Laceration repair

Revision as of 23:15, 2 April 2011 by Jswartz (talk | contribs)

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

Wound Management

Sutures

Source

UpToDate

Retrieved from "https://www.wikem.org/w/index.php?title=Laceration_repair&oldid=1903"