Vulvovaginal Surgery Hope Haefner, M.D. University of Michigan Health - PDF document

2/20/2015 Vulvovaginal Surgery Hope Haefner, M.D. University of Michigan Health System February 21, 2015 Vertical Mattress Courtesy Dr. E.J. Mayeaux, Jr. 1

2/20/2015 Halving Principle Courtesy Dr. E.J. Mayeaux, Jr. Courtesy Dr. E.J. Mayeaux, Jr. Dog-ear Revision Burrow’s triangle  Triangle of excess tissue excised  Cut a line at about a 90 to 135 o angle Courtesy Dr. E.J. Mayeaux, Jr. 2

2/20/2015 Dog-ear Revision  Place a corner suture Hockey stick” Courtesy Dr. E.J. Mayeaux, Jr. Corner Suture  Started Opposite side Tip wound edge from tip Dermis  Enter 5 to Fat 8mm from corner00 Entrance Exit Direction of Pull Courtesy Dr. E.J. Mayeaux, Jr. 3

2/20/2015 Corner Suture  Enter the skin only to the level of the dermis  Gently elevate the tip  5mm loop goes through the dermis only of the flap tip Courtesy Dr. E.J. Mayeaux, Jr Courtesy Dr. E.J. Mayeaux Corner Suture  Exit the skin parallel to the entrance point along the line of pull  Tie across Courtesy Dr. E.J. Mayeaux, Jr. 4

2/20/2015 Skene’s Duct Cyst Surgery Skene’s Duct Cyst Surgery Video 5

2/20/2015 Full Thickness Skin Grafts Full Thickness Skin Grafts 6

2/20/2015 4/2 Full Thickness Skin Graft Video 7

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2/20/2015 S plit Thickness S kin Grafts • One major procedure – HSIL, VIN differentiated, Paget’s disease, Cancers • Two major procedures – Hidradenitis suppurativa Paget’s Disease 11

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2/20/2015 Split Thickness Skin Grafts 15

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2/20/2015 Video 4 Months Post Op Grafts 17

2/20/2015 2 Years After Surgery 18

2/20/2015 Summary Hope K. Haefner, MD Merck & Co - Advisory Board newyork.issvd.org Come to the ISSVD World Congress July 26-29, 2015 Come to the ISSVD Postgraduate Course July 30-31, 2015 19