Undermining

 

Undermining of the wound edges, after removal of the specimen, confers several benefits.

• helps eversion of wound edges

• reduces tension on the wound

• eases closure

Blunt tipped curved scissors are highly satisfactory and are used by cutting and spreading. Hold the wound edge with a skin hook. The amount of undermining varies according to wound site, site, skin laxity. But it must allow closure with minimal tension and with wound eversion. It is important to undermine all the way round including the two ends.

Depth of Undermining- This varies according to site.

Scalp - best in the avascular space below the galea to avoid cutting follicles

Scalp 1Scalp 2

 

 

Face - upper subcutaneous fat

Face 1Face 2

 

 

Torso - any level of fat. Deeper fat for larger excisions

Torso 1

 

Hands - just below dermis

 

Hands 1