Minor Trauma Flashcards
Rank the following from highest to lowest amount of devitalised tissue
Blunt trauma 90 degrees
Knife/shear force
Blunt trauma less than 90 degrees
Knife/shear force
Blunt trauma less than 90 degrees
Blunt trauma 90 degrees
Which of the following has the highest risk of infection?
Shear force
Blunt trauma 90 degrees
Blunt traums < 90 degrees
Blunt trauma 90 degrees
When does a laceration regain its strength?
5% of their previous strength 2 weeks after injury, 30% after 1 to 2 months, and full tensile strength 6 to 8 months after the original injury
When does a trauma have the potential for scarring?
Deeper than the dermis
When does collagen synthesis occur after a lac?
Collagen synthesis begins within 48 hours of the injury and reaches a peak within the following week
When will a scar reach maturity/stability?
6-9 mo
What is the % of infection of sutured wounds?
2%
When should use of antibiotics be considered for a wound?
bites, devitalized tissue, and heavily contaminated
For whom is a tetanus vaccine indicated after a skin lac?
< 3 doses of vaccine
3 initial doses but no booster x 10 years
3 initial doses but > 5y since last
For whom is a tetanus Ig indicated after a skin lac?
< 3 doses of vaccine w dirty wound
Up to how long after injury can a facial lac be repaired?
24hrs
Which wounds ahould be closed within 6 hrs?
high risk for infection such as those in anatomic locations with poor blood supply, contaminated or crush wounds, and those involving immunocompromised hosts
What wounds should NEVER be closed?
Bites or gotten on a farm in an immunocompromised host
How much irrigation is required per cm of wound?
100mL/cm of laceration
What kind of sutures are best for areas with high dynamic and static tension?
Synthetic absorbable
What size sutures should be used for the following situations: Fascia Subcutaneous tissue Oral mucosa Face Scalp, trunk, extremities Thick skin & over large joints
Fascia - 3-0 SubC - 4-0 Oral mucosa - 3-0 to 4-0 Face - 6-0 Scalp/trunk/extremities - 4-0 Thick skin/joints - 3-0 to 4-0
When is a vertical mattresss stitch useful?
deep wounds in which it may be difficult to tie a simple, deep, interrupted suture
How long should original dressing stay on after suture repair?
12-24hrs
Why are topical antibiotics recommended after suturing?
prevent infection, help with reepithelialization, decrease crust formation, prevent wound dehiscence, and aid in suture removal
What antibiotic should be given for wounds secondary to mammalian bite?
Amox-clav
What antibiotic should be given for open fractures?
Amox-clav + aminoglycoside
When should non absorbable sutures be removed?
Neck 3–4 Face 4–5 Scalp 7–10 Upper extremities, trunk 7–10 Lower extremities 8–10 Joint surface 10–14
What size & location of lip laceration does not require repair?
< 2cm, inner aspect of lip without communication to skin surface
What type of suture material is best to close lacs 2-3cm in length with a flap in the buccal mucosa?
coated vicryl 4-0 on round needle
