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Dermabrasion Workup

  • Author: Gaurav Bharti, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
 
Updated: Jan 05, 2015
 

Approach Considerations

Preoperative laboratory studies should include a hepatitis panel, HIV antibody screening with an informed consent, and a nasal swab for patients with a history of impetigo. Some patients may warrant a complete blood cell (CBC) count and chemistry profile.

 
 
Contributor Information and Disclosures
Author

Gaurav Bharti, MD Resident Physician, Department of Plastic and Reconstructive Surgery, Wake Forest University Baptist Medical Center

Gaurav Bharti, MD is a member of the following medical societies: American Medical Association, American Medical Student Association/Foundation, Phi Kappa Phi

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph A Molnar, MD, PhD, FACS Medical Director, Wound Care Center, Associate Director of Burn Unit, Professor, Department of Plastic and Reconstructive Surgery and Regenerative Medicine, Wake Forest University School of Medicine

Joseph A Molnar, MD, PhD, FACS is a member of the following medical societies: American Medical Association, American Society for Parenteral and Enteral Nutrition, American Society of Plastic Surgeons, North Carolina Medical Society, Undersea and Hyperbaric Medical Society, Peripheral Nerve Society, Wound Healing Society, American Burn Association, American College of Surgeons

Disclosure: Received grant/research funds from Clinical Cell Culture for co-investigator; Received honoraria from Integra Life Sciences for speaking and teaching; Received honoraria from Healogics for board membership; Received honoraria from Anika Therapeutics for consulting; Received honoraria from Food Matters for consulting.

Christopher B Harmon, MD Private Practice, Surgical Dermatology Group

Christopher B Harmon, MD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Mohs Surgery, American Medical Association, American Society for Laser Medicine and Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Christian N Kirman, MD Clinical Instructor, Department of Surgery, Division of Plastic Surgery, University of California, San Francisco, School of Medicine

Christian N Kirman, MD is a member of the following medical societies: Alpha Omega Alpha, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery

Disclosure: Nothing to disclose.

Benjamin Daniel Liess, MD Assistant Professor, Department of Otolaryngology, University of Missouri-Columbia School of Medicine

Benjamin Daniel Liess, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, The Triological Society, American Medical Association, Missouri State Medical Association

Disclosure: Nothing to disclose.

Chad L Prather, MD Clinical Assistant Professor, Department of Dermatology, Louisiana State University School of Medicine in New Orleans

Chad L Prather, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, Louisiana State Medical Society, Dermatology Foundation

Disclosure: Nothing to disclose.

Chief Editor

Gregory Gary Caputy, MD, PhD, FICS Chief Surgeon, Aesthetica

Gregory Gary Caputy, MD, PhD, FICS is a member of the following medical societies: Wound Healing Society, American Society for Laser Medicine and Surgery, International College of Surgeons, International College of Surgeons US Section, Pan-Pacific Surgical Association

Disclosure: Receive salary from Advantage Wound Care for employment. for: On the speaker's bureau for Smith and Nephew for Santyl Ointment.

Acknowledgements

John G Albertini, MD Private Practice, The Skin Surgery Center; Clinical Assistant Professor (Volunteer), Wake Forest University School of Medicine, Department of Plastic and Reconstructive Surgery; Secretary-Treasurer, American College of Mohs Surgery

John G Albertini, MD is a member of the following medical societies: American Academy of Dermatology and American College of Mohs Surgery

Disclosure: Nothing to disclose.

Danielle M Dauria, MD Resident Physician, Division of Plastic and Reconstructive Surgery, St Louis University School of Medicine

Danielle M Dauria is a member of the following medical societies: American Medical Student Association/Foundation

Disclosure: Nothing to disclose.

Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Keith A LaFerriere, MD Clinical Professor, Fellowship Director, Department Otolaryngology-Head and Neck Surgery, University of Missouri-Columbia School of Medicine

Keith A LaFerriere, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Missouri State Medical Association

Disclosure: Nothing to disclose.

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting

Margaret Napolitano, MD Clinical Instructor of Plastic Surgery, University of Louisville School of Medicine; Consulting Surgeon, Department of Plastic Surgery, Kleinert, Kutz and Associates

Disclosure: Nothing to disclose.

