A multi-utility skin clamp for clinical examination and minor procedures in dermatology and other specialities

Problem

Clinical examination and procedures in difficult-to-access sites have always been a challenge for clinicians. Due to their opaque nature, instruments like tongue depressors obscure the view when examining the mucosae in conditions like lichen planus and vesiculobullous disorders. Another frequent problem encountered is achieving haemostasis during excision or suturing of the scalp skin or during procedures like the electrosurgery of pyogenic granuloma. The ring handle of surgical instruments was proposed to address this issue and get an annular occlusion.¹

Solution

We propose a stainless-steel instrument that can address all the above issues in addition to many other potential uses in dermatology and other specialties. The instrument is inexpensive, handy, autoclavable, atraumatic (not sharp, does not have any screws or forceps), and has all the qualities of a sturdy surgical instrument [Figure 1].

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Figure 1:

Stainless steel skin clamp with a grooved shaft handle, a tapering neck and an oblong fixing ring inclined at 135° at the distal end, which provides a wide view of the operating field. The inclination helps in better positioning and grip of the fixing ring onto the target surface.

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Some of the possible uses include examination of the oral cavity, especially the buccal mucosa, examination and cryotherapy of lesions on the female genitalia, annular pressure to achieve haemostasis during skin suturing (especially on the scalp), and providing a taut surface for punch biopsies, punch grafting and dermabrasion in vitiligo surgery. [Figures 2 and 3, Video 1]. It can also provide a better haemostatic field during graft harvesting in hair transplantation and injecting platelet-rich plasma on the scalp. The specifications of the instrument, like the diameter of the ring and the shape, can be varied at the manufacturing level depending on the target surface. Due to its angulated shape and grooved handle, this instrument can be used to exert pressure more effectively when compared to the ring occlusion attained using other surgical instruments.

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Figure 2:

Examination of the oral cavity using the instrument. The skin clamp provides a large window for visualising mucosa (which is not possible with a tongue depressor) and also provides a good view to perform a biopsy. Gentle pressure from outside could help further in stabilising the tissues.

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Figure 3:

Annular haemostasis for skin suturing or other procedures especially on highly vascular areas like the scalp.

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This devise named Dr. Ashique’s Skin Clamp is protected by Patent [Intellectual Property Right/IPR] from the Controller General of Patent, Designs & Trade Marks. Government of India (Patent number 548121 dated 26/11/2020).