Increasing the accuracy of sterile marker pens

Skin  preparation  with  disinfectant  solution  for  hand  surgery  patients  is  difficult  to perform single-handedly. It requires  the help of either an assistant or the scrub nurse or  surgeon to use an extra set of sterile gloves.  This problem may be  circumvented by the novel use of the  Rhys-Davies exsanguinator (Trellebourg Woodville Rail, Derbyshire,  United Kingdom)  to support the arm after exsanguination  and inflation of the tourniquet (Fig. 1). The arm  is raised above the sterile surface,  allowing it to be cleaned  and draped single-handedly.