were multiple fibroma. CONCLUSION: In our case of tuberous sclerosis, we chose the tangential excision to remove the large nodules of angiofibroma, and then dermabrasion was used to smooth the final contour. The patient appeared to have a good results from this treatment modality. But, tuberous sclerosis is an disease that needs long term follow-up to check up the recurrence of skin problem.