Dermabrasions

 Definition

1. Dermabrasions consist of the removal of the epidermis and as much of the superficial dermal layer as necessary, with preservation of the epidermal adnexa in sufficient quantity to allow for reepitheliazation with minimal or no scarring.
2. Surgical abrasions, as it often referred to, is performed to smooth irregularities and discolorations on the surface of the skin or revisions of scar tissue, pox marks, or pits of acne.
3. Healing of abraded areas is similar to that of donor areas of split thickness graft, and usually by the fifth day (5-7 days), the epidermis is completely regenerated, showing signs of developing hair follicles and sebaceous glands.

Positioning

• Supine, with arms tucked in at the side.

Instrumentation

• Dermabrader with wire brush and sanding cylinder and cord.
• Basin set
• Local anesthetic with epinephrine
• Marking pen
• A plastic tray or selected instruments should be available.
• A basic pack with head drape and split sheet is usually appropriate for this procedure.

Procedure

1. The skin is stretched by hand and the epidermis is abraded by means of a dermabrader.
2. If the area to be treated is on or near the cheek, the surgeon may wish to pack the patient’s mouth with gauze to stretch the skin taut.
3. The area is irrigated copiously with saline during and after the procedure.
4. The wound may be dressed with a nonadherent gauze dressing or Telfa moistened with saline.
5. A light compression bandage may be applied.

Perioperative Nursing Considerations

1. Do not allow preparation solution to pool in or around the eyes or ears.
2. Table may be turned to facilitate easier access, and slightly flexed for patient comfort.
3. Do not leave loose sponges near the dermabrader, they may caught in the mechanism.
4. Keep distraction in the room in a minimum.