Hazards and Danger Zones in Cutaneous Surgery

Cutaneous surgery carries the risk of injury to nerves and other anatomical structures, which can cause significant morbidity. In this article we provide an overview of common pitfalls and 'danger zones' to be aware of during skin procedures, including how to identify and avoid specific key landmarks. General techniques such as positioning, lighting, preoperative marking, and appropriate use of local anesthesia can help to optimize surgical outcomes. Keloid scarring is most common on the neck and upper torso. The head and neck is a common site for skin lesions, but includes numerous danger zones. Nerve plexuses, joints, and flexor surfaces are other high-risk sites. Appropriate preparation and a detailed understanding of relevant surface anatomy are necessary for practitioners to perform safe cutaneous surgery.