Department of Surgery, Medico Surgical Clinic and Hospital, Ghatkopar, Mumbai, 400086, India.
World J Surg. 2011 Feb;35(2):311-5. doi: 10.1007/s00268-010-0864-y.
For many surgical procedures skin marking is required well before surgery and induction of anesthesia. In some cases, the patient may need to be standing or sitting while the skin area is marked. Marking of perforators and varicosities in chronic venous diseases, marking of stoma sites for urinary or fecal diversions are some examples. The side of surgery should ideally be marked preoperatively to avoid wrong side surgery. Marks made with conventional marking pens fade or disappear with preoperative skin preparation, whereas marks made with henna paste, which is orange to dark brown in color, last for up to 3 weeks in spite of regular showers and skin cleansing, even with ethanol. This property of henna encouraged us to use it as a preoperative skin marker.
Henna paste was used as a preoperative skin marker in 250 patients. In 154 patients with chronic venous diseases, perforators and varicosities were marked during duplex scanning. Henna was used to mark the colostomy site in 28 patients with carcinoma of the rectum prior to abdominoperineal resection of the rectum (APR) (four of them laparoscopic APR) and the aspiration site in 11 patients with liver abscesses and 4 patients with pleural empyemas, under ultrasonographic (USG) guidance. In addition, henna was used to mark the correct side of surgery in 47 patients undergoing unilateral inguinal hernia surgery. Marking was done from 1 to 8 days before surgery.
The marking with henna was clearly visible in all the cases even after preoperative skin preparation with ethanol up to 8 days after application. There were no complications associated with the marking. All marks disappeared 4 weeks after application. In terms of successful execution of the desired procedure, the use of henna marking was successful in all the cases.
Henna is an ideal substance for use as a preoperative skin marker. It can be safely and effectively used as a marker for varicose vein surgery, ultrasound-guided identification of lesions, establishing the ideal site for stomas on the abdominal wall, and to identify the correct side of surgery. Markings made with henna are durable and do not fade with routine bathing or preoperative skin preparation. In most cases there are no associated complications. Henna is cheap, safe, and convenient, and indications for its use can be ubiquitous.
对于许多外科手术，在手术和麻醉诱导之前，都需要提前对皮肤进行标记。在某些情况下，患者可能需要站立或坐着，同时对皮肤区域进行标记。在慢性静脉疾病中标记穿支和静脉曲张、为尿或粪便转流术标记造口部位就是一些例子。为了避免手术侧错误，理想情况下应在术前对手术侧进行标记。传统标记笔所做的标记会随着术前皮肤准备而褪色或消失，而用指甲花制成的糊剂（颜色为橙棕色到深棕色），即使在常规淋浴和皮肤清洁（甚至使用乙醇）的情况下，也能持续长达 3 周。指甲花的这种特性促使我们将其用作术前皮肤标记物。
在 250 例患者中，我们使用指甲花糊剂作为术前皮肤标记物。在 154 例慢性静脉疾病患者中，在双功能超声检查期间对穿支和静脉曲张进行了标记。在直肠癌行腹会阴切除术前（4 例为腹腔镜 APR），用指甲花标记 28 例直肠癌患者的结肠造口部位，在超声引导下对 11 例肝脓肿和 4 例脓胸患者进行引流部位标记。此外，在 47 例单侧腹股沟疝手术中，用指甲花标记手术的正确侧。标记时间从手术前 1 天到 8 天不等。
即使在应用后用乙醇进行了术前皮肤准备，标记也清晰可见，直至应用后 8 天。标记没有任何并发症。应用后 4 周，所有标记均消失。在完成预期手术的效果方面，指甲花标记在所有病例中均成功。
指甲花是一种理想的术前皮肤标记物。它可以安全有效地用于静脉曲张手术、超声引导下识别病变、确定腹壁造口的理想部位，以及识别手术的正确侧。指甲花标记持久，不会因常规沐浴或术前皮肤准备而褪色。在大多数情况下，不会有相关并发症。指甲花价格便宜、安全且方便，其使用范围广泛。
