The typical lipoma is an encapsulated subdermal tumor, usually easily removed if necessary. We recently encountered two lipomas that infiltrated muscles of the forearm. Excision of infiltrating lipomas may be complicated by their deep location and potential involvement of vascular and neural structures. This paper should increase dermatologists' awareness of this uncommon variant and facilitate appropriate referral for definitive treatment. We believe that this is the first report in the dermatologic literature of infiltrating lipoma of the upper extremity.
The suspension suture is a tension-reducing stitch that anchors the undersurface of a flap or elliptical wound edge to the underlying periosteum. The technique of placing the stitch is described and the indications for and the benefits derived from its use are discussed.
This article contains a potpurri of surgically related stratagems, alternative techniques, and philosophies. These surgical pearls have been selected for their simplicity, usefulness, and applicability.
This paper describes a simple technique for inserting basting sutures to secure full-thickness skin grafts. By applying the suture under visualized conditions before fully securing the perimeter of the graft, exact placement and knot security of the basting suture can be enhanced, and injury to underlying structures can be avoided. Furthermore, by securing the center of the graft early in the repair, alignment on and conformation to the underlying wound bed is improved.
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