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Introduction
Thyroid and parathyroid surgery often uses heated instruments to achieve adequate dissection and good exposure, and to reduce intra-operative bleeding. Whilst the use of electrical instruments (e.g. Harmonic scalpel) are beneficial to the procedure, accidental thermal damage to the exposed skin edges can occur intra-operatively. This can result in an unsatisfactory cosmetic outcome in what would otherwise be an occult skin crease incision.
Tonsil swabs can be used in head and neck surgery intra-operatively to control bleeding. This paper describes an alternative use for them in protecting wound edges during the procedure.
Technical description
The patient is prepped and draped for surgery. The skin and subcutaneous tissue is incised. Two damp tonsil swabs are sutured to the wound edge using size 3.0 silk. The sutures are placed around the wound edges at four separate points (corresponding with 12, 3, 6 and 9 o'clock) to secure the tonsil swabs, as illustrated in Figure 1. Skin retractors (e.g. Robson retractors) are then placed over...