Wound Repair

Indications: see timing of wounds eval below

Contraindications: contaminated wounds or bite wounds

PEARLS: Evert edges

Use layered closure for deep lacerations

Pitfalls:

1. Tendon injuries – easily missed – wounds in the vicinity of important structures should be gently explored. If visualization is difficult or the anatomy complex, then an appropriate surgeon should be consulted.
   1. A missed flexor injury of the finger may result in long term disability.
2. Digital nerve injuries – Sensory testing is best done using two-point discrimination.
3. Tetanus prophylaxis not addressed
4. Antibiotics – There is NO evidence (based on many clinical studies and a meta-analysis) to support the routine use of prophylactic oral, IM or IV antibiotics to prevent wound infections after closure of routine lacerations.

You have to click watch on YouTube – start at 6:06