Chen David L, Carlson Ekama O, Fathi Ramin, Brown Mariah R
Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado.
Dermatol Surg. 2015 Oct;41 Suppl 10:S201-15. doi: 10.1097/DSS.0000000000000489.
Undermining and hemostasis are basic surgical techniques that can have a significant impact on surgical outcomes.
To review the mechanisms and techniques of undermining and hemostasis, with an emphasis on the advantages and limitations of each modality.
The PubMed database was searched for articles with the keywords "undermining," "hemostasis," and "electrosurgery."
Whether 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.
Understanding and optimizing hemostasis and undermining will allow dermatologic surgeons to execute complex closures with minimal complications.
潜行分离和止血是基本的外科技术，可对外科手术结果产生重大影响。
回顾潜行分离和止血的机制与技术，重点关注每种方式的优缺点。
在PubMed数据库中检索关键词为“潜行分离”“止血”和“电外科手术”的文章。
无论是采用钝性、锐性还是电外科技术，在缝合时进行适当深度和宽度的潜行分离对于组织移动都是必要的。过度或不足的潜行分离都会影响手术愈合。手术止血技术包括压迫、缝合结扎、局部止血剂和电外科手术。皮肤科外科医生应针对每个手术选择合适的止血量和类型。鉴于电外科手术有引发并发症的可能性，操作时应格外小心。
理解并优化止血和潜行分离将使皮肤科外科医生能够以最少的并发症完成复杂的缝合。
