ABSTRACT
Skin and Hemovac The skin is closed with subcutaneous stitches of 3-0 or 4-0 Vicryl followed by a running subcuticular stitch of undyed 4-0 Vicryl. The Hemovac drain that lies inside the carotid sheath is brought out, always through the caudal end of the wound and with care taken not to harpoon the external jugular vein in the process. As mentioned, the Hemovac drain is placed to canister suction only and is removed on the first postoperative day. I have found that the use of the Hemovac drain prevents the large ecchymotic neck frequently associated with subcutaneous dissection of minor wound bleeding. In my patients, the heparin is not reversed intraoperatively and they are placed back on their aspirin regimens immediately after surgery.
