ABSTRACT
This chapter aims to illustrate the intraoperative techniques that improve outcomes for the patient and the surgeon, and to demonstrate that a simpler approach is often most suitable. Once surgical planning and patient preparation have been accomplished, attention must be turned proper surgical and perioperative techniques that aim to optimize wound healing and minimize surgical complications. In the surgical suite, the surgical team can take a number of measures to reduce patient anxiety and to set the stage for a successful outcome. Appropriate instruments, judicious use of electrosurgical hemostasis, and conservative undermining minimize trauma to the skin and subcutaneous tissues. Successful design of surgical repairs requires a thorough understanding of skin tension lines, cosmetic subunits, free margins, tissue biomechanics, and soft tissue anatomy. The location of the surgical defect is the most important factor in determining whether healing by second intent will produce an acceptable aesthetic outcome. Proper planning and surgical technique are critical to the success of cutaneous reconstruction.
