Surgical Pearl: Cups for caps—monitoring doses of local anesthesia

Abstract

wound bed. As the thermoplastic cools, it becomes inflexible and maintains the shape of the graft. Once hardened, it can be trimmedwith scissors to extend 5 mm beyond the graft margins. Next, a piece of nonadherent dressing covered in ointment is applied to the graft, and the thermoplastic dressing is sutured or stapled into place (Figs 2 and 3). An absorbent dressing can be placed over the thermoplastic dressing. The thermoplastic bolster is removed in 5 to 7 days. In summary, the thermoplastic dressing increases surface adherence between a full-thickness skin graft and its recipientwoundbed.Once sutured into place, it immobilizes the graft against mechanical forces. One of its major advantages is that the moldable plastic can be shaped to fit the convex and concave surfaces of the nose and ear. In contrast to traditional gauze bolsters, the perforated thermoplastic dressing allows the patient to shower normally. A potential complication is the possibility of contact dermatitis in sensitive individuals. Expense may be another disadvantage based on the size, color, and number of dressings purchased. A package of 10 (33 3-in), ivory thermoplastic splints costs $46. In our clinic, we have not observed graft failure or any other adverse outcome related to this dressing. We have found it tobeapractical tool forsecuring full-thickness skingrafts.