- Email: [email protected]
Disposable syringe punching: An aseptic alternative to a comedone extractor
Journal Pre-proof Disposable syringe punching: An aseptic alternative to a comedone extractor Jun Young Kim, M.D PII:
S0190-9622(19)33212-8
DOI:
https://doi.org/10.1016/j.jaad.2019.11.062
Reference:
YMJD 14046
To appear in:
Journal of the American Academy of Dermatology
Received Date: 4 November 2019 Revised Date:
22 November 2019
Accepted Date: 28 November 2019
Please cite this article as: Kim JY, Disposable syringe punching: An aseptic alternative to a comedone extractor, Journal of the American Academy of Dermatology (2020), doi: https://doi.org/10.1016/ j.jaad.2019.11.062. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier on behalf of the American Academy of Dermatology, Inc.
1 1
Clinical Pearl
2
Disposable syringe punching: An aseptic alternative to a comedone
3
extractor
4
Jun Young Kim, M.D.
5
Department of Dermatology, School of Medicine, Kyungpook National University,
6
Kyungpook National University Hospital, Daegu, South Korea
7 8
Correspondence to
9
Jun Young Kim, M.D.
10
Department of Dermatology, Kyungpook National University Hospital,
11
130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea
12
E-mail: [email protected] / Tel: +82-53-420-5838/ Fax number: +82-53-426-0770
13 14
Word count: 250
15
Number of figures/tables: 1/0
16
Number of references: 2
17
Funding source: None
18
Conflicts of interest: None declared
19
IRB Approval: Not necessary
20 21
Keywords: Alternative; Aseptic; Comedone; Extraction; Punching; Syringe
2 22 23
Clinical challenge Generally, dermatologists extract comedones using a clean comedone extractor in their
24
clinic, but comedone extractors are sometimes not available. The comedones can be squeezed
25
out directly using fingernails or extracted using alternatives such as pen punching, safety pins
26
or versatile paper clips; 1, 2 however, these alternatives are hard to find and have
27
contamination issues.
28 29 30
Solution Common aseptic disposable syringes are an option for comedone extraction (Fig 1a). The
31
diameter of the tip of a needleless syringe is approximately 2 mm (Fig 1b). The lesions
32
should be prepped with alcohol (Fig 1c) and light-to-medium pressure should be applied
33
directly on the top of the lesion with the tip of a needleless syringe (Fig 1d) until all of the
34
materials are exposed (Fig 1e, f). If the lesion is a closed comedone, a tiny prick incision
35
using the removed beveled needle can be used to slightly pierce the epidermis. Although the
36
patient may feel minor discomfort, secondary to pressure, complaints of pain can prompt the
37
physician to stop and retry the technique. The advantages of this technique include the
38
availability of syringes in any clinic and the use of a disposable aseptic syringe that allows for
39
the procedure to be conducted aseptically. In addition, there is no need for a scalpel when
40
making prick incisions, no chance for injury because the margin of the syringe tip is blunt,
41
and the 1 cm protruding tip of the syringe can reach concave and deep areas. Importantly, this
42
technique is useful and easy.
43
3 44 45 46
47 48
49
References 1. Ashique KT, Srinivas CR. Pen punching: An innovative technique for comedone extraction from the well of the concha. J Am Acad Dermatol. 2015;73(5):e177.
2. Mukhtar M, Sharma R. Surgical pearl: the safety pin as a better alternative to the versatile paper clip comedo extractor. Int J Dermatol. 2004;43(12):967-8.
4 50
Figure legends
51
Figure 1. A: Three kinds of common disposable syringes, including 10 cc, 2.5 cc, 1 cc. B:
52
The diameters of the tip of needleless syringes are approximately 2 mm, but the 1 cc syringe
53
(left upper one) has the largest diameter. C: During surgery, a patient wanted to remove a
54
black comedone on the left cheek. D: Needleless 10 cc syringe tip was placed on the lesion
55
and light-to-medium pressure was applied. E, F: The comedone was completely extracted
56
aseptically without a comedone extractor.
