Laceration Repair Flashcards
Which anesthetic type is used?
1% lidocaine w/ or w/o epinephrine
when would you use epinephrine
reduce bleeding
extend duration of action
what are the concerns for using epinephrine?
can cut off blood supply
what anesthetic is used for longer duration?
bupivacaine
what equipment is used to repair a laceration?
saline
30/60-mL syringe with splash guard
skin-cleansing agent
sterile gauze
local anesthetic
5/10-mL syringe
25/30-gauge needle
needle holder
Adson-brown forceps
suture scissors
suture material
Can Betadine be used to wash the inside of an incision or laceration?
Can Betadine be used to wash the inside of an incision or laceration?
No
Angle of needle for insertion of lidocaine?
10-20 degree-between the dermis and hypodermis
Describe injecting lidocaine with epi
Needle is fully inserted, pull back on plunger to avoid pushing lidocaine into vessel, then push lidocaine in as you withdraw the needle. Look for tissue to elevate and blanch from lidocaine with epi
What material is best used to irrigate and wash a wound?
sterile saline
What PPE’s should be used
sterile gloves
mask
face sheild
How do you hold the needle holder?
Where do you grasp the needle?
2/3 way down the needle
What angle is the needle on the needle holder?
90
What angle does the needle enter the skin?
90
Which is bigger-bite width or bite depth?
depth
Which is better for healing-inversion or eversion of the skin?
eversion
How should the surgeon be oriented with the incision or laceration?
parallel
Do you hold the tissue with forceps while taking a bite of tissue?
no
Do you grab the needle with your sterile gloved fingers after the first bite?
no
How many times do you loop the suture material around the needle holder on the first throw of the surgeon’s knot?
2
How many loops on the next 2-4 throws?
1 loop
How long do you leave the tails?
1 cm
Describe “rule of halves”
divide the lesion in half and begin suturing there then divide it in half again to put your next suture
How would you Describe Spacing between sutures compared to the bite width?
equal
Is the Betadine left on after finishing the suturing?
no
List potential complications with a laceration repair
infection
tetnus
foreign body
wound dehiscence
unreccognized deep-structure injury
scar formation
When should suture’s be removed?
face 3-5 day
high tenstion 10-14 days
back or scalp, or extremites 7 days
List and describe aftercare
12-24 hours keep dry
cover laceration with nonadherent dressing
antibiotics
tetanus
