D

Debridement	The removal of necrotic or damaged tissue. The aim is to avoid the spread of bacteria and toxic substances from the necrotic tissue and to promote wound-healing of the remaining skin. Link: https://plastsurgeon.com/burns-treatment/procedures/procedure-surgical-debridement/
Decubitus/ pressure ulcer	The terms for wounds arising due to prolonged pressure often on a bone protrusion over os sacrum, tuber ischia at nates, lateral malleolus and heels. This causes ischemic necrosis and ulceration of the tissue involved.  All the layers of the skin can be involved, as well as underlying structures such as muscles and bones.
Delayed primary suturing	Suturing after 4-5 days. At this time, antibiotic therapy is required and the wound is only sutured if there is no clinically ongoing infection.
Dem. (Deminuatur)	This indicates that the prescribed dosage should be lowered.
Dermabrasion	Mechanical abrasion of the upper or middle layer of the skin, after which the skin restores the lost tissue. It is carried out for cosmetic purposes to promote superficial changes in the skin.
Dermatome (anatomical)	The skin of the body can be divided into different areas that are being provided by an individual nerve root. The individual dermatomes are belt-shaped and extend from the head and down the body.  Certain diseases affect a nerve root (eg. a herniated disc or varicella-zoster virus). Hereby, symptoms of pain or sensory disturbance may be located to the precisely defined skin area/dermatome innervated by the nerve root.
Dermatome (instrument)	A surgical instrument used to “harvest” split skin graft to cover skin defects. It is available as manual, air pressure driven or electronic versions. The thickness of the graft can be adjusted.
Dermatophytes	A group of pathological skin fungi, which attacks the skin, nails, and hair.
Dermatoscopy	An examination of the skin using a magnifying glass with built-in light and magnification. It is used in dermatology and plastic surgery especially in relation to an assessment of possible malignancy of the naevi (be aware of malignant melanoma) and sometimes by skin cancers.
Dermis	Also referred to as the leather skin, it lies between the epidermis and subcutis. This layer is particularly important when suturing due to its tensile strength. Histologically, the dermis is divided into two layers; stratum papillary (the superficial layer) and stratum reticulare (the profound layer).
Dexter	Latin term for “right”.
Diabetic wound	A skin defect in a diabetic patient. It usually occurs on the lower legs and feet. The skin is more vulnerable due to peripheral polyneuropathy as well as reduced peripheral blood circulation.
Diastasis recti	A widening of the linea alba fascia with lateralization of the rectus abdominis muscles but without fascial defect. Physical examination is done with the patient lying flat and raising their shoulders while palpating the abdomen from the umbilicus to processus xiphoideus.
DIEP-flap (deep inferior epigastric perforator flap)	A microsurgical dissected skin flap, based on perforation from arteria epigastria inferior with the associated skin and fat from the lower abdomen. It is used for breast reconstruction, where the performant is being anastomosed to a. and v. mammaria interna using a microscope.  Link: https://plastsurgeon.com/microsurgery/diep-flap/
Direct closure of a wound	A designation indicating that a wound defect can be directly sewn together without the need for local skin flaps or grafts.
Discontinue	Indicates stop of medication or other treatments.
Disseminated	The spread of disease. For example, dissemination of malignant melanoma with metastatic melanoma to the lungs or liver.
Dog ears/ donkey ears	Excessive skin that may occur at the end of a scar when suturing. It can be avoided by making an elliptical excision with a length of 2-3 times the width of a circular excision around a tumor.
Donor site	An area where the surgeon harvests skin, muscle or fat for reconstruction at the recipient site. The donor site is often located somewhere with an excess of the desired component.
Drain	A plastic tube used to ensure fluid and blood flow. The thickness of the plastic tube is classified by “French”; the higher the number, the thicker the tube. The classic size is 14 french. It is often used in conjunction with operations where relative post-operative bleeding or serum fluid formation is expected.