S0190-9622(19)33212-8
DOI:
https://doi.org/10.1016/j.jaad.2019.11.062
Reference:
YMJD 14046
To appear in:
Journal of the American Academy of Dermatology
Received Date: 4 November 2019 Revised Date:
22 November 2019
Accepted Date: 28 November 2019
Please cite this article as: Kim JY, Disposable syringe punching: An aseptic alternative to a comedone extractor, Journal of the American Academy of Dermatology (2020), doi: https://doi.org/10.1016/ j.jaad.2019.11.062. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier on behalf of the American Academy of Dermatology, Inc.
1 1
Clinical Pearl
2
Disposable syringe punching: An aseptic alternative to a comedone
3
extractor
4
Jun Young Kim, M.D.
5
Department of Dermatology, School of Medicine, Kyungpook National University,
6
Kyungpook National University Hospital, Daegu, South Korea
7 8
Correspondence to
9
Jun Young Kim, M.D.
10
Department of Dermatology, Kyungpook National University Hospital,
11
130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea
12
E-mail: [email protected] / Tel: +82-53-420-5838/ Fax number: +82-53-426-0770
13 14
Word count: 250
15
Number of figures/tables: 1/0
16
Number of references: 2
17
Funding source: None
18
Conflicts of interest: None declared
19
IRB Approval: Not necessary
20 21
Keywords: Alternative; Aseptic; Comedone; Extraction; Punching; Syringe
2 22 23
Clinical challenge Generally, dermatologists extract comedones using a clean comedone extractor in their
24
clinic, but comedone extractors are sometimes not available. The comedones can be squeezed
25
out directly using fingernails or extracted using alternatives such as pen punching, safety pins
26
or versatile paper clips; 1, 2 however, these alternatives are hard to find and have
27
contamination issues.
28 29 30
Solution Common aseptic disposable syringes are an option for comedone extraction (Fig 1a). The
31
diameter of the tip of a needleless syringe is approximately 2 mm (Fig 1b). The lesions
32
should be prepped with alcohol (Fig 1c) and light-to-medium pressure should be applied
33
directly on the top of the lesion with the tip of a needleless syringe (Fig 1d) until all of the
34
materials are exposed (Fig 1e, f). If the lesion is a closed comedone, a tiny prick incision
35
using the removed beveled needle can be used to slightly pierce the epidermis. Although the
36
patient may feel minor discomfort, secondary to pressure, complaints of pain can prompt the
37
physician to stop and retry the technique. The advantages of this technique include the
38
availability of syringes in any clinic and the use of a disposable aseptic syringe that allows for
39
the procedure to be conducted aseptically. In addition, there is no need for a scalpel when
40
making prick incisions, no chance for injury because the margin of the syringe tip is blunt,
41
and the 1 cm protruding tip of the syringe can reach concave and deep areas. Importantly, this
42
technique is useful and easy.
43
3 44 45 46
47 48
49
References 1. Ashique KT, Srinivas CR. Pen punching: An innovative technique for comedone extraction from the well of the concha. J Am Acad Dermatol. 2015;73(5):e177.
2. Mukhtar M, Sharma R. Surgical pearl: the safety pin as a better alternative to the versatile paper clip comedo extractor. Int J Dermatol. 2004;43(12):967-8.
4 50
Figure legends
51
Figure 1. A: Three kinds of common disposable syringes, including 10 cc, 2.5 cc, 1 cc. B:
52
The diameters of the tip of needleless syringes are approximately 2 mm, but the 1 cc syringe
53
(left upper one) has the largest diameter. C: During surgery, a patient wanted to remove a
54
black comedone on the left cheek. D: Needleless 10 cc syringe tip was placed on the lesion
55
and light-to-medium pressure was applied. E, F: The comedone was completely extracted
56
aseptically without a comedone extractor.