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The ‘Gallipot’ splash guard: a simple and effective safety measure for wound irrigation
Correspondence and communications
1555
The ‘Gallipot’ splash guard: a simple and effective safety measure for wound irrigation High-pressure irrigation is an effective means of decontaminating wounds.1 The widely used technique uses a syringe (20 or 50 ml) and a ‘broken-off’ hypodermic needle hub to deliver a high-pressure jet. This can result in a splash-back of irrigants and body fluids onto the patient, the surrounding area, and more seriously, onto the face and clothing of those performing the procedure, thus carrying the risk of transmitting blood-borne viruses and contaminating the clinical area.2 Various safety techniques have been described.3 However, here we describe a technique that minimises splash-back using readily available materials such as: a 50 ml disposable ‘gallipot’; a 10, 20 or 50 ml Luer-lock syringe; a 19- or a 21-gauge hypodermic needle and a dressing pack. A needle is pierced at the base of the inverted gallipot (Figure 1), and is then broken 0.5e1 cm from the hub (Figure 2). This technique prevents deformation of the
Figure 1 gallipot.
A needle is pierced at the base of the inverted
Figure 3 This technique prevents deformation of the needle lumen and the risk of needle-stick injury.
Figure 4 The needle is then passed through the hole at the base of the gallipot and the syringe is attached to the hub. Irrigation is then performed under direct vision through the transparent base of the gallipot with little risk of splash-back to the face, clothing or the surroundings.
needle lumen (Figure 3) and the risk of needle-stick injury. The needle is then passed through the hole at the base of the gallipot and the syringe is attached to the hub. Irrigation is then performed under direct vision through the transparent base of the gallipot with little risk of splash-back to the face, clothing or the surroundings (Figure 4).
References
Figure 2 The needle is broken 0.5e1 cm from the hub using the back-end of a pair of sturdy forceps (opposite end to jaws) acts as a noncrushing fulcrum point against which to bend the needle to snap it to the desired length.
1. Anglen J. ‘‘Wound irrigation in musculoskeletal injury’’. J Am Acad Orthop Surg 2001;9:219e26. 2. Greene DL, Akelman E. ‘‘A technique for reducing splash exposure during pulsatile lavage’’. J Orthop Trauma 2004 Jan; 18:41e2. 3. Pigman EC, Karch DB, Scott JL. ‘‘Spatter during jet irrigation cleansing of a wound model: a comparison of three inexpensive devices’’. Ann Emerg Med 1993 Oct;22:1563e7.
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Correspondence and communications E.H.C. Wright C.M. Estela Frenchay Hospital, Bristol, UK E-mail address: [email protected]
ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2008.03.056
A simple technique for approximating wound edges during instrument tying under tension Approximating wound edges under tension during instrument tying can sometimes be difficult. We describe
Figure 3 The long thread is held between the thumb and middle finger of the free hand. The index finger still hooks the second throw. The needle holder holding the short end of the suture is pushed away from the wound (black arrow) to tighten the first loop, therefore pulling the wound edges together (white arrows).
Figure 1 Having done the first double throw, the second throw is prepared. No attempt is made to tighten the first throw. Figure 4 Traction is maintained on the needle holder to avoid loosening of the first throw. The index finger is unhooked from the second throw and the long end of the suture is pulled tightening the second throw, locking the first throw.
a simple, quick technique that the operator can utilize without the help of an assistant. We describe a technique that we find very useful to approximate wound edges under tension during instrument tying. It is simple, quick and the operator can perform it without the help of an assistant. It is illustrated in the Figures 1e4 on a pig skin model.
Figure 2 Instead of tightening the second throw on the first, the index finger of the free hand hooks the loop of the second throw, preventing it from tightening.
L.A. Galea Department of Plastic and Reconstructive Surgery, St Vincent’s Hospital, NSW, Australia E-mail address: [email protected]
1555
The ‘Gallipot’ splash guard: a simple and effective safety measure for wound irrigation High-pressure irrigation is an effective means of decontaminating wounds.1 The widely used technique uses a syringe (20 or 50 ml) and a ‘broken-off’ hypodermic needle hub to deliver a high-pressure jet. This can result in a splash-back of irrigants and body fluids onto the patient, the surrounding area, and more seriously, onto the face and clothing of those performing the procedure, thus carrying the risk of transmitting blood-borne viruses and contaminating the clinical area.2 Various safety techniques have been described.3 However, here we describe a technique that minimises splash-back using readily available materials such as: a 50 ml disposable ‘gallipot’; a 10, 20 or 50 ml Luer-lock syringe; a 19- or a 21-gauge hypodermic needle and a dressing pack. A needle is pierced at the base of the inverted gallipot (Figure 1), and is then broken 0.5e1 cm from the hub (Figure 2). This technique prevents deformation of the
Figure 1 gallipot.
A needle is pierced at the base of the inverted
Figure 3 This technique prevents deformation of the needle lumen and the risk of needle-stick injury.
Figure 4 The needle is then passed through the hole at the base of the gallipot and the syringe is attached to the hub. Irrigation is then performed under direct vision through the transparent base of the gallipot with little risk of splash-back to the face, clothing or the surroundings.
needle lumen (Figure 3) and the risk of needle-stick injury. The needle is then passed through the hole at the base of the gallipot and the syringe is attached to the hub. Irrigation is then performed under direct vision through the transparent base of the gallipot with little risk of splash-back to the face, clothing or the surroundings (Figure 4).
References
Figure 2 The needle is broken 0.5e1 cm from the hub using the back-end of a pair of sturdy forceps (opposite end to jaws) acts as a noncrushing fulcrum point against which to bend the needle to snap it to the desired length.
1. Anglen J. ‘‘Wound irrigation in musculoskeletal injury’’. J Am Acad Orthop Surg 2001;9:219e26. 2. Greene DL, Akelman E. ‘‘A technique for reducing splash exposure during pulsatile lavage’’. J Orthop Trauma 2004 Jan; 18:41e2. 3. Pigman EC, Karch DB, Scott JL. ‘‘Spatter during jet irrigation cleansing of a wound model: a comparison of three inexpensive devices’’. Ann Emerg Med 1993 Oct;22:1563e7.
1556
Correspondence and communications E.H.C. Wright C.M. Estela Frenchay Hospital, Bristol, UK E-mail address: [email protected]
ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2008.03.056
A simple technique for approximating wound edges during instrument tying under tension Approximating wound edges under tension during instrument tying can sometimes be difficult. We describe
Figure 3 The long thread is held between the thumb and middle finger of the free hand. The index finger still hooks the second throw. The needle holder holding the short end of the suture is pushed away from the wound (black arrow) to tighten the first loop, therefore pulling the wound edges together (white arrows).
Figure 1 Having done the first double throw, the second throw is prepared. No attempt is made to tighten the first throw. Figure 4 Traction is maintained on the needle holder to avoid loosening of the first throw. The index finger is unhooked from the second throw and the long end of the suture is pulled tightening the second throw, locking the first throw.
a simple, quick technique that the operator can utilize without the help of an assistant. We describe a technique that we find very useful to approximate wound edges under tension during instrument tying. It is simple, quick and the operator can perform it without the help of an assistant. It is illustrated in the Figures 1e4 on a pig skin model.
Figure 2 Instead of tightening the second throw on the first, the index finger of the free hand hooks the loop of the second throw, preventing it from tightening.
L.A. Galea Department of Plastic and Reconstructive Surgery, St Vincent’s Hospital, NSW, Australia E-mail address: [email protected]