Occlusive dressing removal

After the tape mask removal the exudate is cleaned by sterile saline. Spot peeling and retaping may be done if the skin looks underpeeled, particularly in areas with severe wrinkling. It is usually accompanied by a short-duration burning sensation. The tape is left for an additional 4-6 h and then removed by the patient. We cover the face with bismuth subgalate antiseptic powder for 7 days (Fig. 8.10). Other options include occlusive moisturizers, antibiotic ointments, and biosynthetic occlusive dressings such as Meshed Omiderm. 

After the 2-h exposure period, the occlusive dressing, as well as the patches on the right side of the animal, will be removed. 

Nonemulsif3dng ointments do not nux with water. They adhere to the skin to prevent evaporation and heat loss, i.e. they can be considered a form of occlusive dressing (with increased systemic absorption of active ingredients) skin maceration may occur. Nonemulsifying ointments are helpful in chronic dry and scaly conditions, such as atopic eczema, and as vehicles they are not appropriate where there is significant exudation. They are difficult to remove except with oil or detergents and are messy and inconvenient, especially on hairy skin. Paraffin ointment contains beeswax, paraffins and cetostearyl alcohol. 

The cream is applied to the skin and is usually contained under a transparent dressing for 45-60 minutes. Local anesthesia persists for 60 to 120 minutes after removal of the occlusive dressing [1,2]. The amount of EMLA that should be applied to the skin is... 

Rabbit 6 4 0.5 ml of 100% Occlusive No signs of irritation were observed in one animal, and only slight erythema (grade 1) in another on day 1, which had resolved by day 7. Four animals showed a mild to moderate erythema (grade 1-2) and a mild to marked oedema (grade 1-3) after removal of the dressing. The oedema had resolved by day 7 post-exposure. Necrosis at the application site was reported in 3/6 rabbits from day 1 until the end of the observation period on day 7. Desquamation was observed in 4/6 rabbits on day 7. 8... 

A 30-year-old woman received two 5 g apphcahons of 40% hdocaine cream with occlusion by plastic wrap during and after laser therapy to areas of her skin (29). She developed dizziness and headache postoperatively, followed 45 minutes later by light-headedness, increasing dizziness, and confusion. The dressings were removed. The hdocaine concentration was 2.7 pg/ml 7 hours later. 

The anterior hairline is a special area. A first strip of Leukoflex is placed directly on the patient s skin, at the edge of the hairline. Any hair sticking out over this edge should be cut off so that it does not get pulled out when the mask is removed 24 hours later. A hairnet is placed on the patient s hair. An impermeable or plastic shower cap should not be used, as it holds the sweat on the scalp and makes the occlusion very uncomfortable for the patient. The (loose) elastic edge of the hairnet is positioned on the first strip of Leukoflex . A second layer of Leukoflex holds the elastic of the hairnet in place the net thus forms an integral part of the occlusive mask and can be used to pull the whole dressing off smoothly and painlessly when the time comes to remove the mask. 

A simple gauze pad can be used instead of a hairnet (Figure 35.2). The gauze should be cut close enough to the dressing for the patient to be able to brush or comb the hair, and at the same time there must be enough gauze to hold onto to remove the occlusive mask later. Around the eyes, the occlusion should completely cover the eyebrows... 

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