Percutaneous injury during dermatologic surgery

Dermatologist and electrologist perspectives on laser procedures by nonphysicians

BACKGROUND

As hair removal technology continues to evolve and new equipment comes to market, conflicts may develop between dermatologists and electrologists regarding the professional control and use of these devices.

METHODS

A total of 1004 Fellows of the American Academy of Dermatology and 719 electrologists from the southern United States were anonymously surveyed about clinical laser procedures (CLPs).

RESULTS

Compared to electrologists, dermatologists were more likely to support clinical laser regulations that placed licensed physicians in control (P =.001) and preferred that a delegating physician be physically present on the premises when CLPs were performed (P =.001). If a laser device was invented for permanent hair removal that was identical to traditional needle/probe electrolysis in every respect except energy type ("laser fiberoptic probe," LFP), electrologists were more likely than dermatologists to support independent use of this device by electrologists (P =.001). A greater percentage of electrologists from Texas, a state without electrolysis licensing, were more likely to support the unlicensed use of the LFP and CLPs than electrologists from states requiring electrolysis licensing.

CONCLUSIONS

These data are consistent with previously published literature and permit a greater understanding of the multiple attitudinal, regulatory, and ethical issues involved when considering delegated and independent CLPs by electrologists.

The surgical tray

This article provides an overview of the most commonly used instruments for excisional surgery. It has also discussed some of the specialty instruments that may be of value. It may serve as a starting point for the outfitting of a dermatologic surgery practice. However, it is no substitute for seeing, touching, and handling the instruments. At many of the larger specialty meetings, the instrument vendors will be displaying their wares. These displays offer an excellent opportunity to evaluate the many instruments. All of these fancy shiny instruments are merely tools to be used as an extension of the surgeon's hand and brain. They should work for the surgeon in a manner that is comfortable and efficient. Only the surgeon can decide what works best.