Laceration repair: Difference between revisions
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Anesthesia | ==Anesthesia== | ||
*Lidocaine (1% solution (10mg/mL) | |||
* Lidocaine (1% solution (10mg/mL) | **Maximum safe dose = 300mg | ||
* Maximum safe dose = 300mg | *Lidocaine + epinephrine | ||
* Lidocaine + epinephrine | **Maximum safe dose = 500mg | ||
* Maximum safe dose = 500mg | **Delays healing, increases infection risk? | ||
* Delays healing, increases infection risk? | *Bupivicaine (0.25%) | ||
* Bupivicaine (0.25%) | **Maximum safe dose = 175mg | ||
* Maximum safe dose = 175mg | *Bupivicaine + epinephrine | ||
* Bupivicaine + epinephrine | **Maximum safe dose = 225mg | ||
* Maximum safe dose = 225mg | |||
* To decrease pain of injection: | * To decrease pain of injection: | ||
* Buffer lidocaine with bicarbonate (1mL bicarb: | ** Buffer lidocaine with bicarbonate (1mL bicarb:9mL lidocaine) | ||
==Skin Preparation== | |||
Skin Preparation | |||
* Avoid betadine/chlorhexadine in wound | * Avoid betadine/chlorhexadine in wound | ||
* Not necessary to remove hair (if do, avoid using razor) | * Not necessary to remove hair (if do, avoid using razor) | ||
==Wound Preparation== | |||
Wound Preparation | |||
* Debridement is most important step in reducing infection/ promoting healing | * Debridement is most important step in reducing infection/ promoting healing | ||
* High pressure irrigation (can be achieved with 19 gauge syringe) | *Irrigation | ||
* Tap water is as effective as sterile water/ normal saline | **High pressure irrigation is best (can be achieved with 19 gauge syringe) | ||
* Irrigation optional for face/scalp wound as long as: | **Tap water is as effective as sterile water/ normal saline | ||
* Not a bite wound | **Irrigation optional for face/scalp wound as long as: | ||
* Not a contaminated wound | ***Not a bite wound | ||
* Not older than 6 hours | ***Not a contaminated wound | ||
***Not older than 6 hours | |||
==See Also== | ==See Also== | ||
[[Wound Management]] | |||
[[Sutures]] | |||
==Source== | ==Source== | ||
UpToDate | UpToDate | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Revision as of 23:15, 2 April 2011
Anesthesia
- Lidocaine (1% solution (10mg/mL)
- Maximum safe dose = 300mg
- Lidocaine + epinephrine
- Maximum safe dose = 500mg
- Delays healing, increases infection risk?
- Bupivicaine (0.25%)
- Maximum safe dose = 175mg
- Bupivicaine + epinephrine
- Maximum safe dose = 225mg
- To decrease pain of injection:
- Buffer lidocaine with bicarbonate (1mL bicarb:9mL lidocaine)
Skin Preparation
- Avoid betadine/chlorhexadine in wound
- Not necessary to remove hair (if do, avoid using razor)
Wound Preparation
- Debridement is most important step in reducing infection/ promoting healing
- Irrigation
- High pressure irrigation is best (can be achieved with 19 gauge syringe)
- Tap water is as effective as sterile water/ normal saline
- Irrigation optional for face/scalp wound as long as:
- Not a bite wound
- Not a contaminated wound
- Not older than 6 hours
See Also
Source
UpToDate