Editing Temporal artery biopsy (section)

== Procedure: ==

* Supine, head ring, bed positioned with space on both sides of head, shave
* IV ABx
* Head drape - back to back side drapes under head then wrapped around, with wet pack over face
* Mark out artery based on pulse palpation, starting at superior edge of anti-helix and moving upwards
* Linear incision starting at about level of superior aspect of ear (cut skin only)
* Diathermy to stop skin edge bleeding
* Use scissors to cut through fascia
* Self-retaining retractor
* Locate the proximal part of artery (tortuous) and differentiate it from the nerve
** If you can't find it
*** Feel for pulsations
*** Search each quadrant in turn
** Nerve should be more anterior, less tortuous, deeper
** The nerve is more closely associated with the frontal branch of STA - can target a more proximal segment, or extend towards the parietal branch of STA if a longer segment is needed.
* Put 3 medium weck clips at bottom
** Prefer to ties, as if the tie snaps and artery retracts you end up with a large unsightly wound
* Define 3cm of artery (don't need to fully dissect it out)
* Put 2 medium weck clips at top
* Properly dissect out the artery, putting small weck clips on large branches and ignoring tiny ones
* Haemostasis, LA, closure
** SQ closes with 3x interrupted 3/0 vicryl, then running vicryl rapide, then dermabond

[[Category:Vascular]]