By Thomas J. Zuber MD MPH MBA, E. J. Mayeaux Jr MD

Atlas of basic Care Procedures is a finished, hands-on source at the scientific strategies most typically played in an place of work surroundings. The textual content provides practitioners with step by step directions for appearing greater than 70 methods. greater than seven-hundred photos totally illustrate every one technique. Plus, universal pitfalls are mentioned besides techniques to prevent them while acting sure techniques. every one bankruptcy comprises: ordering info for beneficial fabrics or apparatus, CPT codes, and typical charges for every procedure.

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Zuber TJ, DeWitt DE. The fusiform excision. Am Fam Physician 1994;49:371–376. Zuber TJ. Administration of local anesthesia. AAFP manuals and videotapes of skin surgery techniques. Kansas C ity: American Academy of Family Physicians, 1999. ; Mayeaux, E. J. Title: Atlas of Primary Care Procedures, 1st Edition C opyright ©2004 Lippincott Williams & Wilkins > Table of Contents > Dermatology > 10 - Punch Biopsy of the Skin 10 Punch Biopsy of the Skin Punch biopsy is one of the most widely used dermatologic procedures in primary care medicine.

PROCEDURE Stretch the skin with the nondominant hand before insertion of the needle into the skin. Patients dread having the needle inserted; the discomfort is reduced if the pain sensors in the skin are stretched. (1) Reduce the patient's discomfort by stretching the skin with your nondominant hand before insertion of the needle. PITFALL: Replace the needle used for drawing the anesthetic from the stock bottle with a smaller (30-gauge) needle before injection into the patient. 7 The syringe is held in the dominant hand in the position ready to inject (Figure 2A).

Basics of dermatologic surgery. C hicago: Year Book Medical, 1982. Swanson NA. Atlas of cutaneous surgery. Boston: Little, Brown, 1987:14–15. Usatine RP, Moy RL, Tobinick EL, et al. Skin surgery: a practical guide. St. Louis: Mosby, 1998;55–76. Zalla MJ. Basic cutaneous surgery. Cutis 1994;53:172–186. Zitelli JA. Wound healing by secondary intention: a cosmetic appraisal. J Am Acad Dermatol 1983;9:407–415. Zuber TJ. Dermal electrosurgical shave excision. Am Fam Physician 2002;65:1883–1886, 1889–1890, 1895, 1899–1900.

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