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Chapter: Medical Surgical Nursing: Management of Patients With Dermatologic Problems

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Dermabrasion

Dermabrasion is a form of skin abrasion used to correct acne scarring, aging, and sun-damaged skin.

DERMABRASION

Dermabrasion is a form of skin abrasion used to correct acne scar-ring, aging, and sun-damaged skin. A special instrument (ie, motor-driven wire brush, diamond-impregnated disk, or serrated wheel) is used in the procedure. The epidermis and some superficial der-mis are removed, while enough of the dermis is preserved to allow re-epithelization of the treated areas. Results are best in the face because it is rich in intradermal epithelial elements.

Preparation and Procedure

The primary reason for undergoing dermabrasion is to improve appearance. The surgeon explains to the patient what can be ex-pected from dermabrasion. The patient should also be informed about the nature of the postoperative dressing, what discomfort may be experienced, and how long it will be before the tissues look normal.

 

 

Dermabrasion may be performed in the physician’s office, the operating room, or an outpatient setting. It is performed under local or general anesthesia. During the procedure, some surgeons use refrigerant anesthetics to turn the skin into a numb, solid mass of rigid tissue and to provide a momentarily bloodless sur-gical field. During and after planning, the area is irrigated with copious amounts of saline solution to remove debris and allow the surgeon to see the area. A dressing impregnated with oint-ment is usually applied to the abraded surface.

Management

The nurse instructs the patient about postoperative effects. Edema occurs during the first 48 hours and may cause the eyelids to close. The head of the bed is elevated to hasten fluid drainage. Erythema occurs and can last for weeks or months. After 24 hours, the dressing may be removed if the physician approves. When the serum oozing from the skin begins to gel, the patient applies the prescribed ointment to the face several times each day to prevent hard crusting and to keep the abraded areas soft and flexible. With the physician’s approval, clear-water cleansing or soaking of the face is started to remove crusts from the healing skin.

 

The patient is advised to avoid extreme cold and heat and ex-cessive straining or lifting, which may bruise delicate new cap-illaries. Direct or reflected sunlight should be avoided for 3 to 6 months and a sunscreen used.

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