Page 97 - Radiology Book

lacerations
95
lacerations
Laceration
Anesthesia
Suture Size and Type
Remove
Hand
1-2% PLAIN Lido or regional block with 50/50 mix of 1% Lido
and Bupivicaine
· S: 5-0 - Nylon · D: 5-0 - Vicryl
10-14 days 12-14 days 7-9 days 12-14 days
Foot/Sole
· S: 3-0 or 4-0 - Nylon
· D: Absorb. 4-0 - Vicryl
Nail Beds
· S: 4-0 Nylon-corners of nail · D: 6-0 or 7-0 - Vicryl-nailbed
Extremity
1% Lido with Epinephrine
· S: 4-0 - Nylon
· D: 3-0 or 4-0, Vicryl
As a general rule, lacerations on any part of the body may be closed for up to 12 hours following the injury.
Facial wounds may be closed up to 72 hours. Can add Bupivicaine in 50/50 mix with lidocaine for prolonged anesthetic. Digital blocks are preferred for any nger laceration, including the nail beds. No Epinephrine use on nger, toes, ear lobes, nose, or penis.
Primary Closure (Intention): The immediate closure of a clean wound without delay.
Secondary Closure (Intention): When the wound is allowed to remain open and heal by granulation, epithelization, and contraction –
used for dirty wounds to prevent abscess formation.
Teritary Closure (Intention, or Delayed Primary Closure): When the wound is allowed to remain open for period of time (2-7 days) allowing for debridement and other wound care to reduce bacteria prior to closure.
D: DEEP (buried) Absorbable Sutures 1. Brand.......................Generic
2. Monocryl ................Polyglecaprone 3. Vicryl .......................Polyglactin-910 4. PDS ........................Polydioxanone
S: SUPERFICIAL, Mono. Nonabsorbable
1. Ethilon ....................Nylon
2. Polypropylene .........Prolene
Super cial Facial lesions .............6-0 Nylon Low skin tension areas ................5-0 Nylon High skin tension areas ...............4-0 Nylon
SutureS