Cosmetology & Oro Facial Surgery
Open Access

This method of study is original and we have been doing it for several years in different schools and courses related to the surgical practice to obtain better tissue management, doing different exercises described in other workshops, thus expanding the field of practice with pig skin.

Here we propose a method to carry out the Skin closure workshop using a 20×20 cm square of pig skin, to have a wider area for the soft tissue exercises that were carried out on pig's legs.

Following are the equipment needed for the procedure:

• Adult pre-folded diaper (Figure 1)

Figure 1: Pre-folded diaper used for drying of the Pig skin.

• Pig skin (A 20×20 cm square)

• Suture equipment including scalpel handle, scalpel blade, dissection forceps (Adson with teeth), needle holder, scissors, fine leather hooks, ruler, compass, sutures, and gentian violet (for marking)

For this procedure clean Pig skin is used. The skin may include some subcutaneous adipose tissue, some meat which should be completely clean. The Pig skin is previously shaved so that it is perfectly clean of hair and washed perfectly well. Salt is applied for preservation, so it won’t get rancid or spoil (Figure 2). Pig skin has a subcutaneous cellular tissue and the plane between the dermis and the subcutaneous tissue is quite free, thus facilitating the control of the depth of the detachment plane. The desired detachment plane lies between the dermis and the subcutaneous cellular tissue (Figure 3).

Figure 2: Perfectly shaved and cleaned Pig skin.

Figure 3: Pig skin marked with gentian violet.

Exercises for soft tissue management can be performed easily since the material is larger, malleable and resembles human skin (Figures 4 and 5).

Figure 4: Exercises done for soft tissue management.

Figure 5: Exercises done for soft tissue management.

The exercises performed in a workshop includes subcuticular running suture, horizontal and vertical mattress sutures, simple interrupted suture, simple running suture, “Z” plasty and half buried suture (Figure 6).

Figure 6: Exercises done for soft tissue management.

When we do this method of study, students improved their surgical skills in the management of tissue, the types of injury, differentiate the use of points of suture and the material to be used, as well as the techniques of knotting, and getting to know its advantages and disadvantages.

It takes time and patience for their individual understanding, critical thinking, decision-making and clinical judgment.

As result of the above, great care must be taken and no greater skill is required when taking off human skin [1-5].

This model will be of great help for future students in face wounds and scars handling courses, which can be students, interns, residents, general practitioners and relatives, since the responsibility of handling these problems is not reserved to anyone in particular, being the doctor the one responsible for knowing how to handle these problems adequately since achieving the best result depends on it (Figure 7) [6-9].

Figure 7: A soft tissue practice workshop to students for improving their surgical skills.

This reference is specially addressed to any doctor who receives a patient with wounds or scars on his/her face, so that he/she acquires sufficient knowledge to solve the problem immediately as well as in the best way. Although is not a simple task, if you persevere, it can be achieved.