Daniel R Olney, MD, FACS Assistant Professor of Otolaryngology, Facial Plastic Surgery, State University of New York at Buffalo

Daniel R Olney, MD, FACS, is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Medical Association

Disclosure: Nothing to disclose.

Christian E Paletta, MD, FACS Clinical Professor of Surgery and Instructor of Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth; Clinical Professor of Surgery and Instructor in Surgery, Rwanda Human Resources for Health, Rwanda Ministry of Health and Clinton Health Access Initiative

Christian E Paletta, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, Association of Academic Chairmen of Plastic Surgery, and Plastic Surgery Research Council

Disclosure: Nothing to disclose.

Désirée Ratner, MD Director, Comprehensive Skin Cancer Center, Continuum Cancer Centers of New York, Director of Dermatologic Surgery, Beth Israel Medical Center and St. Luke's and Roosevelt Hospitals, Professor of Clinical Dermatology, College of Physicians and Surgeons of Columbia University

Désirée Ratner, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, American Society for Dermatologic Surgery, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Michael Brent Seagle, MD Associate Professor, Division of Plastic Surgery, University of Florida College of Medicine; Consulting Staff, Florida Surgical Center

Disclosure: Nothing to disclose.

Wayne Karl Stadelmann, MD Stadelmann Plastic Surgery, PC

Wayne Karl Stadelmann, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society of Plastic Surgeons, New Hampshire Medical Society, Northeastern Society of Plastic Surgeons, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael J Wells, MD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Tolbert Wilkinson, MD Consulting Staff, Department of Surgery, Southwest Texas Methodist Hospital

Tolbert Wilkinson, MD is a member of the following medical societies: American College of Surgeons, American Society for Aesthetic Plastic Surgery, Phi Beta Kappa, and Texas Medical Association

Disclosure: Nothing to disclose.

Andrea Leigh Zaenglein, MD Professor of Dermatology and Pediatrics, Department of Dermatology, Hershey Medical Center, Pennsylvania State University College of Medicine

Andrea Leigh Zaenglein, MD is a member of the following medical societies: American Academy of Dermatology, American Acne and Rosacea Society, and Society for Pediatric Dermatology

Disclosure: Galderma Consulting fee Consulting; Valeant Consulting fee Consulting; Promius Consulting fee Consulting; Anacor Consulting fee Consulting; Stiefel Grant/research funds Investigator; Astellas Grant/research funds Investigator

References
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Skin anatomy.
Technique and hand position for dermabrading raised scars.
Dermabrasion of a raised scar.
Technique of dermabrasion for a depressed scar.
A Bell hand engine is pictured.
End pieces, such as a wire brush and a diamond fraise, commonly used for abrading are shown.
Frigiderm is an effective spray refrigerant used in wire brush and diamond fraise dermabrasion.
Freeze defects and rhytides in their relaxed state without stretching or distorting so that they may be sculpted and recontoured.
To hold the hand engine properly, the forefingers grasp the body of the hand engine while the thumb stabilizes the neck.
For full-face procedures, beginning abrading at the dependent areas along the mandible or the chin and working toward the center of the face is best.
Dressing for full-face dermabrasion is shown.
Table 1. Fitzpatrick Skin Classification[18]
TypeSkin ColorCharacteristics
IVery whiteAlways burns, never tans
IIWhiteUsually burns, tans with difficulty
IIIWhite or light brownMildly burns, average ability to tan
IVBrownRarely burns, tans easily
VDark brownVery rarely burns, tans very easily
VIBlackNever burns, darkly pigmented
Table 2. Glogau Scale of Facial Rhytides Formation and Photoaging
Skin TypeAge (y)Clinical Findings
I (mild)20-30Early photoaging, fine wrinkling
II (moderate)30-40Early to moderate photoaging, present with motion, no keratoses
III (advanced)50 and overAdvanced photoaging, wrinkles with rest, visible keratoses, noticeable discolorations
IV (severe)60 and overSevere photoaging, wrinkles throughout, dynamic and gravitational wrinkling, actinic keratoses
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