Basic laceration repair Flashcards
Laceration repair indications
reduces infection, scarring and patient discomfort
Methods of wound closure
staples- rapid placement, but do not allow for the meticulous wound-edge approximation
Suturing- most common
Adhesives- less painful and more quickly applied, useful for superficial lacerations that are not subject to large degrees of tension
Contraindications to primary closure
delays in repair may increase the risk of infection
The location of the wound and the degree of contamination may affect the acceptable interval between injury and repair
secondary closure should be strongly considered in wounds
that are grossly contaminated and for most puncture and bite wounds to the extremities
Consultation with a specialist should be considered
for wounds involving substantial loss or destruction of tissue, complicated lacerations on the hands or face, or wounds thought to involve serious injury to an underlying structure
The addition of epinephrine to the anesthetic
extends the duration of action, reduces bleeding, increases the amount of anesthetic that can be used, and increases the intensity of the block produced
Solutions with epinephrine should be avoided in
areas with a single blood supply, such as the nose, pinna of the ear, and penis
Sutures appropriate for facial lacerations
6.0 sutures
sutures used on the torso, arms, legs, hands and feet
3.0, 4.0, 5.0 sutures
1% lidocaine duration of action
30 minutes
1% lidocaine with epinephrine
60-240 minutes
0.25% Bupivacaine
240-480 minutes
Timing of suture removal for facial wounds
within 5 days to prevent scarring
Timing of suture removal for wounds of the scalp, torso, arms, legs, hands or feet
within 7-10 days
Timing of suture removal for wounds under tension such as overlying joints
within 10-14 days
