November 2016 • Volume 9, No. 11
From the Editor
November is National Healthy Skin Month, according to the American Academy of Dermatology. Download a copy of their infographic about skin care. While their tips focus on skin protection, the basics of proper hydration and diet are key, too.

Awareness of these principles can help us nurture our own healthy skin. But when you are standing in the OR assisting with a skin cancer surgery, you cannot go back in time and tell your patient to use sunscreen or eat wisely to protect their skin from future damage. Skin care education must start early. What you CAN do is keep yourself healthy—and make sure you are knowledgeable about the skin you are about to suture.

In this issue we look at some of the latest developments in scar revision surgery, bring you news about face transplants, and offer an all-new crossword puzzle so you can test your knowledge about the skin.

Our student in the spotlight is Edgar Somera, RN, CNOR, of Daytona Beach, FL.

Read on for jobs we have gathered for you, NIFA’s favorite links and more.



Julie Lancaster, Editor

Scar Revision Surgery

Scar revision surgery is meant to minimize a scar so that it is more consistent with the surrounding skin tone and texture, according to the American Society of Plastic Surgeons.

The types of scar revision surgeries include (definitions courtesy

Punch graft. Punching out a core of skin containing the scar and filling it with a core of unscarred skin from another area. Punch grafts are especially useful for small, deep scars such as acne scars.

Scar excision. Cutting out the scar and closing the incision. A new scar will form, but it should be less visible than the original scar.

Z or W-plasty. Cutting a series of triangular flaps through the scar in a “Z” or “W” pattern. This can reposition the new scar into natural creases or relieve a contracted scar by cutting across fibrous tissue.

For more information, see Surgical Techniques for Scar Revision by R. S. Batra, MD, MSc, MPH, Skin Care Physicians of Chestnut Hill, and Department of Dermatology, Brigham and Women’s Hospital, Boston, MA. The article addresses scar classification, types and possible causes of scar abnormalities and surgical techniques used.

Earlier this year, a study was done to compare the perceived cosmetic appearance of linear scars vs. zigzag scars by the general public.
Read the abstract or access the full study…
Read an article about the study: “Scar Wars: Perception vs. Reality”…


Face Transplant Surgery

The world’s first partial face transplant was performed in France in 2005, and the first full face transplant was done in Spain in 2010. Since then surgeons in many countries have done ground-breaking work in this field. Here are a few stories:

  • Face Transplant Recipient Looks Unrecognizable Two Years After Life-Changing Surgery Read more…
  • Face Transplant Patient Celebrates Life in Public Read more…
  • Meet The Doctor Behind The Most Extreme Face Transplant Ever Read more…

Perioperative Puzzle: Skin Surgery Crossword

This month’s crossword puzzle is all about skin anatomy and skin surgery.

When you’re ready to check your answers, follow this link to see how well you did. Good luck!


We’ve brought you this app before but it keeps getting better. Touch Surgery is an app for iPhone and iPad that allows students and surgeons to practice surgical procedures before going into the OR. Using cognitive mapping techniques, cutting-edge artificial intelligence and 3D-rendering technology, the company has codified some 50 surgical procedures in separate modules.

Student Spotlight: Edgar Somera

Name:  Edgar Somera

Credentials:  RN, CNOR

Student Status: Current NIFA RNFA student, very close to graduating!

City and State: Moving from NJ to Daytona Beach, FL

Work experience: I’ve worked as an RN in New Jersey for 19 years; 6 years in radiology, 3 years in telemetry, and 10 years in the OR. I am a circulator and scrub. My specialty at the moment is robotics and orthopedics; I also have experience in vascular.

Current job: I’ve just been hired as an RN at Florida Hospital Memorial Medical Center, Daytona Beach, FL.  with a promise of transitioning to an RNFA position when I get certified. (One of the directors who interviewed me was an alum of NIFA!)

Where did you get your RN degree? The University of Medicine and Dentistry of New Jersey-Middlesex County.

Why did you choose perioperative nursing? When I was working in radiology, my manager was also a manager in the OR and they needed a nurse specializing in vascular. With my background in radiology, I got hired in the OR and ended up in perioperative nursing.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
One thing that has stuck in my mind and that I always think about when doing my first assisting clinicals is being told to buy myself really, really good footwear, and to always mind my body mechanics. Being across the surgeon, doing things for the surgeon, I have to contort my body. Dean (NIFA Instructor) told me to mind my body positions: not leaning back, not forward, but neutral. I did buy some really good shoes with insoles, and I make sure I take care of my body. This lets me perform long procedures without any problem. 


Click here for the RNFA job postings we’ve collected for you this month.

NIFA – Office Hours

Monday-Friday 8:00am – 4:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

ACS Surgery News: Specialty News and Commentaries, Videos and More
AORN Legislative Map: What’s Happening in My State (2013 document is most current by AORN as of this eNews)
RNFA Scope of Practice by State
ACS List of Cases that Require an Assistant at Surgery, 2016 (PDF)
AORN Perioperative Bookstore
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.

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