Manual techniques?

[Dr. Trafalgar Law]

Hey all, MS2 interested in dermatology here. Anyone want to share some good techniques I should be practicing and getting comfortable with? For both general and procedural dermatology. I didn't grow up working with my hands a lot so I'd like to practice however I can early-on.

Thanks!

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[asmallchild]

Medical students very rarely get to be hands-on during their dermatology rotation. When you get to the rotation, I would focus more on the best way to assist your resident without getting in the way.

If the rotation does have a county hospital or a VA rotation where both residents and students get to be more hands-on, knowing your anatomy is probably first and foremost. Then being able to suture the epidermis neatly (more important) and efficiently (less important) is a bonus. This is something you may get some exposure to on your general surgery rotation (again, program/school-dependent)

 

[Dral]

If you REALLY are so inclined you could pick up a biopsy/suturing sim kit. But in general, not at all necessary...plus you run the risk of starting bad habits.

Thus I probably would not use said kit unless you can have someone first show you general proper techniques.

 

[drpatricktran]

suturing you can learn in general with a suture kit and practice at home, which would be helpful for surgery rotations and derm if they have you sew a wound or a punch biopsy. I would recommend just practicing sewing stuff with needle driver and practice needles for manual dexterity once someone teaches you.

derm specific techniques require punch bx kit and shave blade (derma blade or personna blade) -- you can practice shaving bits of apple or orange skin. like put a dot on with a sharpie and cut it out shave style. if you find a willing person just bring a fruit, ask for a shave to have, and draw a dot on the orange peel or apple and ask them to show you how to shave it off. it's a back and forth pseudo-sawing motion.

 

[Earl Simmons]

get a suture kit and check out YouTube videos for:
-basic videos on how to hold needle driver and forceps
then can look up these techniques:
-simple interrupted
-running suture
-how to throw deeps
try and work on a couple of things too:
-repetition and comfort with transitioning from driving the needle through and re-loading
-comfort with knowing where your ends of suture are any tying using the needle driver

for biopsies:
-can see if you can snag a derma blade from derm clinic from a resident and try and do "shave biopsies" on orange peels
-can see if you can snag a punch biopsy from resident and practice doing that + throwing in a suture to close it on some other surface (can't think of something off the top of my head)