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Innovations and Ideas
ARTICLE IN PRESS
doi:
10.25259/IJPGD_182_2024

Use of Wooden Spatula for Palpation of Mucosal Lesions as an Alternative Tool to Gloved Finger

Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India.

*Corresponding author: Priyanka Sangwan, Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India. priyankasangwan90@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Gupta P, Sangwan P. Use of Wooden Spatula for Palpation of Mucosal Lesions as an Alternative Tool to Gloved Finger. Indian J Postgrad Dermatol. doi: 10.25259/IJPGD_182_2024

PROBLEM FACED

Examination of oral and genital mucosa forms an integral part of the physical examination of dermatology patients.[1] Naked finger palpation is rarely done at these sites because of concerns regarding hygiene and the risk of cross-infection. To surmount this, the gloved finger is the preferred method of examination. However, the presence of an extra layer of gloves between the finger and lesion being examined decreases the sensitivity of tactile receptors on fingertips.[2] In addition, individuals sensitised to latex, rubber or talc avoid using gloves during the examination.

SOLUTION PROPOSED

We tried to overcome this problem by replacing the gloved finger with a disposable wooden tongue depressor/spatula or ice-cream stick for palpation [Figure 1]. The wooden spatula commonly used to retract buccal mucosa while inspecting the oral cavity can be held with fingers to palpate the consistency and surface change of mucosal lesions [Figure 2]. The wooden spatula functionally is an extension of fingers with the ability to detect palpatory findings better than gloved fingers and comparable to naked fingers in our observation. This is similar to the use of surgical instruments by surgeons to palpate internal structures during procedures. It offers the additional advantage of palpating lesions located distally in mucosa which cannot be easily reached with fingers. Better sensitivity, decreased chance of allergy to glove material and easy availability of the disposable wooden tongue depressor or spatula at ice-cream parlours add to the advantage of this novel method. The inability to perform bimanual palpation with a spatula as well as need for sterilisation forms the limitation of this tool.

Image showing gloves (below) and wooden spatula (above) commonly used for examination.
Figure 1:
Image showing gloves (below) and wooden spatula (above) commonly used for examination.
Clinical image to demonstrate palpation of a lesion (leukoplakia) on left buccal mucosa using wooden spatula.
Figure 2:
Clinical image to demonstrate palpation of a lesion (leukoplakia) on left buccal mucosa using wooden spatula.

Ethical approval

Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , . Anatomic and Examination Considerations of the Oral Cavity. Med Clin North Am. 2014;98:1225-38.
    [CrossRef] [PubMed] [Google Scholar]
  2. , , , . Touch Sensitivity with Sterile Standard Surgical Gloves and Single-use Protective Gloves. Anaesthesia. 2006;61:959-61.
    [CrossRef] [PubMed] [Google Scholar]

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