Derm Procedures Flashcards
resting deformity
does not occur with partial tendon laceration
complete tendon laceration only
vascular injury
pallor, low pulse, decreased cap refill
hematoma
bruit
Foreign body evaluation
LOCALIZED pain or tenderness
patient complaint of FO must be heeded
Imaging is best (evaluate depth of wound)
c/i to wound closure
acute wound >6h old (EXCEPT ON FACE) Cannot remove debris active bleeding dead space under closure too much tension on wound
delayed primary closure
compromise between primary repair and allowing an acute wound to heal secondarily.
need to add a wet-to-dry dressing for 2-3 days
may close once everything has subsided
When not to use epi
fingers, toes, nose, penis, earlobes
TERMINAL BLOOD SUPPLY
Nylon suture
cheap, strong, and NON REACTIVE in skin
but it does require more knots
Polypropylene
stronger than nylon
synthetic and non-immunogenic
expensive
Stainless steel suture
only really used to close the thoracic cavvity
Catgut sutures
natural product that is derived from sheep or cattle
lasts for 5-7days
Chromic gut
cat gut treated w/ chromium salts to resist degradation
lasts 10-17days
best used in oral lesions
Vicryl (polyclactin)
synthetic carbohydrate that has good handling and easliy tied
lasts 3-4 wks (completely abs in 60-90days)
less reactive than catgut
Continuous suture
good: better for cosmetic, distributes dension
bad” if one breaks, they all break
Interrupted
good: if one breaks the wound wont open
bad: poor cosmetic result
Vertical mattress
good bc it promotes wound edge eversion, which promotes healing
horizontal mattress
strongest, place over joints or high motion areas
dermabond
basically just superglue
good for superficial, or facial wounds
good cosmetic result
Cant use over high motion or moist areas areas
incisional bx
shave or a punch or needle
extensional bx
entire area of the abnormal tissue is removed
Length is 3-4x Width