Use of Tegaderm™ for postoperative eye dressing in children Craig Lewis, MD, and Elias I. Traboulsi, MD Creating a secure postoperative eye dressing after pediatric surgery can be challenging. Children frequently attempt to remove dressings, especially those covering their face and eyes. Any dressing or tape with loose ends may be pulled and dislodged. We report a fast and simple method to create a secure postoperative eye dressing using transparent Tegaderm™ dressing. Eye Dressing Technique A fter completion of the surgery, the adnexal skin is cleaned and dried. Two pediatric eye pads, fash- ioned by cutting a regular eye pad in half, are gently placed over the closed eye. Next, a 6 7 cm Tegaderm™ (3 M Healthcare, St. Paul, MN) transparent dressing is applied over the eye pads and firmly secured to the surrounding skin (Figure 1A). Tegaderm™ dressings of this size fit best over an infant’s periocular area. Larger sizes are available and can be used in older children and adults. If a shield is necessary, it can be applied over the first Tegaderm™ dressing and secured with another layer of Tegaderm™ (Figure 1B). Discussion This method of eye dressing has several advantages over one that uses tape. It is faster and simpler to create than a traditional tape patch because it uses a single continuous sticky dressing over the gauze dressing, as opposed to multiple strips of tape. It is more secure than a traditional patch due to the excellent adhesion and thin profile of the Tegaderm™ dressing. Tegaderm™ is composed of a thin polyurethane film with an acrylic adhesive surface. It is exceptionally thin in profile, and it is difficult for infants to find the edge with their fingers and peel off the dressing. The adhesive remains firmly secured overnight and does not leave a residue upon removal. Tegaderm TM dressings are routinely used to secure the eyelids of children and adults during ocular surgery. 1 In addition, Tegaderm TM dressings have been used to create a moisture chamber to treat chronic exposure keratopathy. 2 Eye patches using Tegaderm TM dressings may be used for any pediatric eye surgery that requires a dressing. Maintaining a secure dressing is especially important after pediatric cataract surgery, where eye rubbing may result in wound opening and increase the risk of complications, including endophthalmitis. This method may also be use- ful in adult patients, especially those who are unable to comply with postoperative instructions to leave a patch in place, such as mentally challenged individuals or those with dementia. References 1. Tychsen L, Packwood E, Berdy G. Correction of large amblyopio- genic refractive errors in children using the excimer laser. J AAPOS 2005;9:224-33. 2. Airiani S, Braunstein RE, Kazim M, Schrier A, Auran JD, Srinivasan BD. Tegaderm transparent dressing (3M) for the treatment of chronic exposure keratopathy. Ophthal Plast Reconstr Surg 2003;19:75-6. Author affiliations: Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio Submitted October 7, 2007. Revision accepted January 22, 2008. Published online April 18, 2008. Reprint requests: Elias Traboulsi, MD, i32, 9500 Euclid Avenue, Cleveland, OH 44195 (email: [email protected]). J AAPOS 2008;12:420. Copyright © 2008 by the American Association for Pediatric Ophthalmology and Strabismus. 1091-8531/2008/$35.00 0 doi:10.1016/j.jaapos.2008.01.014 FIG 1. A, Infant patched with eye pad and single Tegaderm™ dressing in operating room after cataract surgery. B, The same infant after the addition of an eye shield and second layer of Tegaderm™ dressing. Journal of AAPOS 420

Use of Tegaderm™ for postoperative eye dressing in children

Download PDF Report

Upload
craig-lewis
View
225
Download
5

Embed Size (px)

Citation preview

Page 1: Use of Tegaderm™ for postoperative eye dressing in children

Use of Tegaderm™ for postoperative eye dressingin childrenCraig Lewis, MD, and Elias I. Traboulsi, MD

Creating a secure postoperative eye dressing after pediatric surgerycan be challenging. Children frequently attempt to remove dressings,especially those covering their face and eyes. Any dressing or tapewith loose ends may be pulled and dislodged. We report a fast andsimple method to create a secure postoperative eye dressing usingtransparent Tegaderm™ dressing.

Eye Dressing Technique

A fter completion of the surgery, the adnexal skin iscleaned and dried. Two pediatric eye pads, fash-ioned by cutting a regular eye pad in half, are

gently placed over the closed eye. Next, a 6 � 7 cmTegaderm™ (3 M Healthcare, St. Paul, MN) transparentdressing is applied over the eye pads and firmly secured tothe surrounding skin (Figure 1A). Tegaderm™ dressingsof this size fit best over an infant’s periocular area. Largersizes are available and can be used in older children andadults. If a shield is necessary, it can be applied over thefirst Tegaderm™ dressing and secured with another layerof Tegaderm™ (Figure 1B).

DiscussionThis method of eye dressing has several advantages overone that uses tape. It is faster and simpler to create than atraditional tape patch because it uses a single continuoussticky dressing over the gauze dressing, as opposed tomultiple strips of tape. It is more secure than a traditionalpatch due to the excellent adhesion and thin profile of theTegaderm™ dressing. Tegaderm™ is composed of a thinpolyurethane film with an acrylic adhesive surface. It is

Author affiliations: Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OhioSubmitted October 7, 2007.Revision accepted January 22, 2008.Published online April 18, 2008.Reprint requests: Elias Traboulsi, MD, i32, 9500 Euclid Avenue, Cleveland, OH 44195

(email: [email protected]).J AAPOS 2008;12:420.

1091-8531/2008/$35.00 � 0

doi:10.1016/j.jaapos.2008.01.014

420

exceptionally thin in profile, and it is difficult for infants tofind the edge with their fingers and peel off the dressing.The adhesive remains firmly secured overnight and doesnot leave a residue upon removal.

TegadermTM dressings are routinely used to secure theeyelids of children and adults during ocular surgery.1 Inaddition, TegadermTM dressings have been used to create amoisture chamber to treat chronic exposure keratopathy.2

Eye patches using TegadermTM dressings may be usedfor any pediatric eye surgery that requires a dressing.Maintaining a secure dressing is especially important afterpediatric cataract surgery, where eye rubbing may result inwound opening and increase the risk of complications,including endophthalmitis. This method may also be use-ful in adult patients, especially those who are unable tocomply with postoperative instructions to leave a patch inplace, such as mentally challenged individuals or thosewith dementia.

References1. Tychsen L, Packwood E, Berdy G. Correction of large amblyopio-

genic refractive errors in children using the excimer laser. J AAPOS2005;9:224-33.

2. Airiani S, Braunstein RE, Kazim M, Schrier A, Auran JD, SrinivasanBD. Tegaderm transparent dressing (3M) for the treatment of chronic

FIG 1. A, Infant patched with eye pad and single Tegaderm™ dressing inoperating room after cataract surgery. B, The same infant after theaddition of an eye shield and second layer of Tegaderm™ dressing.

exposure keratopathy. Ophthal Plast Reconstr Surg 2003;19:75-6.

Journal of AAPOS

mailto:[email protected]