ABSTRACT
Platysma with Michel Clips Shown are initial stages of wound opening for CEA. I infiltrate the skin with 1% xylocaine with 1:200,000 parts of epinephrine to reduce superficial bleeding. The skin is then opened sharply down to the level of the platysma, which is left intact. Michel clips are applied to hold sponges all along the wound edge before the platysma is opened. This technique allows the platysma to be closed at the end of the procedure without removing the clips and thus prevents troublesome skin bleeding during platysmal closure. As the platysma is opened sharply, the first blunt Weitlaner retractor is placed in the field to hold the skin edges apart; the handle is typically placed caudally so it will not interfere with the surgeon’s right hand.
