The only concern is that there are inventions that are still being worked out

Editor's note

The Edison Files is a recurring column in which we showcase the creative ends to which you will go to optimize your cosmetic surgery gear. One theme we see emerging from your e-mails is that every great idea begins with a nettling dissatisfaction with what's already out there. The second is that no nail is driven with the first whack. In fact, this column's namesake ardently shared your passion for iteration — and for stick-to-itivness! So, tell us. What's the big idea? E-mail us with your inventive journey — what was missing and how did you improve it? Was coming up with it the easy part — or getting the prototype right? We'd love to feature your tinkerings or triumph in a future edition of The Edison Files. E-mail us at TheEditors@cosmeticsurgerytimes.com
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Plastic surgeon David S. Kirn, M.D., says he does not know of a single household appliance over the years that he hasn't taken apart and put back together. And while he currently holds several U.S. and foreign patents, his passion for garage-based tinkering hasn't always worked to his advantage.

Dr. Kirn devised the Arm Channel apparatus both to boost patient safety, and to save time in the O.R.

LEAN ON ME Since those days, the Lexington, Ky.-based plastic surgeon has fabricated his way to five U.S. patents, one U.S. patent pending, two foreign patents and two foreign patents pending.

One of his more recent surgical solutions is the trademarked Arm Channel, an armboard that surgeons can attach to standard operating room tables. The device quickly and easily supports patients' arms on the OR table.

"Operating room tables have attachments that fit along rails, to which you attach an armboard. Sometimes, particularly for breast surgery, abdominoplasty and liposuction, we put people into different types of positions that are not well accommodated by the currently available products," Dr. Kirn explains. "I was just tired of wrapping people's arms and went shopping for a solution, but it didn't exist."

The Arm Channel offers a safe alternative to conventional practice, he says. Crude wrapping or taping of arms onto tables can, in and of itself, cause injury because the patient under general anesthesia isn't capable of communicating pain. In addition, making sure to properly wrap patients' arms can take precious minutes in the operating room, while the Arm Channel takes only seconds to click in.

THE UN-YANKABLE FEEDING TUBE Dr. Kirn, voluntary faculty for the University of Kentucky's plastic surgery division, says that his most commercially successful product to date has been a bridle that keeps patients from pulling out their feeding tubes. Its inspiration came when he saw a patient who had an improperly taped nasal tube that had resulted in a nose injury, and he began thinking about the shortcomings of current nasal tube designs.

"When I was a resident, we would make a homemade bridle. It worked well, but I thought that there had to be an easier way," Dr. Kirn relates. "I had been using tissue expanders with magnetic port locators and thought, if we just used those magnets to loop the bridle around, we would have a good device. Sure enough, it works extremely well." Final development of the bridle was completed in concert with Applied Medical Technology who sells the device.

INSTRUMENTS THAT MAKE SENSE Dr. Kirn has also developed a few surgical instruments, including the endoscopic bipolar forceps used for endoscopic brow lifts.

"I couldn't find a cautery that worked very well for endoscopic brow lifts, so I developed this bipolar cautery," Dr. Kirn says. "This is an improvement on what was on the market because it's shaped so that it allows you to use it through a small endoscopic incision while accommodating the curvature of the skull, so that you can get where you need to be."