Problem Faced
Excision surgery for skin lesions on concha and fossa of the ear is performed with angulated blades. There are Unitome (100°), ophthalmic (120°) orthopedic (160°), tympanoplasty (120°) blades which have been used for excision of cutaneous lesions on the ear.[1,2] However, the alignment of the blades is not proper with the surfaces of concha and fossa of the ear.[1,2] Moreover, these blades are costly and usually not available in the dermatology clinics.
Solution Proposed
To alleviate the problem of the angulated blades, the razor blade is used which is sharp, inexpensive, and readily available cutting instrument in the clinic. This blade is modified into a looped blade. For dealing with sharp, elastic, and flexible razor blade, under double protection of hand gloves, the blade is halved and its cutting edge on both sides is trimmed. Then the blade is folded manually, and is held into a looped shape with the help of a needle holder [Figure 1a-c]. This looped blade makes a proper alignment with the surfaces of the concha and the fossa, and can be used for excising the cutaneous lesions of the ear [Figure 2a-e]. The blade is also applicable with same advantage over concave surfaces of pinna, nose [Figure 3a-e]. Thus, the mid-portion of the edge is enough to excise the lesion on concave surfaces of the ear, nose, and eye [Video 1]. The trimming of the blade has few advantages. First, less effort is required in flexing and looping the blade. Second, some applied force is transferred to the lateral trimmed slender part of the blade that helps in avoiding its breakage. Third, there is less chance of injury to the fingers of the operators in handling the blade having no cutting edge at the site of manipulation. Fourth, on cutting lateral edges, there is minimal or no chance of injury to the walls of concha and fossa of the ear of the patients.
Figure 1.
(a-c) The trimmed and halved razor blade is looped with a needle holder
Figure 2.
(a-e) The looped blade has better alignment with curved surfaces of concha and fossa of the ear
Figure 3.
(a-e) The looped blade has better alignment with curved surfaces of pinna and nose
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Video Available on: www.idoj.in
References
- 1.Shelton RM. Use of a curved blade to harvest mohs micrographic sections. In: Harahap M, editor. Innovative Techniques in Skin Surgery Network. Marcel Dekker; 2002. pp. 149–57. [Google Scholar]
- 2.Richards LE, Samie F, Troob S, Lewin JM. The use of tympanoplasty blade for tumor extirpation of the auricle. J Am Acad Dermatol. 2019;80:e121–2. doi: 10.1016/j.jaad.2018.06.041. [DOI] [PubMed] [Google Scholar]
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