NAPLES, FLA. The best place to acquire surgical blades and materials for abrading is not necessarily the medical supply house, said Daniel M. Siegel, M.D.
The hardware store has supplies for medical procedures that are usually much cheaper, and often actually work better.
"During medical school, internship, and residency, I used to think about gadgets I grew up with that could be used in the medical office," explained the dermatologist and son of a hardware store owner.
The old double-edged razor blade is a case in point of the hardware store item being both cheaper and better, Dr. Siegel said. The classic blade is the old Gillette Blue Blade. Those blades are much sharper and much thinner (4/10,000th of an inch) than a scalpel, said Dr. Siegel of State University of New York Downstate Medical Center, New York.
Their thinness makes them easier to handle, and they can be bent and bowed to curettage (but practice on an orange first). Their sharpness allows the user to cut more cleanly with less collateral damage. This has even been touted in the literature, Dr. Siegel said, citing a paper that said one can perform excision biopsies of melanocytic nevi with less scarring. "Only a diamond knife is sharper."
The thicker, carpet-cutting blades sold in the hardware store are ideal for harvesting split thickness skin grafts because of their stiffness. The razor blades sometimes are covered with anticorrosive oil that is bacteriostatic, but the carpet blades need to be cleaned with Betadine and alcohol, he said.
Sandpaper, sanding sponges, and even drywall screens can be handy forwhat else?abrading, Dr. Siegel said. Sandpaper, which he makes wet with Betadine, can be used on warts, small scars, and even onychomycotic nails. The sponges are handy because they can be used and then washed in a dishwasher or washing machine. Drywall screen can be quite rough but it works well for treating larger areas, hypertrophic scars, or actinic keratoses, because it can be rinsed during use.
Dr. Siegel even suggested that sandpaper could be used for cosmetic dermabrasion, perhaps to advantage.
"It clogs quickly, so you have to use a lot of it," he said. "But it is difficult to do any real harm because it is a slow-moving, not very aggressive abrader."
For microdermabrasion, he suggested using Lava soap, which contains pumice from volcanic lava. Lava soap can be used before phototherapy or a peel, to remove some of the stratum corneum.
Dr. Siegel said he has made his own silicone gel sheeting using silicone caulking. He spreads it between two sheets of wax paper or into a plastic bag to flatten it out, and then lets it dry overnight.
As with all the hardware items, the cost of this sheeting is much less than the medical-grade sheeting, Dr. Siegel stressed. In fact, the first time he used the caulking was specifically for a patient who needed an economic alternative.
Among the other items available at the hardware store that Dr. Siegel mentioned using were electrical tape (to put over imiquimod), duct tape (on warts), foam tapes (to protect areas during cryotherapy), headlamps (only about $20), and dimethyl sulfoxide (DMSO).
DMSO can be bought in many hardware stores. He mixes it with 50% water then adds whatever medication he wants to have better penetration, such as fluconazole (Diflucan). He even suggested that someone might want to try adding it to ciclopirox (Penlac) for infected nails.
"You may actually get something that works," he said.