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Knight and Wedge illustrate an important and familiar problem with marking limbs preoperatively with arrows or symmetric symbols.1 I have taken to marking limbs with either my initials or my signature. I insist that residents under supervision do this before I check the patient. Thus, even if the signature is barely legible, its owner, who is also the operating surgeon, can determine which is the original signature and which is the transferred mirror image.
I encourage each operating surgeon to consider this approach as a practical and safe marking method.
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