- Email: [email protected]
The story of ‘the wiggly worm’
580
Short reports and correspondence
Transmission of hepatitis C by blood splash into conjunctiva in a nurse. AJIC 2003;31(8):502–4. 2. Pietrabissa A, Merigliano S, Montorsi M, Poggioli G, Stella M, Borzomati D, et al. Reducing the occupational risk of infections for the surgeon: multicentric national survey on more that 15,000 surgical procedures. World J Surg 1997; 21(6):573–8. 3. Prior AJ, Montgomery PQ, Srinivasan V. Eye protection in ear, nose and throat surgery. J Laryngol Otol 1993; 107(7):618–9.
R.L. Pollard P. Banwell P. Critchley Department of Plastic Surgery, South Manchester Hospitals—Manchester, UK Radcliffe Infirmary—Oxford, UK E-mail address: [email protected]
q 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2004.12.021
The story of ‘the wiggly worm’ Sir, Post-operative mobilisation of the paediatric patient following hand surgery is a difficult and challenging task. Distraction therapy is a well recognised paediatric technique used to ameliorate pain. Personalisation of body parts is also often used and encourages movement by the patient and facilitates a degree of monitoring by the surgeon. We believe, we have a technique encompassing both these principles which, warrants popularisation. Child hand surgery is a challenging field from both an anatomical and rehabilitational point of view. Ensuring post-operative mobilisation of a traumatised digit, especially of pre-school age is often difficult and associated with pain and discomfort. We use a simple and effective method to facilitate movement. This early mobilisation helps to prevent adhesion, reduce swelling, minimise pain and improve function. Distraction therapy is a well established ‘non-pharmacological method to reduce anxiety and pain by concentrating on something else other than the procedure’.1 Personification of body parts is one technique often used in association with the pre-school child’s love of puppets. By drawing a caricature on the tip of
Figure 1
Personification of an injured middle right.
the subject finger, one effectively creates a finger-puppet, which the child is able to mobilise during play (Fig. 1). It also allows the doctor to relate to the child on a paediatric level by asking the child to ‘wiggle the worm’ which is no longer a source of pain, but rather a character over which they have control and which assists post-operative monitoring of the digit. It is both simple and economical and has a ‘major part to play in the management of pain in children’.2 We have used this method with great success to the delight of patient, parent and hospital staff.
References 1. National Association of Hospital Play Staff—Guidelines for Professional Practice www.nahps.org.uk. 2. Jackson IJB. The management of pain following day surgery. Br J Anaesth CEPD Rev 2001;1(2):48–51.
R.J.W. Knight J. Haeney R. Hall S.J. Southern Department of Plastic and Reconstructive Surgery, Pinderfields General Hospital, Wakefield, UK E-mail address: [email protected]
q 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2004.12.023
Short reports and correspondence
Transmission of hepatitis C by blood splash into conjunctiva in a nurse. AJIC 2003;31(8):502–4. 2. Pietrabissa A, Merigliano S, Montorsi M, Poggioli G, Stella M, Borzomati D, et al. Reducing the occupational risk of infections for the surgeon: multicentric national survey on more that 15,000 surgical procedures. World J Surg 1997; 21(6):573–8. 3. Prior AJ, Montgomery PQ, Srinivasan V. Eye protection in ear, nose and throat surgery. J Laryngol Otol 1993; 107(7):618–9.
R.L. Pollard P. Banwell P. Critchley Department of Plastic Surgery, South Manchester Hospitals—Manchester, UK Radcliffe Infirmary—Oxford, UK E-mail address: [email protected]
q 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2004.12.021
The story of ‘the wiggly worm’ Sir, Post-operative mobilisation of the paediatric patient following hand surgery is a difficult and challenging task. Distraction therapy is a well recognised paediatric technique used to ameliorate pain. Personalisation of body parts is also often used and encourages movement by the patient and facilitates a degree of monitoring by the surgeon. We believe, we have a technique encompassing both these principles which, warrants popularisation. Child hand surgery is a challenging field from both an anatomical and rehabilitational point of view. Ensuring post-operative mobilisation of a traumatised digit, especially of pre-school age is often difficult and associated with pain and discomfort. We use a simple and effective method to facilitate movement. This early mobilisation helps to prevent adhesion, reduce swelling, minimise pain and improve function. Distraction therapy is a well established ‘non-pharmacological method to reduce anxiety and pain by concentrating on something else other than the procedure’.1 Personification of body parts is one technique often used in association with the pre-school child’s love of puppets. By drawing a caricature on the tip of
Figure 1
Personification of an injured middle right.
the subject finger, one effectively creates a finger-puppet, which the child is able to mobilise during play (Fig. 1). It also allows the doctor to relate to the child on a paediatric level by asking the child to ‘wiggle the worm’ which is no longer a source of pain, but rather a character over which they have control and which assists post-operative monitoring of the digit. It is both simple and economical and has a ‘major part to play in the management of pain in children’.2 We have used this method with great success to the delight of patient, parent and hospital staff.
References 1. National Association of Hospital Play Staff—Guidelines for Professional Practice www.nahps.org.uk. 2. Jackson IJB. The management of pain following day surgery. Br J Anaesth CEPD Rev 2001;1(2):48–51.
R.J.W. Knight J. Haeney R. Hall S.J. Southern Department of Plastic and Reconstructive Surgery, Pinderfields General Hospital, Wakefield, UK E-mail address: [email protected]
q 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2004.12.023