Preface
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2003, several decades of dermatologic surgery evolution
was recognized with the designation of fellowships in procedural
dermatology. The editors have encouraged the contributing
authors to capture the art and practice of dermatologic
surgery at the beginning of this century. We use the available
technology to present the core curriculum to the learner
in a way that promotes those who read the text, view the
demonstrations of techniques on the CD and the website,
and use the hand- held personal digital assistant to further
our understanding of the field in the next decade. The textbook,
Surgery of the Skin: Procedural dermatology, is
organized into four sections: basic concepts, basic surgical
procedures, aesthetic surgical procedures, and special procedures.
This format allows the novice to learn sequentially as the
book unfolds. Those who have mastered some aspects can move
from highly specialized procedures toward the beginning
of the book to refresh their knowledge of basic surgical
procedures and concepts. The chapters are organized with
consistent heading levels throughout the book, which makes
thumbing ahead or back an easy task.
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| Reading
can take the learner just so far, but then a point is reached
where hands on training is the best way to learn. We learn
by watching the movement of the hands of those performing
surgery as well as reading the writing of those same hands.
The educational methods used in this text allow the reader
to watch the hands of those performing the procedures. The
operative sequences are taken from the “surgeon’s
view” of the operative field. Eventually, the learner
simply has to take the plunge and perform the surgery. When
the mentor is in the surgical room during performance of the
procedure, the experience of the senior physician naturally
serves to troubleshoot the novice’s first attempt at
performing a new procedure. Experience is the best teacher
but also the toughest teacher. The experienced teacher allows
the student to make small mistakes in order to learn judgment
and technique and buffers the patient from large errors from
which there is no recovery. At certain points in a procedure,
the teacher may need to take over the more difficult or delicate
portions of the procedure because only the experienced hands
can achieve the result needed. Also, there is a need for the
teacher to “feel the tissue” to evoke their memory
and experience. Some teachers have learned to verbalize their
tactile skills and teach by both demonstrating and describing
what they are doing at the surgical table. Others have learned
how to commit those experiences to writing. The editors present
the work of these highly skilled teachers to you in their
writing and by having you watching them. The future of our
specialty rests within these physicians, who represent the
art and form of dermatologic surgery. Each author is a treasure
of surgical experience learned from the preceding generation
of dedicated teachers, developed over the years as each individual
daily practices the art of dermatologic surgery, and devotedly
teaches their students |
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| As
we apply the knowledge gained from ongoing basic research
to solve clinical problems, we will continue to improve
the overall quality of patient care. Dermatologists have
a tradition of outpatient ambulatory surgery and have expanded
the scope of procedures performed in this setting. Historically,
dermatology and especially dermatologic surgeons have generously
shared their knowledge with other dermatologists and with
physicians from other disciplines. This cooperative learning
is integral to the successful evolution of dermatologic
surgery. The editors wish the website version of this textbook
to provide an international forum for interactive learning
and discussion. This discourse, which represents the joining
of hands in cyberspace, will enhance the evolution of the
field.
The hands of the surgeon are the meeting place of mind,
matter and spirit. Surgeons’ hands become a metaphor
for their creative manual and intellectual skills as well
as their knowledge and memory. The sense of touch and motion
of the hands are necessary to inscribe and recall ordered
sequences in performing procedures. Our hands are our messengers
to the world of surgery and to our patients. We hold the
book in our hands. Physicians’ hands are unique
because our hands perform procedural dermatology, comfort
patients by laying on our hands, and our guiding hands comfort
the family. As we care for others with our hands, we demonstrate
that we are the handiwork of the creator. May this textbook
and its components, the work of our hands, be inspirational
to you.
“
… the hand is the instrument of instruments.”
Aristotle, De Anima, 3.8
June K. Robinson, MD
C. William Hanke, MD, MPH
Roberta D. Sengelmann, MD
Daniel M. Siegel, MD
2004 |
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