Outpatient Surgery Magazine

The Great Prepping Debate - December 2012 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 150 of 159

OSE_1212_part3_Layout 1 12/5/12 9:34 AM Page 151 SAFETY LATEST TRENDS What You're Likely to See M ore and more individuals are presenting with dermal anchors, which are placed in the uppermost part of the dermis, not the hypodermis, meaning they're not deep piercings. Dermal anchors aren't implants, which live totally under the dermis with no outside exposure. They can be taken out, regardless of what a patient might tell you. Never use a scalpel (I've seen that done by a doctor who obviously didn't care for the piercing). A disc exposed to the air is attached to a piece of U-shaped metal that sits inside the skin. Some scar tissue can form in that open center, making removal difficult. Don gloves, palpate the skin around the piercing, unscrew the disc, lock a hemostat onto the jewelry's stem and apply pressure to gently work it out. Once removed, apply direct pressure to the opening to stop the bleeding; there's no reason to suture the hole. What about other piercings? The jewelry is the same, no matter where it's placed in the body: some form of barbell — straight, circular, curved or ringed. Nose piercings are usually done with a nostril screw, which is a straight piece of jewelry bent inside of the nose. Navel piercings are comprised of curved barbells and rings of various forms. Eyebrow piercings are often done with a curved barbell or ring. When removing barbell pieces, unscrew 1 or both balls. If the barbell's shaft has threads on its outside surface, lubricate it before pulling it through the wound. If you don't use lubrication, the threading will tear the scar tissue that has formed the fistula that holds the jewelry. Captive jewelry — many lip or navel piercings, for example — is held in place by pressure. To remove these piercings, insert a hemostat inside the ring and slowly open it. That will open the ring, take the pressure off the ball holding it in place and let you slide the piercing out. — David Vidra, CLPN, WCC, MA D E C E M B E R 2012 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E 1 5 1

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