lacerations

Question 1

complicated lacerations

Answer 1

second- versus third-degree perineal tear,

lip or eyelid lacerations involving margins,

arterial lacerations

Question 2

requiring more than simple sutures

Answer 2

flexor tendon lacerations,
open fractures,
bites to hands or face,

neurovascular injury,

foreign bodies

Question 3

do not close wounds that are..

Answer 3

at high risk of infx:
- bites
- contaminated wounds

Question 4

hx

Answer 4

Mechanism of injury
Age of injury
Contaminant or foreign body
Tetanus immunization/booster status
Allergies to anesthetics/antibiotics

Question 5

Sutures

Answer 5

6-0 for face, 3-0 for thick skin (back, scalp, palms, soles), 4-0 for rest

Question 6

procedure

Answer 6

wound irrigation

get out debris

primary closure

tetanus
antibio

Question 7

antibio animal bites

Answer 7

clavulin 875-125 q12h x 5d

Question 8

with animal bites consider

Answer 8

• post-exposure rabies vaccine and immunoglobulin within 24h if high risk (call public health, send animal to laboratory if available)

Question 9

with human bites consider

Answer 9

• Consider HIV/Hep B/C in human bites