Excisional surgery involving the vermilion cutaneous junction of the lips presents several problems for the dermatologist. There is concern not only with adequate and thorough eradication of the lip pathology but also with cosmetic and functional restoration of the incised surfaces.
The occasion arises frequently in office practice to treat cysts, nevi, keratoses, and malignancies involving the vermilion surface of the lips. At times, successful eradication by excisional surgery involves removal of portions of the adjacent skin surface.
Because the dermatologist most frequently uses local infiltration anesthesia (often with epinephrine in a vascular area such as the lip), there is obliteration of the vermilion skin border. Under such circumstances during excisional surgery in this area, it is difficult to approximate vermilion surface to vermilion surface while maintaining the cosmetic line of the lip. To help solve this problem the use of guide sutures is suggested.
Various surface skin marking methods
POPKIN GL, BRODIE SJ. Guide Sutures in Excisional Surgery of the Lip. Arch Dermatol. 1961;83(6):1008–1009. doi:10.1001/archderm.1961.01580120120032
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