Journal of Plastic, Reconstructive & Aesthetic Surgery (2009) 62, e495ee496
CORRESPONDENCE AND COMMUNICATION A sports jacket clip: a simple method of securing tie-over dressings The tying and twisting of sutures over traditional tie-over dressings is usually a time-consuming and tedious job requiring some assistance. An extremely simple modification of the traditional tie-over dressing, which incorporates all of the above requirements, is described below. When the graft is applied to a defect, the margins are sutured with silk with one end left long. In this way the graft is securely placed onto the defect and the longer parts of the threads are simultaneously prepared for the tightening of the bolus. Non-adherent petrolatum gauze and petrolatum-rivanoll soaked cotton is then used as a bolus over it. All the long silk threads are gathered between the thumb and index finger, and then twisted using a Pean
Figure 2 Final appearance of bolus tie-over dressing secured by the clip.
instrument over the bolus dressing until the even compression of the complete dressing is produced. To avoid the threads tangling after twisting, ointment taken from the paper of the used non-adherent petrolatum gauze is applied to other parts of thread ends keeping them taut and adherent, making a tail. The threads are then temporarily secured with non-tooth forceps which are lightly pressed against the bolus (Figure 1). The tail is then easily pulled through the tightened lever of the jacket clip, which is hesledded down. When sufficient and even pressure on the bolus dressing is achieved, the lever is released and the clip is applied (Figure 2). If early inspection of grafted skin is needed, the removal and reapplication of the tie-over and clip are made easy by simply pressing the lever on the clip without removing the secured sutures.
Figure 1 All threads are twisted by the instrument by means of a self-locking system until even compression of the complete dressing is produced; the twisted and ointmented thread ends are secured with a non-tooth forceps, which are lightly pressed against the bolus, making a tail.
Acknowledgements This communication has received no funding or support of any kind.
1748-6815/$ - see front matter ª 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2008.08.041
Conflict of interest statement We declare that we as authors of the text are not in any kind of conflict of interest regarding the submitted text.
Ethics All the procedures described were carried out to a high ethical standard. Formal and documented ethical approval
Correspondence and communication from our Clinical Hospital Research Ethics Committee was obtained. Srecko Budi Jerko Rados Zdenko Stanec Plastic, Aesthetic and Reconstructive Surgery, Clinical Hospital Dubrava, Avenija Gojka Suska 6, 10000 Zagreb, Croatia E-mail address: [email protected]