Laceration Repair

Question 1

Which anesthetic type is used?

Answer 1

1% lidocaine w/ or w/o epinephrine

Question 2

when would you use epinephrine

Answer 2

reduce bleeding
extend duration of action

Question 3

what are the concerns for using epinephrine?

Answer 3

can cut off blood supply

Question 4

what anesthetic is used for longer duration?

Answer 4

bupivacaine

Question 5

what equipment is used to repair a laceration?

Answer 5

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

Question 6

Can Betadine be used to wash the inside of an incision or laceration?

Question 7

Can Betadine be used to wash the inside of an incision or laceration?

Answer 7

No

Question 8

Angle of needle for insertion of lidocaine?

Answer 8

10-20 degree-between the dermis and hypodermis

Question 9

Describe injecting lidocaine with epi

Answer 9

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

Question 10

What material is best used to irrigate and wash a wound?

Answer 10

sterile saline

Question 11

What PPE’s should be used

Answer 11

sterile gloves
mask
face sheild

Question 12

How do you hold the needle holder?

Answer 12

Question 13

Where do you grasp the needle?

Answer 13

2/3 way down the needle

Question 14

What angle is the needle on the needle holder?

Answer 14

90

Question 15

What angle does the needle enter the skin?

Answer 15

90

Question 16

Which is bigger-bite width or bite depth?

Answer 16

depth

Question 17

Which is better for healing-inversion or eversion of the skin?

Answer 17

eversion

Question 18

How should the surgeon be oriented with the incision or laceration?

Answer 18

parallel

Question 19

Do you hold the tissue with forceps while taking a bite of tissue?

Answer 19

no

Question 20

Do you grab the needle with your sterile gloved fingers after the first bite?

Answer 20

no

Question 21

How many times do you loop the suture material around the needle holder on the first throw of the surgeon’s knot?

Answer 21

2

Question 22

How many loops on the next 2-4 throws?

Answer 22

1 loop

Question 23

How long do you leave the tails?

Answer 23

1 cm

Question 24

Describe “rule of halves”

Answer 24

divide the lesion in half and begin suturing there then divide it in half again to put your next suture

Question 25

How would you Describe Spacing between sutures compared to the bite width?

Answer 25

equal

Question 26

Is the Betadine left on after finishing the suturing?

Answer 26

no

Question 27

List potential complications with a laceration repair

Answer 27

infection
tetnus
foreign body
wound dehiscence
unreccognized deep-structure injury
scar formation

Question 28

When should suture’s be removed?

Answer 28

face 3-5 day
high tenstion 10-14 days
back or scalp, or extremites 7 days

Question 29

List and describe aftercare

Answer 29

12-24 hours keep dry
cover laceration with nonadherent dressing
antibiotics
tetanus