title: Undermining and Hemostasis.
abstract: BACKGROUND
  Undermining and hemostasis are basic surgical techniques that can have a significant impact on surgical outcomes.
  
  
  OBJECTIVE
  To review the mechanisms and techniques of undermining and hemostasis, with an emphasis on the advantages and limitations of each modality.
  
  
  METHODS
  The PubMed database was searched for articles with the keywords "undermining," "hemostasis," and "electrosurgery."
  
  
  RESULTS
  Whether performing blunt, sharp, or electrosurgical techniques, undermining at the appropriate depth and width is necessary for tissue movement during closures. Both excessive and inadequate undermining can compromise surgical healing. Surgical hemostasis techniques include pressure, suture ligation, topical hemostatic agents, and electrosurgery. Dermatologic surgeons should select the appropriate amount and type of hemostasis for each procedure. Particular care should be taken in performing electrosurgery, given the potential for complications.
  
  
  CONCLUSIONS
  Understanding and optimizing hemostasis and undermining will allow dermatologic surgeons to execute complex closures with minimal complications.
authors.affiliation: Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: David L
authors.initials: DL
authors.lastname: Chen
authors.forename: Ekama O
authors.initials: EO
authors.lastname: Carlson
authors.forename: Ramin
authors.initials: R
authors.lastname: Fathi
authors.forename: Mariah R
authors.initials: MR
authors.lastname: Brown
mesh_terms: D000279:Administration, Cutaneous; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D004598:Electrosurgery / Q000295:instrumentation / Q000379:methods; D019317:Evidence-Based Medicine; D006488:Hemostasis, Surgical / Q000295:instrumentation / Q000379:methods; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008026:Ligation / Q000379:methods; D012871:Skin Diseases / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D006490:Hemostatics