Punch Biopsy

Jacob O. Levitt

doi:10.1007/978-3-319-13347-8_6

Punch Biopsy

Jacob O. Levitt

Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review

Abstract

The functional and cosmetic outcome of a punch biopsy demands proper traction technique and proper trephine positioning. Lack of traction results in trephine slippage. Three-point traction provides maximal stability. Not stabilizing the hand holding the trephine may miss the target or place too much pressure on the trephine, damaging structures below. Use toothed forceps to avoid crushing the specimen. Retrieving a specimen stuck in the punch trephine must preserve the specimen’s integrity. Gelfoam, hemostatic solutions, or pressure dressings are safe alternatives to suturing smaller punch defects. On the scalp, hair must be moved away from the field and anticipated brisk bleeding can be mitigated with sufficient epinephrine or circumferential pressure with a loop-grip instrument. Colored suture or white gauze facilitates visualization in scalp hair.

Original language	English
Title of host publication	Safety in Office-Based Dermatologic Surgery
Publisher	Springer International Publishing
Pages	41-52
Number of pages	12
ISBN (Electronic)	9783319133478
ISBN (Print)	9783319133461
DOIs	https://doi.org/10.1007/978-3-319-13347-8_6
State	Published - 1 Jan 2015

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10.1007/978-3-319-13347-8_6

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abstract = "The functional and cosmetic outcome of a punch biopsy demands proper traction technique and proper trephine positioning. Lack of traction results in trephine slippage. Three-point traction provides maximal stability. Not stabilizing the hand holding the trephine may miss the target or place too much pressure on the trephine, damaging structures below. Use toothed forceps to avoid crushing the specimen. Retrieving a specimen stuck in the punch trephine must preserve the specimen{\textquoteright}s integrity. Gelfoam, hemostatic solutions, or pressure dressings are safe alternatives to suturing smaller punch defects. On the scalp, hair must be moved away from the field and anticipated brisk bleeding can be mitigated with sufficient epinephrine or circumferential pressure with a loop-grip instrument. Colored suture or white gauze facilitates visualization in scalp hair.",

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AB - The functional and cosmetic outcome of a punch biopsy demands proper traction technique and proper trephine positioning. Lack of traction results in trephine slippage. Three-point traction provides maximal stability. Not stabilizing the hand holding the trephine may miss the target or place too much pressure on the trephine, damaging structures below. Use toothed forceps to avoid crushing the specimen. Retrieving a specimen stuck in the punch trephine must preserve the specimen’s integrity. Gelfoam, hemostatic solutions, or pressure dressings are safe alternatives to suturing smaller punch defects. On the scalp, hair must be moved away from the field and anticipated brisk bleeding can be mitigated with sufficient epinephrine or circumferential pressure with a loop-grip instrument. Colored suture or white gauze facilitates visualization in scalp hair.

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Punch Biopsy

Abstract

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