A multipurpose handle for vitiligo surgery and beyond

Karalikkattil T Ashique; Puravoor Jayasree; Feroze Kaliyadan

doi:10.25259/IJDVL_996_2022

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Pearls

89 (

6

); 923-924

doi:

10.25259/IJDVL_996_2022

pmid:

37609753

A multipurpose handle for vitiligo surgery and beyond

Karalikkattil T Ashique^,, Puravoor Jayasree¹, Feroze Kaliyadan²

Department of Dermatology, Amanza Skin Clinic, Perinthalmanna, Kerala, India

1Department of Dermatology, Consultant Dermatologist, Medical Trust Hospital, Cochin, Kerala, India

2Department of Dermatology, Sree Narayana Institute of Medical Sciences, Cochin, Kerala, India

Corresponding author: Dr. Karalikkattil T Ashique, Department of Dermatology, Amanza Skin Clinic, 4/220, Queen Complex, Perinthalmanna, Kerala, India. ashique@amanzadermatology.in

Received: 2022-11-03, Accepted: 2023-05-13, Epub ahead of print: 2023-07-10, Published: 2023-10

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ashique KT, Jayasree P, Kaliyadan F. A Multipurpose handle for vitiligo surgery and beyond. Indian J Dermatol Venereol Leprol 2023;89:823-4.

Problem

Vitiligo surgery is an important procedure amongst the surgical therapies offered by dermatologists in their day-to-day practice. The commonest procedures undertaken are mini-punch grafting, suction blister grafting and cellular grafting popularly known as the melanocyte transplantation. By default, the dermatosurgical instruments are adapted from other specialties and hence may require modification or innovation of new instruments especially suited to the requirements of dermatologic surgery. There are numerous tricky steps in the various vitiligo surgeries including precise placement of the punches in the recipient area without altering the dermal and epidermal side (in minipunch grafting), removing the mucous tissue from the dermal side and spreading the blister grafts on the glass slide (in blister grafting) and teasing the incubated graft in epidermal suspension transplantation. As of now, varied instruments including jeweler’s forceps, hypodermic needles, non-toothed forceps, broken prong of forceps, etc., are used for the above steps. There is an unmet need for a standardised, reliable, sturdy, user friendly, maintenance-free, sterilisable instrument that can handle all these situations.

Solution

We customised a stainless-steel instrument that can address all the issues as a one for all tool [Figures 1a and 1b] [Video 1]. The instrument is user friendly, can be made by any surgical manufacturer at ease and has all the qualities of a sturdy surgical instrument for procedural dermatology. In addition to aforementioned indications, it can be tried in hair transplantation too to fix the grafts in the recipient area.

The dimensions of the instrument explained graphically. The outer surface of the 1” length area is roughened to facilitate easy clearing of the mucus in the blister interior and teasing of the graft after incubation.

Video 1: Video showing the utility of the instrument in vitiligo surgeries

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Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflict of interest

There is no conflict of interest.

References

Ashique KT, Kaliyadan F. Long-term follow-up and donor site changes evaluation in suction blister epidermal grafting done for stable vitiligo: A retrospective study. Indian J Dermatol. 2015;60:369-72.
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