title: The use of hyaluronidase as an adjunct to surgical procedures.
abstract: BACKGROUND
  Although the use of hyaluronidase as an adjunct to anesthesia is frequently described for plastic surgery and ophthalmologic procedures, its use in dermatologic surgery has not been well investigated.
  
  
  OBJECTIVE
  In this report we review the advantages and disadvantages of using hyaluronidase in dermatologic procedures.
  
  
  METHODS
  The effect of adding hyaluronidase to local anesthesia was evaluated in 72 operations performed over a 1-year period.
  
  
  RESULTS
  Although the duration of anesthesia is slightly decreased, the addition of hyaluronidase to local anesthesia offers the benefits of minimizing loss of surface contour and enhanced ease in undermining and dissection through subcutaneous tissue planes. The onset of anesthesia using hyaluronidase is immediate and the area of anesthesia appears increased over anesthesia without hyaluronidase.
  
  
  CONCLUSIONS
  We therefore recommend the adjunct of hyaluronidase to local anesthesia as a useful advancement in surgical technique.
authors.affiliation: Department of Dermatology, University of Colorado Health Sciences Center, Denver.
authors.forename: L E
authors.initials: LE
authors.lastname: Clark
authors.forename: J R
authors.initials: JR
authors.lastname: Mellette
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D062109:Dermatologic Surgical Procedures; D004210:Dissection; D005145:Face / Q000601:surgery; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D015580:Mohs Surgery; D013524:Surgical Flaps; D013997:Time Factors
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D008012:Lidocaine; D006821:Hyaluronoglucosaminidase