Kaolin-impregnated gauze for hemostasis following nail surgery

A bloodless field can be effectively achieved during nail surgery by using a digital tourniquet, but the nail unit is highly vascularized, with profuse bleeding after tourniquet removal. Prolonged bleeding increases the risk of postoperative wound infections and delayed wound healing. Many hemostatic products and techniques have been used in nail surgery with variable efficacy, including direct pressure with gauze, application of aluminum chloride, ferric subsulfate, and absorbable gelatin. With these agents, wound healing and further pathologic evaluation may be compromised. Brimonidine 0.33% gel has been used in nail surgery with promising results; nonetheless, it is contraindicated in infants and patients with neurologic or cardiac disease. 1 Lipner S.R. Novel use of brimonidine 0.33% gel for hemostasis in nail surgery. Dermatol Surg. 2019; 45: 993-996 Crossref PubMed Scopus (5) Google Scholar There is a need for a safe, effective, inexpensive, and widely applicable hemostatic technique for nail surgery.