Lacerations/Foreign Bodies-Ross

Question 1

What do you need to treat ALL cat bites with? Why?

Answer 1

Amoxicillin-clavulanate (Augmentin) to cover for Pasteurella

Question 2

What do you use to treat Plantar puncture wounds that get infected? Why?

Answer 2

Ciprofloxacin for Pseudomonas (not Augmentin).

Question 3

What local anesthetics should be used during wound closure?

Answer 3

Use bupivacaine for most procedures (long-acting).

Use Lidocaine for mouth and digits if they will need to be used within 4 hours.

Question 4

Where should you inject the anesthesia during wound closure?

Answer 4

Inject slowly through CUT margins and start proximal (don’t go into the intact skin)

Question 5

When should you consider delayed primary closure?

Answer 5

Consider delayed primary closure after 4 days for wounds at high risk of infection

Question 6

What size suture should you use on the FACE and when should they be removed?

Answer 6

remove in 4-5 days w/ 6-O nylon (smaller sutures)

Question 7

What size suture should you use on the SCALP, TRUNK, EXTREMITIES and when should they be removed?

Answer 7

remove in 7-9 days w/ 4-O nylon

Question 8

What size suture should you use on the HANDS and when should they be removed?

Answer 8

remove in 10-12 days w/ 4-O and 5-O nylon
• Over the knuckle = 12 days
• Less tension areas = 10 days

Question 9

What size suture should you use on the FEET (soles) and when should they be removed?

Answer 9

remove in 14 days w/ 4-O nylon

Question 10

What pt populations heal more slowly?

Answer 10

patients on steroids, with renal failure and diabetes may heal more slowly

Question 11

What wounds heal with scarring? How should you advise the pt?

Answer 11

ALL wounds heal with some scarring…scars usually become much less noticeable 6-12 months after suture removal.

Question 12

What should you worry about with wounds through the vermillion border?

Answer 12

cosmetics.