Fluorouracil wraps, also known as chemowraps, are an in-office occlusive treatment for extensive field treatment for actinic keratoses and intraepidermal carcinomas . They are most often used to treat severely sun damaged lower legs. After cleansing the area to be treated, a thick coat of fluorouracil cream is applied to scaly lesions and surrounding skin, often circumferentially around the limb. About 10 to 20 g of 5-FU is used for each limb. Paraffin gauze is applied over the fluorouracil cream to areas of movement (eg ankle) as protection. The limb is then carefully bandaged using loose layers of zinc oxide (to improve healing and reduce pain), cotton conforming bandage and crepe or self-adherent roll for compression .
All media require collection of an adequate sample of infected material. Scale may be collected in a manner similar to that used for the KOH preparation or with a cotton swab. The swab must first be moistened with sterile water and then rubbed vigorously over the active border of the lesion. This method is best used when the lesion is not scaly or when the use of a blade or slide is impractical. 19 The physician performing the culture must comply with stricter CLIA regulations. Performing cultures requires a level of certification that necessitates a laboratory inspection.