Difference between revisions of "Laceration repair"

(Created page with "Anesthesia * Lidocaine (1% solution (10mg/mL) * Maximum safe dose = 300mg * Lidocaine + epinephrine * Maximum safe dose = 500mg * Delays healing, increases infection risk? * B...")
 
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Anesthesia
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==Anesthesia==
 
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*Lidocaine (1% solution (10mg/mL)  
* Lidocaine (1% solution (10mg/mL)  
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**Maximum safe dose = 300mg
* Maximum safe dose = 300mg
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*Lidocaine + epinephrine  
* Lidocaine + epinephrine  
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**Maximum safe dose = 500mg
* Maximum safe dose = 500mg
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**Delays healing, increases infection risk?
* Delays healing, increases infection risk?
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*Bupivicaine (0.25%)  
* Bupivicaine (0.25%)  
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**Maximum safe dose = 175mg
* Maximum safe dose = 175mg
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*Bupivicaine + epinephrine  
* Bupivicaine + epinephrine  
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**Maximum safe dose = 225mg
* Maximum safe dose = 225mg
 
 
   
 
   
 
 
* To decrease pain of injection:  
 
* To decrease pain of injection:  
* Buffer lidocaine with bicarbonate (1mL bicarb: 10mL lidocaine)
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** Buffer lidocaine with bicarbonate (1mL bicarb:9mL lidocaine)
 
   
 
   
 
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==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)
 
   
 
   
 
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==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)
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*Irrigation
* Tap water is as effective as sterile water/ normal saline
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**High pressure irrigation is best (can be achieved with 19 gauge syringe)
* Irrigation optional for face/scalp wound as long as:
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**Tap water is as effective as sterile water/ normal saline
* Not a bite wound
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**Irrigation optional for face/scalp wound as long as:
* Not a contaminated wound
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***Not a bite wound
* Not older than 6 hours  
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***Not a contaminated wound
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***Not older than 6 hours  
 
   
 
   
 
 
==See Also==
 
==See Also==
  
 +
[[Wound Management]]
  
Trauma: Wound Management
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[[Sutures]]
 
 
Trauma: 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

Wound Management

Sutures

Source

UpToDate