Preoperative Surgical Skin Marking in Plastic Surgery

(Extract From "British Journal of Plastic Surgery" Volume 54 Number 6 2001)
In plastic and re-constructive surgery, the importance of fine accurate indelible preoperative skin markings of key reference points and lines is essential if surgery is to be precise. Often the visible success of the operation is determined by this. Skin markings made preoperatively need to be robust to withstand the surgical skin preparation with anti-septic prepping solutions.

We investigated a small sample of skin-marking pens used commonly in plastic surgery departments in Southeast England. Theatre sisters were contacted in a number of hospitals to ascertain local practice among plastic surgeons. Viomedex® and Porex® as well as Sommerland were reported as the most commonly used.

A small study using six such pens was carried out on the forearm skin of a volunteer to determine their relative ‘performance’ and their ability to withstand surgical skin preparation. In keeping with recent trends, Betadine® and Hydrex® were used. A single operator cleaned each mark for 60 seconds. The end results are shown in table 1. (range: 0 = disappeared, through to 5 = no fading)

Figure 1: Pre-preparation skin markings on volunteer's forearms (Viomedex® circled)	Figure 2: Results following preparation (Viomedex® circled)

Table 1 – Pens used and ‘durability score’ in withstanding surgical skin preparation

"The results confirm the relative indelibility and success of the Viomedex® pen in withstanding both alcohol-based skin preparations."
Written by Taran Tatla MRCS, Senior House Officer, Hamid Yazdian-Tehrani MBBS, Senior House Officer and M. Shibu FRCSEd, FRCS(Plast), Consultant Plastic Surgeon
Reproduced with permission of Harcourt Publishers Ltd.

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