From the Department of Dermatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China.
The authors report no conflict of interest. Medical Gauze Cloth
Correspondence: Hongguang Lu, PhD, Department of Dermatology, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyijie St, Guiyang, Guizhou 550004, People’s Republic of China (luhongguang@gmc.edu.cn).
Affixing a scalp dressing is challenging because of the presence of hair. Many methods have been recommended; their limitations include their effect on aesthetics and discomfort to the patient during the procedure. We describe a method for using hairpins to affix a dressing after scalp surgery or trauma that is sturdy, does not compromise aesthetics, and does not cause additional discomfort.
Ginzburg A, Mutalik S. Another method of tie-over dressing for surgical wounds of hair-bearing areas. Dermatol Surg. 1999;25:893-894. doi:10.1046/j.1524-4725.1999.99155.x Yanaka K, Nose T. Braid dressing for hair-bearing scalp wound. Neurocrit Care. 2004;1:217-218. doi:10.1385/NCC:1:2:217 Bu W, Zhang Q, Fang F, et al. Fixation of head dressing gauzes with paper clips is similar to and better than using tape. J Am Acad Dermatol. 2019;81:E95-E96. doi:10.1016/j.jaad.2018.10.046
Wound dressings protect the skin and prevent contamination. The hair often makes it difficult to affix a dressing after a minor scalp trauma or local surgery on the head. Traditional approaches for fastening a dressing on the head include bandage winding or adhesive tape, but these methods often affect aesthetics or cause discomfort—bandage winding can make it inconvenient for the patient to move their head, and adhesive tape can cause pain by pulling the hair during removal.
To better position a scalp dressing, tie-over dressings, braid dressings, and paper clips have been used as fixators.1-3 These methods have benefits and disadvantages.
Tie-over Dressing—The dressing is clasped with long sutures that were reserved during wound closure. This method is sturdy, can slightly compress the wound, and is applicable to any part of the scalp. However, it requires more sutures, and more careful wound care may be required due to the edge of the dressing being close to the wound.
Braid Dressing—Tape, a rubber band, or braided hair is used to bind the gauze pad. This dressing is simple and inexpensive. However, it is limited to patients with long hair; even then, it often is difficult to anchor the dressing by braiding hair. Moreover, removal of the rubber band and tape can cause discomfort or pain.
Paper Clip—This is a simple scalp dressing fixator. However, due to the short and circular structure of the clip, it is not conducive to affixing a gauze dressing for patients with short hair, and it often hooks the gauze and hair, making it inconvenient for the physician and a source of discomfort for the patient when the paper clip is being removed.
To address shortcomings of traditional methods, we encourage the use of hairpins to affix a dressing after a scalp wound is sutured. Two steps are required:
A, Use of hairpins to tightly affix a dressing to a scalp wound in a patient with short hair. B, Hairpins are smoothly removed.
Hairpins are common for fixing hairstyles and decorating hair. They are inexpensive, easy to obtain, simple in structure, convenient to use without additional discomfort, and easy to remove (Figure, B). Because most hairpins have a powerful clamping force, they can affix dressings in short hair (Figure, A). All medical staff can use hairpins to anchor the scalp dressing. Even a patient’s family members can carry out simple dressing replacement and wound cleaning using this method. Patients also have many options for hairpin styles, which is especially useful in easing the apprehension of surgery in pediatric patients.
See more with MDedge! See our Other Publications
MDedge: Keeping You Informed. Saving You Time.
Dressing Roll Bandage Copyright © 2024 Frontline Medical Communications Inc., 283-299 Market Street, 2 Gateway Center, 4th Floor, Newark, NJ 07102. All rights reserved. Unauthorized use prohibited. The information provided is for educational purposes only. Use of this Web site is subject to the medical disclaimer.