Lacerations Flashcards

1
Q

What are the complicated lacerations that may require special skills

A

3rd degree perineal tears
Lip or eyelid lacs - Lip - muscle, then vermilion border, then rest
Arterial lacs
PMH - DM, immunosuppressed, keloid former

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2
Q

Which lacs are at risk of Tetanus?

A

> 6hrs, >1cm deep
Crush, burn, gunshot, puncture
Contaminated, FB

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3
Q

How to determine incision length, width + placement

A

Ellipset w/ 30 corners, length 3x longer than width
Use Langer’s lines

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4
Q

Types of suture

A

Ethilon + Prolene – non-dissolvable, Vicryl – dissolvable
Face - fast cut, everywhere else - chromic
Deep - muscle = vicryl, subcut = monocryl

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5
Q

Suture sizes + when to use

A

6-0 = face
5-0 = fingers + toes
4-0 = arms + legs
3-0 = torso + back
2-0 = scalp

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6
Q

lidocaine duration + max dose (w + w/o epi)

A

Lidocaine
46-60 mins
5mg/kg (28ml)

Lido w/ epi
2-6 hrs
7mg/kg (50ml)

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7
Q

mepivacaine onset, duration + max dose

A

3-5 mins
45-90 mins
7mg/kg (50ml)

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8
Q

bupivacaine onset, duration + max dose

A

5 mins
2-4 hrs
3mg/kg (70ml)

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9
Q

When to remove sutures

A

Scalp = 2 weeks
Face = 5 days
Hands = 5 days
Arms = 10 days
Legs = 2 weeks
Chest + torso = 2 weeks
Joints = 2 weeks

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10
Q

Bacteria in dog/ cat bites

A

Pasteurella multocida
S aureus
S viridans

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11
Q

Rx for dog/ cat bites

A

Consider rabies IgG (20 IU/kg around wound or IM)
Rabies vaccine 1ml deltoid day 3, 7, 14, 28
Rx: tetanus, amox-clav or doxy

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12
Q

Bacteria in human bites

A

Staph
Alpha-hemolytic strep
Eikenella corrodens
Bacteroides

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13
Q

Complication of lacerations

A

Flexor tendon lacs
Open fractures
Neurovascular injury
FB

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14
Q

How to optimise cosmetic results

A

Layer closure
Revise if needed
Regional anesthesia

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15
Q

Making lido less painful

A

buffer with bicarbonate, warm the lido, inject slowly at perpendicular angle to skin

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