CHAPTER 42: Face and Scalp Lacerations Flashcards
Three common principles guide repair of facial and scalp laceration
1) Cleanse, irrigate, and remove foreign material
2) Limit debridement of skin edges
3) Consider regional nerve blocks or topical anesthesia
Indications for Tissue Adhesives on the Face (Table 42-1 page 285)
- Tension (minimal)
- Epidermal closure only (no mucosa)
- Not a hair-covered area
Mnemonic: TEN
TRUE or FALSE?
Incidence of facial fractures is high in patients with isolated facial trauma
FALSE
In most patients with isolated facial trauma resulting in lacerations, the incidence of facial fractures is low, especially in children
Primary closure of facial & scalp lacerations can usually be done in wounds up to —?— hours after the injury,
up to 24 hours post-injury
Facial and scalp lacerations have a low incidence of postrepair infection, so primary closure can usually be done in wounds up to 24 hours after the injury,11-13 including most bite wounds
Eyelid injuries within —?— mm of the medial canthus are at risk for canalicular laceration
Within 6 to 8 mm of the medial canthus
Especially if associated with medial wall blowout fractures
Injuries to be referred to an ophthalmologist or oculoplastic specialist
(1) involving the inner surface of the lid
(2) across lid margins
(3) lacrimal duct
(4) associated with ptosis
(5) extending into the tarsal plate
The most common fracture in victims of domestic violence and assault
Nasal fracture
Clinical features that suggests a basilar skull fracture
Hemotympanum
Otorrhea (CSF)
Mastoid Ecchymoses
Mnemonic: HOME base (basilar)
Is a potentially damaging complication after repair of auricular lacerations
Perichondral hematoma
The cosmetically important junction of the skin and the red portion of the lip
Vermilion border
TRUE or FALSE?
Mucosal lip lacerations need to be sutured always
FALSE
Mucosal lip lacerations may not need to be sutured if they are isolated and the wound edges spontaneously approximate
Indications for intraoral lacerations
- Large enough to trap food particles
* Have a tissue flap that interferes with chewing
Suspect parotid duct injury when the wound —?—
- Crosses a line from the tragus to the corner of the mouth
* Posterior to a vertical line downward from the lateral canthus
Scalp sutures or staples are removed in —?— days
14 days
Nonabsorbable percutaneous sutures in the forehead, external ear, or lips are removed in —?— days
5 days
