Below is my write up I compiled about a week prior to my surgery to make sure I hadn’t missed anything for my magnet implant. Below is the abbreviated list I used during the procedure itself to make sure I didn’t miss anything.
Strikethrough indicates plans changed due to initial failure on my first attempt.
24 hours before surgery, test treated magnets in saline to ensure parylene coating integrity remains intact (surface bubbling indicates integrity failure).
Occlude all airflow including vents and windows. Scrub down all exposed skin surfaces with soap and water. Dry well. Don sterile gloves. Scrub down all surfaces in and near work area with soap and water, dry, and then wipe with saniwipes (allowing time for disinfection to complete).
Take off gloves. Don new ones. (Overkill) Lay down a clean towel. Take off gloves. Don new ones. Use wrapping from gloves as a sterile operating surface on top of the towel, although treat any tool, sharp, or skin that touches the surface as contaminated and discard.
Draw up sterile saline into syringe for irrigation.
Prepare an assistant to don sterile gloves and wipe down magnet with steri-wipe immediately prior to insertion. Ensure it is given ample time to dry. Prepare multiple magnets that have been saline tested for parylene irregularities or anomalies.
Implant Incision Prep
Take off gloves. Mark lateral crease points, and extend lines laterally to create Littler’s diamond to indicate safest locations for lateral incisions. Mark point of incision and desired magnet location. Scrub down with soap and water. Dry thoroughly.
Wipe down hands with sani-wipes. Dry thoroughly. Don sterile gloves. Lay out wrapped tools and lido ampule with sterile, guarded needle, with scissors, tweezers sterilized as needed with saniwipes. CAREFULLY cut tip off of left ring pinky middle finger glove (running out of fingers I haven’t cut into, yet…) to expose incision site and lido injection sites with sterile scalpel.
Clean lido injection site with
alcohol prep pad chlorhexidine prep swab included with the lido kit and proceed with digital nerve block by drawing up lido and creating a wheel on skin lateral to the knuckle on the palmar surface to the left and right lateral sides of the knuckle just distal to metacarpophylangeal joint, then, using aspiration as an indicator of unwanted blood vessel intrusion, proceed 5-10mm deeper and dispense 1cc injection as close to the bone as safely possible, twice per side (1cc due to size restriction of provided syringe). As numbness grows, Once finger is numb, place hair tie tourniquet and scrub incision site with chlorhexidine solution. Allow to dry.
Incision & Magnet Implant
Proceed with marked 5mm incision, blotting with sterile sponge held by sterilized hemostats.
Use the scissors as a probe to open a pocket from the incision such that the desired placement site is hollow. Use the #15 scalpel to open a pocket ~7mm long into the pulp of the finger. Blot blood.
Ensure the magnet is disinfected and dried. Gently grasp corner with sterile tweezers, and visually inspect for signs of parylene degradation. Discard any anomalous magnets and restart magnet sterilization if needed. Insert the magnet into the incision and push into place with
blunt end of scalpel or scissor tip finger to avoid attraction to the ferrous tweezers.
press air out of the wound and blot away blood. Suture wound with one stitch. Wipe the incision area down with sterile sponge and apply triple antibiotic ointment before applying a light bandage and wrapping the finger in gauze.
Change dressing and antibiotic ointment twice daily for the first week, taking care not to get the incision site wet. After the first week, dressings can be omitted for a simpler bandaid with antibacterial treatment continued until the wound is entirely closed. Stitches will be removed after one week or, if healing progresses quickly, sooner. Treat site with gentle caution until healing is entirely complete. Refrain from playing with or using magnet for at least 4 weeks post-procedure. Magnet implant is complete!
Cut off glove around
ring pinky middle finger.
Prep injection site.
Inject posterier and anterior sides of the knuckle just distal to the metacarpophylangeal joint from the dorsal side. Create a small tent/2CC.
Scrub incision site with chlorhexidine.
Proceed with marked incision.
scissors tip scalpel to open a pocket.
Check magnet for parylene degradation (already checked for oxidation in saline solution over night).
Insert magnet into wound, using
tweezers and butt of scalpel finger tip to push fully in.
Check placement with magnet stack.
Suture. Tie square knot, then 2 granny knots. Unfortunately only have massive crile forceps but they’ll do.
Apply triple antibacterial ointment.
Add sterile gauze pad and wrap in sterile gauze.
Secure with scotch tape because we’re ghetto like that.