Dismiss Notice
Last chance to give your feedback! Fill out the 2019 SDN Member Survey to let us know what's important to you (and win prizes!)

Dissection skinning technique help

Discussion in 'Medical Students - MD' started by DoctorB, Feb 18, 2007.

  1. DoctorB

    DoctorB Member
    2+ Year Member

    Joined:
    May 21, 2006
    Messages:
    133
    Likes Received:
    0
    Status:
    Pre-Medical
    Hi,

    I am an undergraduate in a cadavor dissection lab. I am having trouble efficiently skining parts of the body. Does anyone know of any websites with detailed and diagramatic explanations of the steps one should do to efficiently skin a limb. I am about to work on the upper limb and need to skin the whole arm/forearm/hand. Any suggestions? I apologize if this is such a basic question but the class is an independent study and we are forced to figure things out on our own.

    THANKS!!!
     
  2. OncoCaP

    2+ Year Member

    Joined:
    Aug 28, 2006
    Messages:
    2,016
    Likes Received:
    1
    MDApps:
    Status:
    Medical Student
    Have you thought about buying or inter-libary-loaning a book on the subject? Something like this maybe: http://www.us.elsevierhealth.com/product.jsp?isbn=9780443069512

    If you don't know how to deal with the skin, aren't you going to have a little trouble after you are done with that part? Seems like you would want good instructions for every aspect of the dissection.
     
  3. Tired Pigeon

    10+ Year Member

    Joined:
    Jan 27, 2007
    Messages:
    940
    Likes Received:
    4
    Status:
    Resident [Any Field]
    The key to removing skin is having a SHARP scalpel blade. The blade goes dull really fast when you're working with skin, so have several replacements ready to go.

    Also, I second the advice on getting a good dissection guide.
     
  4. OP
    OP
    DoctorB

    DoctorB Member
    2+ Year Member

    Joined:
    May 21, 2006
    Messages:
    133
    Likes Received:
    0
    Status:
    Pre-Medical
    Thank you for your response. I realize that skinning is very easy but the way I did it took me a lot more time than it should have. Additionaly, I am having trouble with my first cut. How do I know how deep to go? Is it just a guess? I don't want to cut anything important.
     
  5. OncoCaP

    2+ Year Member

    Joined:
    Aug 28, 2006
    Messages:
    2,016
    Likes Received:
    1
    MDApps:
    Status:
    Medical Student
    Get a dissection guide and follow the instructions as best as you can. You are just going to need to make the cuts and you will make mistakes. It's part of the learning process. You'll get better with practice (and it would be really nice if you had someone who knew what they were doing ... any physician friends who would be willing to "lend you a hand"?).
     
  6. OP
    OP
    DoctorB

    DoctorB Member
    2+ Year Member

    Joined:
    May 21, 2006
    Messages:
    133
    Likes Received:
    0
    Status:
    Pre-Medical
    There are medical students in the laboratory at times to help us. We are given a list of muscles/nerves etc... to find. It is a very interesting class and I am glad I am taking it before medical school next year!
     
  7. OncoCaP

    2+ Year Member

    Joined:
    Aug 28, 2006
    Messages:
    2,016
    Likes Received:
    1
    MDApps:
    Status:
    Medical Student
    So what you are basically saying is that you are in a course with instructors who are there to help. They asked you to figure something out on your own, so you posted a question here because it's too much work even before you have made your first cut?

    My guess is that if you made an effort and showed them you are trying, your instructors would help you. You will learn by doing. Take courage. It's going to work out. You're not going to cut anything important ... and if you do, you'll learn and get better
    ;-).
     
  8. DoctorFunk

    DoctorFunk Get down with the boogie
    7+ Year Member

    Joined:
    May 17, 2004
    Messages:
    2,814
    Likes Received:
    17
    Status:
    Resident [Any Field]
    The key to dissecting skin is to make a nice deep scalpel incision and then dissect from that point using your blunt probe while really pulling on the loose flap of skin. Much, much quicker than dissecting with a scalpel the whole time and it allows you to stay in one plane.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  9. PenguinHead

    5+ Year Member

    Joined:
    Nov 16, 2006
    Messages:
    321
    Likes Received:
    1
    Status:
    Resident [Any Field]
    A sharp scalpel and practice will make you faster.

    Also, don't be squeamish. Just cut it. If you go too deep a few times, oh well. It's better than spending twice as long in lab.

    Someone has probably already told you, but if you get the skin started and cut a finger hole in the flap, you can really put some pressure on it w/o tiring out your grip.
     
  10. cfdavid

    cfdavid Membership Revoked
    Removed 7+ Year Member

    Joined:
    Oct 24, 2004
    Messages:
    3,401
    Likes Received:
    7
    Status:
    Resident [Any Field]
    I hate to say this, but you almost have to just "tear" it off. You can make it an art project, but it'll take you forever. I found that blunt dissection with lots of tension worked best. You can't be shy about it, especially if there's lots of fat. All the skin and fat is pretty much useless, so do what you need to do to get down to the fascia.
     
  11. 45408

    45408 aw buddy
    7+ Year Member

    Joined:
    Jun 14, 2004
    Messages:
    16,976
    Likes Received:
    45
    Status:
    Resident [Any Field]
    Good advice. Just remember: they're dead. You can't hurt them. :p I'd recommend trying to cut the fat off with the skin rather than as separate layers. Personally, I was pretty good with using the scalpel to quickly remove skin, and it was cleaner than just ripping it off. But there were times that just ripping was better. Unfortunately, the skin on the hands does NOT easily pull off. You'll probably do plenty of cutting.

