Fig 4.

(A) With the patient supine and left knee slightly flexed, a template is made by placing a sterile foil wrapper from any commercial suture package into the defect and pressing along the edges of the defect (arrows) with a Freer elevator. (B) Once cut, the template can be checked for accurate sizing in the defect, with the 12 o'clock position marked for orientation. After the tourniquet is released, hemostasis at the defect site is achieved with epinephrine-soaked neural patties (C) or thrombin-soaked gel foam (D) (arrows).