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DERMATOLOGY PEARLS
Year : 2021  |  Volume : 12  |  Issue : 2  |  Page : 359-360  

Surgical pearl: A novel technique of wicking hypodermic needles for chemical cauterization


Consultant Dermatologist, Mukhtar Skin Centre, Katihar Medical College Road, Katihar, Bihar, India

Date of Submission23-Jul-2020
Date of Decision09-Aug-2020
Date of Acceptance05-Sep-2020
Date of Web Publication22-Feb-2021

Correspondence Address:
Muhammed Mukhtar
Consultant Dermatologist, Mukhtar Skin Centre, Katihar Medical College Road, Katihar - 854 105, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_579_20

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How to cite this article:
Mukhtar M. Surgical pearl: A novel technique of wicking hypodermic needles for chemical cauterization. Indian Dermatol Online J 2021;12:359-60

How to cite this URL:
Mukhtar M. Surgical pearl: A novel technique of wicking hypodermic needles for chemical cauterization. Indian Dermatol Online J [serial online] 2021 [cited 2021 Apr 18];12:359-60. Available from: https://www.idoj.in/text.asp?2021/12/2/359/308922




   Problem Faced Top


Chemical cauterization is done with caustic agents to destroy skin lesions. To simplify this procedure, its applicators such as micropipette tip, syringe outlet are stuffed with cotton wick.[1],[2] Use of tooth pick and earbud as applicators require frequent dips and have chances of chemical injury. However, we still face difficulty in easy, safe, and precise delivery of chemical agents on skin lesions.


   Solution Proposed Top


To alleviate this problem, a wide bore hypodermic needle wicked with cotton as an applicator can be used. For wicking the applicator with cotton, hypodermic needles of 16, 18, and 23 G are selected. First of all, tips of all the three needles are snipped. Then a wick of cotton thread is made. For capillary action it is inserted and packed in the needles (16 and 18 G) through the beveled end with the help of 23G needles. After this, a small proximal part of the needle is wicked in the same way from the hub end to make the entire length of the needle stuffed with cotton wick [Figure 1]a,[Figure 1]b,[Figure 1]c,[Figure 1]d. Subsequently, the chemical agents (Trichloroacetic acid/TCA and Phenol) are withdrawn into cotton-stuffed 3 or 5 ml disposable syringe to control the flow of the chemical agents. The wicked needle is mounted on the syringe outlet and fixed with cyanoacrylate glue for better safety. The snipped needle tip for spot and beveled tip for non-spot cautery are used [Figure 2]a and [Figure 2]b. After chemical cautery, the needle should be capped. On getting loose of wick, an extra small cotton wick is inserted and packed in tip of the needle. On corrosion or rusting of the needle, particularly due to TCA, it can be replaced with a new one. Thus, a hypodermic needle stuffed with cotton wick is a good option for precise and safe chemical cauterization in office. 20-G-23G needles can be used in the same manner with the help of 26G needle ,or fine pin or copper wire, with extra efforts, for chemical cauterization of smaller lesions.
Figure 1: (a-d) The different stages of wicking hypodermic needles

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Figure 2: (a and b) The syringe (containing trichloroacetic acid and phenol) with cotton wick stuffed needles and their spot size, (which depend upon the tips used), on the paper

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Acknowledgements

I acknowledge Dr. Bushra khan, M.D. (Dermatology) for her help in editing the text of this article.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Jangra RS, Gupta S, Gupta S, Dr A. Chemical cautery pen. J Am Acad Dermatol2020;82:e193-4.  Back to cited text no. 1
    
2.
Mukhtar M. Disposable syringe for chemical cautery. J Am Acad Dermatol 2020;S0190-9622(20)30695-2.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2]



 

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