Dermabrasion using tumescent anesthesia.
BACKGROUND
Dermabrasion is a very useful and versatile technique. However, it suffers from side effects and difficulties that limit its popularity among operating dermatologic surgeons and the public.


OBJECTIVE
To show that it is possible to eliminate the need for chlorofluorocarbons, improve the standard dermabrasion technique, decrease the healing time, improve its side effect profile, and reduce risks to the operating surgeon.


METHODS
Tumescent fluid containing dilute Xylocaine, bicarbonate, and epinephrine in saline was infiltrated before coarse wire brush dermabrasion. Eutectic mixture of local anesthetic (EMLA) was also used topically. The first 14 patients dermabraded by this method are reported on here. Their healing, progress, side effects, and results are described. A patient questionnaire was completed by 12 of the patients who describe the procedure and results from the patient's viewpoint.


RESULTS
The procedure was found to be effective in producing anesthesia, eliminating the use of freezing the skin, and limiting the necessity for sedatives, narcotics, and other anesthesia. It gives a firm surface to dermabrade against, makes the procedure more rapid and technically easier, and produces less splatter and therefore less risk for the surgeon. The results subjectively and objectively would appear to be at least as good as standard techniques. The healing in this small sample would appear to be faster both to reepithelialization and to reestablishment of normal color. There was only one case of transient hyperpigmentation lasting less than 1 week. Otherwise there were no cases of pigmentary or scarring side effects.


CONCLUSIONS
Tumescent dermabrasion is safe, effective, and has many benefits over traditional methods.
Goodman
G
G
Skin and Cancer Foundation, Victoria, Australia.
D000152:Acne Vulgaris / Q000601:surgery; D000328:Adult; D000772:Anesthesia, Local / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001639:Bicarbonates / Q000008:administration & dosage; D002921:Cicatrix / Q000601:surgery; D003869:Dermabrasion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D010859:Pigmentation Disorders / Q000601:surgery; D011318:Prilocaine / Q000008:administration & dosage; D012307:Risk Factors; D015595:Skin Aging; D013653:Tattooing / Q000009:adverse effects; D014945:Wound Healing
D000779:Anesthetics, Local; D001639:Bicarbonates; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine; D004837:Epinephrine