10. Electroshaving of a neoformation from the edge of the eyelid by means of slow pulsed timedsurgical cutting
KEYWORDS: Timed apparatus, timedsurgical Electroshaving, slow pulsed timedsurgical cutting, eyelid surgery-Timedsurgery
Benign neoformations of the edge of the eyelid can easily be removed by means of slow pulsed timedsurgical cutting (Timed, Korpo SRL, Italy). Electroshaving is one of the techniques of Timedsurgery (Technique for Implementation of Misured Electrosurgical date ).
Electroshaving allows optimal visibility, good haemostasis and perfect control of the excision. Moreover, it does not cause burning of the edges. Timedsurgical electroshaving is the technique of choice for the removal of benign neoformations. This method exploits the regenerative capacity of the organism.
Once topical anaesthesia has been carried out, the operator performs local anaesthesia by means of mepivacaine with epinephrine. The needle passes through the anaesthetised conjunctiva. Good anaesthesia is important for haemostasis. The operator has to wait a few minutes for the epinephrine to complete its vasoconstrictive action.
The excision is performed under a magnifying glass. Cutting is carried out with a white electromaniple equipped with a flexible electrode; this conical electrode has a triangular section and the extremity of the tip has a diameter of 0.08 mm (EM10 White). Programme data: Direct Pulsed 0,5/24.5 hundredths of a second – Cut – 38 Watts or 50 Watts.
Excision is now completed. Using the same electrode, the operator obliterates a few capillaries at the bottom of the excision. There are no signs of burning. Cutting is carried out at a speed that cannot be matched by any human hand using any other instrument. The absence of tissue damage enables the organism to begin reconstruction immediately.
The patient will apply a cream until a crust has formed. The result is always perfect.
Before and after Timedsurgical Electroshaving
Capurro S. (2015): Excision of a neoformation from the edge of the eyelid by means of slow-pulsed timedsurgical cutting. CRPUB Medical Video Journal. - Timedsurgery section. http://www.crpub.org
Can slow pulsed timedsurgical cutting be used in other regions?
Electroshaving by means of slow pulsed timedsurgical cutting is the method of choice for the removal of neoformations of the edge of the eyelid. It enables the neoformation to be exercised precisely while maintaining the integrity of the residual tissues. We apply the concept of self-regeneration of the organism that underlies electroshaving to all benign neoformations of the face and body. Surgical excision and suturing would cause evident scarring. Electroshaving does not produce surgical artefacts and, if correctly performed, leaves no visible signs.
Why is it so important to achieve good local anaesthesia?
The haemostatic action of the epinephrine contained in the anaesthetic solution allows the operator to distinguish the plane of cleavage between the neoformation and the healthy tissues.
Does electroshaving presuppose the maintenance of an underlying dermal layer?
Generally speaking, yes. If the neoformation is deep, we sometimes see some small areas of adipose tissue. If the neoformation occupies the entire thickness of the skin, for example in the case of syringomas of the eyelid, the micro-excisions made by means of slow pulsed timedsurgical cutting may be sutured. Let us remember that slow pulsed timedsurgical cutting is able to cut out a 1 mm flap between two lines.
Is medication important?
Yes, medication after electroshaving is important. The edge of the eyelid has a great regenerative capacity and requires the application of a collagenase cream until a crust forms. After electroshaving in other areas of the face and body, a collagenase cream must be applied every day for a week. Before the cream is reapplied, the previously applied cream must be removed by means of a moist cotton wool bud. After a week, an antiseptic powder can be applied. Immediately after applying the powder, the patient must use cotton wool to remove any powder that does not adhere to the site of substance loss.
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