DERMATOLOGIC NURSING

CONTENTS

Preface ixHeather Jones

Preoperative Assessment of the Surgical Patient 361Leslie M. Plauntz

Nurses play an important role in the preassessment of surgicalpatients. With the rise in free-standing surgical clinics and the moveof many surgical procedures to office-based surgical clinics, qualitypatient care could be compromised. Preassessment of surgicalpatients in office-based and hospital clinics ensures quality patientcare from the moment patients enter the office to when they aredischarged from care. The process of preoperative evaluation isessential in assessing the medical condition of patients, evaluatingtheir overall health status, determining risk factors, and educatingthem. Surgical preassessment benefits patients, physicians, andnurses by not only improving surgical outcomes and patientsatisfaction but also ensuring patient safety. Nurses employed inoffice-based surgical suites require specialized knowledge andclinical skills to offer continued, well-informed care to their patients.

The Role of Sentinel Node Biopsy in Patients with CutaneousMelanoma 379Lakshi M. Aldredge

The role of sentinel lymph node biopsy (SLNB) as a prognosticindicator in melanoma patients has been controversial in the fieldsof surgical oncology and dermatology for decades. This minimallyinvasive surgical technique was introduced in 1990 for diagnosingmelanoma lymphatic metastases and has been deemed the stand-ard of surgical care of cutaneous malignant melanoma by theWorld Health Organization and the Sunbelt Melanoma ClinicalTrial. Its usefulness as a prognostic indicator of metastases led toexpanded applications for breast, colon, gastric, esophageal, headand neck, thyroid, and lung cancers. This article first provides anoverview of cutaneous melanoma and staging methods and

VOLUME 42 Æ NUMBER 3 Æ SEPTEMBER 2007 v

treatment modalities. A brief study of the lymphatic system andthe SLNB procedure are reviewed, followed by a discussion of itsusefulness in patients who have melanoma, including risks andbenefits. This article also discusses nursing considerations forpatients undergoing the procedure, and patient education tips.Lastly, future indications for SLNB and new prognostic indicatorsfor melanoma are discussed.

Nurse-Administered Laser in Dermatology 393Heather Jones

Nurses have become an essential part of patient care in lasertherapy. In dermatology, the potential for helping patients achieveexcellent results for individual skin needs is exponential whencombined with appropriate technology, evidence-based care, and acompetent, conscientious nurse. This article explains how a laserfunctions, outlines the use of lasers in treating particulardermatologic conditions, provides guidelines for posttreatmentcare, and discusses the nurse’s role in providing laser treatment.

Atopic Dermatitis 407Susan Tofte

Atopic dermatitis (AD) is a chronic inflammatory skin diseasecharacterized by intense pruritus and frequent relapsing courses. Itoccurs mostly in patients who have a personal or family history ofother atopic conditions, such as asthma or allergic rhinitis. Theprevalence of AD is high, particularly in children, with rapidlyincreasing numbers in the past few decades. The chronicity of thisdisease, along with its relapsing nature, presents treatment andmanagement challenges for clinicians and frustration for patientsand their families.

Cutaneous T-Cell Lymphoma: Overview and NursingPerspectives 421Sue A. McCann

Cutaneous T-cell lymphoma (CTCL) is an uncommon and complexmalignancy of the immune system with a wide range of clinicalpresentations primarily involving the skin. An extensive menu ofskin-directed and/or systemic treatment options exists. Bestpractices in management involve multidisciplinary collaboration.Nursing care for patients who have CTCL is a critical component inthe successful management of the disease and requires specialattention to the patient’s physical, emotional, and spiritual needs.

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Nurses can make a significant impact by being accessible, offeringemotional support, demonstrating advocacy, and providingongoing education for the patient and family.

Using Angiogenesis in Chronic Wound Care with Becaplerminand Oxidized Regenerated Cellulose/Collagen 457Clair Hollister and Vincent W. Li

For most of the last century, chronic wound care was a practice ofpassive techniques, designed to prevent the progression of thewound. In the last decade, however, advanced techniques havefocused on improving the wound at the molecular level toaccelerate wound healing. Successful modalities include tissue-engineered products, hyperbaric oxygen, negative pressure ther-apy, electrical stimulation, and recombinant growth factors. Thisshift in the treatment of wound care saw the development of arecombinant human platelet-derived growth factor, becaplermin,which stimulates granulation and increases the incidence ofcomplete wound closure. Another product is oxidized regeneratedcellulose/collagen, which protects growth factors and granulationtissue by inhibiting wound proteases. Used together, an optimalenvironment for wound healing can be created.

Psoriasis: Hope for the Future 467Mary Sullivan-Whalen and Patricia Gilleaudeau

This article provides a history and statistics of psoriasis. Adescription of the disease follows, including a clinical presentationand pathogenesis and a description of a person with the disease.Therapeutic options are presented, along with the advantages anddisadvantages of each. The last section discusses how to decidewhat treatment should be undertaken.

Aging Skin: Causes, Treatments, and Prevention 485Paula E. Bermann

Intrinsic and extrinsic aging of the skin follow different pathways,but the end result is similar. Treatment options include cosmeceut-icals, laser rejuvenation, chemical peels, and microdermabrasion.Preventing the effects of extrinsic aging involves using sun-screen—the right product, used in the right amount, at the righttime, in the right places.

Index 501

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