anemia and poor wound healing, SCC can metastasize quickly, leading to the need for amputation. 2 The surgical team needs to ensure that cancer precautions are taken, so that the accidental spread of cancer cells does not occur. Typically two set- ups is recommended, with a change of gloves in between. The subcutane- ous layers are closed with an absorbable suture, and the final skin closure is made with a finer, non-absorbable suture. While a compression dressing made of medicated gauze and a cotton wrap is recommended, the surgical team will need to take care not to wrap the wound too tightly as it may cause the tissue to necrose. 2 Currently, there is some research being performed on Alloderm skin grafts. While it is not seen as a panacea for EB, it does show some promise for those who have more severe forms of EB. Alloderm grafts have been used after surgery to correct pseudosyndactyly and Mohs. For those who did not reject the graft initially, the grafts took well and the need for future surgeries was diminished. 2 A B O U T T H E A U T H O R Katherine Hayes, CST, earned her bachelor of arts in his- tory from Christendom College in Front Royal, Virginia, in 2008. After moving to Houston, she returned to school at Houston Community College where she received an associate of applied science degree in surgical technology in 2014. She is currently working as a surgical technologist in otolaryngology at the Houston Methodist Hospital in the Texas Medical Center. R E F E R E N C E S 1. Ames, WA; Mayou, BJ; Williams, K. (1999). Anaesthetic management of epidermolysis bullosa. Br J of Anaesth. 8(5), 746-751. 2. Azizkhan, RG; Denyer, JE; Mellerio, JE; Gonzalez, R; Bacigalupo, M; Kantor, A; Lucky, AW. (2007). Surgical management of epidermolysis bullosa: Proceedings of the IInd International Symposium on Epidermolysis Bullosa, Santiago, Chile, 2005. Int J of Dermat. 46(8), 801-808. http://dx.doi.org/10.1111/j.1365-4632.2007.03313.x 3. Denyer, J; Pillay, E. (2012). Best practice guidelines for skin and wound care in epidermolysis bullosa [Pamphlet]. London, UK: International Consensus. 4. Eyer de Jesus, L; Rangel, M; Moura-Filho, R; Novaes, G; Quattrino, A; &Aguas, A. (2014). Uro- logical surgery in epidermolysis bullosa: Tactical planning for surgery and anesthesia. Int Braz J of Urology, 40(5), 702-707. http://dx.doi.org/10.1590/ 5. Fine, J-D; Hintner, H. (Eds.). (2009). Life with epidermolysis bullosa (EB): Etiology, diagnosis, multidisciplinary care and therapy. New York, NY: Springer-Verlag/Wien. 6. Furukawa, LK; Krane, E. (2012, October). Guidelines for the anesthetic management of epider- molysis bullosa [PDF]. Accessed September 2015. http://pedsanesthesia.stanford.edu/down- loads/guideline-eb-2012.pdf. 7. Marinkovich, P. (2014, January 8). Epidermolysis bullosa. Accessed September 22, 2015.http:// emedicine.medscape.com/article/1062939. 8. Mummert, L; Jones, J; Christopher, J. (2015). Alternative use of an oral endotracheal tube fas- tener in a patient with junctional epidermolysis bullosa. AANA J . 83(5), 326-328. 9. Noszczyk, B; Jutkiewicz-Sypniewska, J. (2012). Limited hand surgery in epidermolysis bullosa. In Z Al-Aubaidi (Ed.), Orthop Surg (Online ed, pp. 61-78). http://dx.doi.org/10.5772/1263. 10. Santana Fantauzzi, R; Oliveira Maia, M; Coelho Cunha, F; Vidal Simoes, R; Utsch Gonçalves, D; FerreiraMaia, A. (2008). Otorhyinolaryngological and esophageal manifestations of epider- molysis bullosa. Br J of Otorhinolaryngol. 74(5), 657-661. 11. Siddiqui, U; Banerjee, S; Barth, B; Chauhan, S; Gottlieb, K; Konda, V; Rodriguez, S. (2013). Tools for endoscopic stricture dilation. 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