The authors have indicated no significant interest with commercial supporters.D ermatology is now a medical-surgical specialty because of the increasing incidence of skin cancer, and skin diseases that must be treated using surgical means. Dermatologists must develop skills to treat benign and malignant lesions while maintaining function and aesthetics. To achieve this, residency programs have been urged to use novel teaching methods to train dermatologists in cutaneous surgery. Skin models that have traditionally been used for these purposes may be expensive, inaccessible, or impractical. We have developed a surgical model that is inexpensive, easily obtainable, and comparable with human skin for the training of dermatologic surgery. ObjectiveOur purpose was to demonstrate that ethylene vinyl acetate (EVA) is an inexpensive and useful tool for teaching suture techniques in dermatologic surgery. MethodsA dermatologic surgery professor gave a 60-minute theoretical and practical lecture on common surgical stitches (simple interrupted, running, horizontal and vertical mattress, interrupted buried, ''8'', three-and four-point corner, and half-buried horizontal stitches) to 15 dermatology residents. The techniques were thoroughly explained with images on color slides. The residents were then asked to draw the sutures to prove that they had learned the techniques. Afterwards, participants used EVA as a skin model to practice the sutures. The materials used included an 8-Â 6-inch sheet of EVA foam with linear incisions, a 5-0 nylon suture, and a surgical instrument kit that included forceps, needle holder, and cutting scissors. The residents were evaluated on their surgical abilities (handling of the needle holder, forceps, and foam and correct angle of entry of the needle) and the final result of the sutured incision. ResultsThe 15 residents were able to reproduce all of the stitches taught during the lecture. The consistency of the EVA allowed handling with the forceps and penetration by the needle without ripping the sheet. The thickness of the sheet allowed all of the superficial and deep stitches to be performed. Some examples are the superficial cuticular and threepoint corner stitch shown in Figures 1 and 2 and the deeper buried stitch (Figure 3). It also allowed proper eversion of the borders of the simulated linear wound. Students and professor were able to evaluate and rate the students' surgical skills with the final result. The residents showed interest and were
NPWT proved to be safe and effective for treating locally complicated PC as an adjuvant therapy to antibiotic and surgical treatment that decreased the length of hospital stay, and the time for recovery in patients that were slow responders. No ocular complications were observed in any of these patients' follow up ranging from 1 to 4 years.
Erythema multiforme is an acute self-limited cutaneous syndrome associated in more than 50% of the cases with herpes simplex virus infection; but it can also be a consequence of other infectious agents or drugs. We report on a 24 year-old female patient with erythema multiforme secondary to Trichophyton mentagrophytes var. mentagrophytes cutaneous infection acquired from contact with animals in a research laboratory.
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