#9 Wound cx

Question 1

Lip laceration empiric tx (3)

Answer 1

Clindamycin 300 mg BID
Pen Vee K 500 mg QID
Augmentin 875 mg TID
—all 5-7 days

Question 2

Cat and human bite empiric tx: (1)

Answer 2

Augmentin 875 BID x 10 days (first dose in ED)

• -12-24 hr wound f/u
• -unasyn 2nd line 3.375g IV

Question 3

MC abx for complex wounds:

Answer 3

cephalexin (keflex) 500 mg TID x 5d

Question 4

Wounds high risk for Infx: 7

Answer 4

1- Potential retained fb
2- Lacerations near joint capsules
3- Lacerations overlying tendons(even with normal ROM)
4- Lacerations caused by crushing forces
5- Bite Laceration
6- Lip lacerations
7- puncture wounds

Question 5

if glass, gravel or metallic foreign bodies are suspected, this is rq. prior to exploration

Answer 5

XR

Question 6

simplest and most effective mechanism for hemostasis

Answer 6

Direct pressure

Question 7

3 fx in ER for hemostats:

Answer 7

1- Direct clamp small BV for hemorrhage control
2- Debriding wounds
3- Deep areas of a wound: exposing, exploring, and visualizing

Question 8

Simple excision

Answer 8

Minimal excision of macerated and devitalized tissue

Question 9

Full wound excision

Answer 9

Involves more extensive excision of devitalized and contaminated epidermal, dermal and subcutaneous tissues.

Question 10

Number of sutures depends on

Answer 10

length
location and
shape of laceration

Question 11

Tongue laceration wounds requiring closure with an absorbable suture: 4

Answer 11

• Large laceration > 1 cm
• Large, gapping wounds, esp w. tongue at rest
• Wounds rq suturing for hemostasis
• Anterior split tongue laceration