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Care of Acute Lacerations

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Family Medicine

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Abstract

The optimum management of lacerations requires knowledge of skin anatomy and the physiology of wound healing. Such knowledge facilitates proper management of wounds of varying depth and complexity. By understanding the healing process the family physician can maximize the options for repair and minimize the dangers of dehiscence and infection. The goals of primary closure are to stop bleeding, prevent infection, preserve function, and restore appearance. The patient always benefits from a physician who treats the patient gently, handles the tissue carefully, understands anatomy, and appreciates the healing process.1,2

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References

  1. Brietenbach KL, Bergera JJ. Principles and techniques of primary wound closure. Prim Care 1986;13:411–31.

    Google Scholar 

  2. Snell G. Laceration repair. In: Pfenninger JL, Fowler GC, editors. Procedures for primary care physicians. St. Louis: Mosby, 1994:12–19.

    Google Scholar 

  3. Bonadio WA, Wagner V. Efficacy of TAC topical anesthetic for repair of pediatric lacerations. Am J Dis Child 1988; 142:203–5.

    PubMed  CAS  Google Scholar 

  4. Hegenbarth MA, Altieri MF, Hawk WH, Green A, Ochsenschlager DW, O’Donnell R. Comparison of topical tetracaine, adrenaline, and cocaine anesthesia with lidocaine infiltration for repair of lacerations in children. Ann Emerg Med 1990;19:63–7.

    Article  PubMed  CAS  Google Scholar 

  5. Matsumoto AH, Reifsnyder AC, Hartwell GD, Angle JF, Selby JB, Tegtmeyer CJ. Reducing the discomfort of lidocaine administration through pH buffering. J Vasc Intery Radiol 1994;5:171–5.

    Article  CAS  Google Scholar 

  6. Bartfield JM, Ford DT, Homer PJ. Buffered versus plain lidocaine for digital nerve blocks. Ann Emerg Med 1993;22:216–19.

    Article  PubMed  CAS  Google Scholar 

  7. Mader TJ, Playe SJ, Garb JL. Reducing the pain of local anesthetic infiltration: warming and buffering have a synergistic effect. Ann Emerg Med 1994;23:550–4.

    Article  PubMed  CAS  Google Scholar 

  8. Brogan BX Jr, Giarrusso E, Hollander JE, Cassara G, Mararnga MC, Thode HC. Comparison of plain, warmed, and buffered lidocaine for anesthesia of traumatic wounds. Ann Emerg Med 1995;26:121–5.

    Article  PubMed  Google Scholar 

  9. Murakami CS, Odland PB, Ross BK. Buffered local anesthetics and epinephrine degradation. J Dermatol Surg Oncol 1994;20:192–5.

    PubMed  CAS  Google Scholar 

  10. Thompson KD, Welykyj S, Massa MC. Antibacterial activity of lidocaine in combination with a bicarbonate buffer. J Dermatol Surg Oncol 1993;19:216–20.

    PubMed  CAS  Google Scholar 

  11. Ernst AA, Marvez-Valls E, Mall G, Patterson J, Xie X, Weiss SJ. 1% Lidocaine versus 0.5% diphenhydramine for local anesthesia in minor laceration repair. Ann Emerg Med 1994; 23:1328–32.

    Article  PubMed  CAS  Google Scholar 

  12. Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practical guidelines for sedation and analgesia by nonanesthesiologists. Anesthesiology 1996;84:459–71.

    Google Scholar 

  13. Qureshi FA, Mellis PT, McFadden MA. Efficacy of oral ketamine for providing sedation and analgesia to children requiring laceration repair. Pediatr Emerg Care 1995;11: 93–7.

    Article  PubMed  CAS  Google Scholar 

  14. