TECHNICAL SECTION
The Wessex wrap circumcision dressing KE Chan, ECP Chedgy, K Turner Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, UK CORRESPONDENCE TO Kevin Turner, E: [email protected]
None of the authors have any financial interests in the products described in this technical tip. Circumcision dressings are challenging. Techniques described include the use of adjuncts (eg a condom) to facilitate wound dressing.1 We describe a dressing that is simple to apply, cost
Figure 3 A strip of Micropore™ tape is drawn by an unscrubbed member of the theatre team and handed to the operating surgeon. This is wrapped around the ends of the sterile gauze and trimmed to leave a handle for ease of urination.
effective and utilises readily available materials: sterile gauze, paraffin gauze (Jelonet®; Smith & Nephew, Hull, UK) and Micropore™ tape (3M, Bracknell, UK). This dressing also has the benefit of achieving safe tamponade of the wound as well as allowing easy manoeuvring of the penis for voiding. The technique is shown in Figures 1–3.
Figure 1 After completion of the circumcision, the paraffin gauze is folded diagonally into a strip with one of the corners forming a triangle in the middle, which is applied to the circumcised penis. The tails of the gauze are wrapped around the suture line.
Reference 1.
Molokwu CN, Peracha AM. Securing the dressing after circumcision in adults. Ann R Coll Surg Engl 2014; 96: 170.
Femoral access for endovascular aneurysm repair in obese patients A Thapar, W Partridge, J Refson Princess Alexandra Hospital NHS Trust, UK CORRESPONDENCE TO Ankur Thapar, E: [email protected]
Figure 2 The sterile gauze is unfolded and refolded to form a rectangular strip. This strip is wrapped around the penis twice with the ends meeting at the dorsal aspect of the penis.
542
Ann R Coll Surg Engl 2015; 97: 541–543
Obesity makes access to the femoral vessels more problematic for endovascular aortic aneurysm repair. An oblique cutdown on top of the pannus is common practice to avoid the infection risk associated with crossing the groin crease but this introduces the problem of the stent graft travelling too obliquely (Fig 1). A useful aid is to make a separate 1cm horizontal incision below the groin cutdown, avoiding bending of the delivery system and bleeding at the puncture site.
The Wessex wrap circumcision dressing KE Chan, ECP Chedgy, K Turner Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, UK CORRESPONDENCE TO Kevin Turner, E: [email protected]
None of the authors have any financial interests in the products described in this technical tip. Circumcision dressings are challenging. Techniques described include the use of adjuncts (eg a condom) to facilitate wound dressing.1 We describe a dressing that is simple to apply, cost
Figure 3 A strip of Micropore™ tape is drawn by an unscrubbed member of the theatre team and handed to the operating surgeon. This is wrapped around the ends of the sterile gauze and trimmed to leave a handle for ease of urination.
effective and utilises readily available materials: sterile gauze, paraffin gauze (Jelonet®; Smith & Nephew, Hull, UK) and Micropore™ tape (3M, Bracknell, UK). This dressing also has the benefit of achieving safe tamponade of the wound as well as allowing easy manoeuvring of the penis for voiding. The technique is shown in Figures 1–3.
Figure 1 After completion of the circumcision, the paraffin gauze is folded diagonally into a strip with one of the corners forming a triangle in the middle, which is applied to the circumcised penis. The tails of the gauze are wrapped around the suture line.
Reference 1.
Molokwu CN, Peracha AM. Securing the dressing after circumcision in adults. Ann R Coll Surg Engl 2014; 96: 170.
Femoral access for endovascular aneurysm repair in obese patients A Thapar, W Partridge, J Refson Princess Alexandra Hospital NHS Trust, UK CORRESPONDENCE TO Ankur Thapar, E: [email protected]
Figure 2 The sterile gauze is unfolded and refolded to form a rectangular strip. This strip is wrapped around the penis twice with the ends meeting at the dorsal aspect of the penis.
542
Ann R Coll Surg Engl 2015; 97: 541–543
Obesity makes access to the femoral vessels more problematic for endovascular aortic aneurysm repair. An oblique cutdown on top of the pannus is common practice to avoid the infection risk associated with crossing the groin crease but this introduces the problem of the stent graft travelling too obliquely (Fig 1). A useful aid is to make a separate 1cm horizontal incision below the groin cutdown, avoiding bending of the delivery system and bleeding at the puncture site.
