Mesentery-like steri-strip: a scarless drain fixation.

Dear Editors, Recently in your journal an interesting trick in steri-strips application was suggested by D’Ettorre et al. (1), we would like to draw the readers’ attention to a further potential use of this common dressing. In fact, suction drains are usually secured by looping suture material around the drain in the form of a ‘Roman garter’. However, the knot is prone to loosening, which allows the drain to slip and the vacuum that creates the suction effect to be lost (2). To avoid slippage, silk is used to create sufficient friction around the drain such that it is secured in place, but excessive force can cause blockage of the tube and clotting. Furthermore, the knot can be the source of contamination (3) or highly irritant (4) to skin and can cause local necrosis if the knot is strongly tightened (2). Variousmethods have been proposed to overcome these problems (5, 6), but they all require sutures to be inserted, creating permanent signs on the skin. In most surgical procedures the drainage is removed postoperatively within the first 24 hours. Hence, strong attachments to enable prolonged fluid drainage become useless. In order to minimise the signs of scarring, we want to draw your readers’ attention to our method for drain fixation with steri-strips after surgery. The skin is prepared for the insertion of drainage by rinsing and drying. The drain is placed in the desired position and fixed to the skin with the use of multiple steri-strips, which are shaped to create a ‘mesentery’. This mesentery arises 1–2 cm distal to the point where the drain left the skin (Figure 1). It is then further secured by other steri-strips placed perpendicular to the first ones. Finally, Mastisol® Adhesive liquid is spread over the steri-strips to ensure the maximal holding power. Our simple method for securing drains avoids the use of sutures and is of low cost per laceration and infected laceration compared with sutures (7). It is quick and as long as the steri-strips are used for wound coverage and suture fixation, no extra costs are required. It is very useful in situations where drains need to be in situ for a short period. It is simple to