    A friend of mine found an excellent website full of really well-done dissections that should give you a pretty realistic idea of what things will look like as you dissect them. I'll come back and post the link if he can find it for me. Ackland's DVDs are wonderful, but nobody gets to dissect a body for undergrad lab that has only been dead a matter of a few days. His specimens are more like autopsies.
     
  12. Winged Scapula

    Winged Scapula Cougariffic!
    Staff Member Administrator Physician Faculty Lifetime Donor Verified Expert Verified Account 15+ Year Member

    Joined:
    Apr 9, 2000
    Messages:
    39,145
    Likes Received:
    27,736
    Status:
    Attending Physician
    Eh, practice with chicken at home. Get the breasts with skin on it, use a sharp knife to make an incision (you'll get the feel of how deep to go), the use your blunt instrument to dissect under the incision while pulling the skin up and out with your other hand to remove the loose areolar tissue from the sub-cut fat and meat.

    Then do the same with the body at school. Come home and eat chicken...now that its skinless its better for you.
     
  13. OP
    OP
    DoctorB

    DoctorB Member
    2+ Year Member

    Joined:
    May 21, 2006
    Messages:
    133
    Likes Received:
    0
    Status:
    Pre-Medical
    Thanks again for all of your help!!!!!
     
  14. 45408

    45408 aw buddy
    7+ Year Member

    Joined:
    Jun 14, 2004
    Messages:
    16,976
    Likes Received:
    45
    Status:
    Resident [Any Field]
  15. Northerner

    Northerner Coquettish Haberdasher
    10+ Year Member

    Joined:
    Aug 1, 2002
    Messages:
    5,582
    Likes Received:
    13
    Stop being such a ****ing baby! Surgery residencies are now closed to you! They may give you a chance if you can demonstrate proper anesthesia demands and scrub nurse berating.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  16. OP
    OP
    DoctorB

    DoctorB Member
    2+ Year Member

    Joined:
    May 21, 2006
    Messages:
    133
    Likes Received:
    0
    Status:
    Pre-Medical
    I hope you are kidding. You are not understanding the intent of my question. I am not afaid of skinning or dissecting as I have been doing if for the last 2 months. I am having trouble EFFICIENTLY skinning the body without causing damage to vital muscles/nerves... (whether my initial cut is too deep or I end up tearing superficial vessels due to my barbaric way of skinning). My approach in the past has been to cut and tear as best as I could with no real strategy. This was not efficient and I was ruining important things thus I came to you guys for help.
     
  17. psipsina

    psipsina Senior Member
    5+ Year Member

    Joined:
    Jun 24, 2005
    Messages:
    1,812
    Likes Received:
    8
    Status:
    Medical Student
    Make an incision somewhere you aren't looking for any major surface vessels or nerves, so if you go too deep it doesn't matter. Cut a cross and start at one of the corners pulling it back really hard until you see a spiderywebby layer of fascia between what your retracting and whats still attached. Pull the skin away from you so you have a clear view of this fascial layer and cut only the fascia while continuing to pull on the skin away from you. The skin should be easily pulling away as you do this. Hold the scalpel so the dull part is down and the sharp part is against the skin and fascia so you can't cut anything you want by mistake. This will leave you with a layer of fat but if you want to save surface vessels picking thru the fat after removing the skin is really the only way.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  18. slick177

    slick177 Junior Member
    5+ Year Member

    Joined:
    Oct 23, 2005
    Messages:
    28
    Likes Received:
    0
    Status:
    Medical Student
    use the finger whole technique, get a section started than cut a hole for your finger and use it to apply a pulling pressure, then use your scalpel or a probe to cut as you pull.
     
  19. Wertt

    Wertt blinking at brains
    10+ Year Member

    Joined:
    Aug 18, 2005
    Messages:
    192
    Likes Received:
    0
    For skinning limbs, I would make a long incision, then stick in scissors and use the spreading technique - simply open the scissors once they are in the meat of the subcutaneous tissue and you will loosen the skin away quite quickly.

    Our anatomy tutor taught us this and he was on the Montel Williams Show, so it must be awesome.
     
  20. gostudy

    gostudy Black covfefe. No sugar, no cream
    10+ Year Member

    Joined:
    Oct 18, 2005
    Messages:
    8,304
    Likes Received:
    1,507
    Status:
    Attending Physician
    Just quoting for importance. As far as the lower and upper limbs go. Cutting a hole and pulling is your best bet.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  21. Sondra

    Sondra UMC 2010
    10+ Year Member

    Joined:
    Aug 6, 2005
    Messages:
    491
    Likes Received:
    1
    MDApps:
    Status:
    Medical Student

    I agree. I was the "skinner" in my lab group. I found that some blades are better than others. I used several blades per area of the body in order to always have a sharp blade.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  22. Northerner

    Northerner Coquettish Haberdasher
    10+ Year Member

    Joined:
    Aug 1, 2002
    Messages:
    5,582
    Likes Received:
    13
    At your age, even the most novice surgeons could skin a 400 lb woman in 3 minutes flat. Just being realistic.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...

Share This Page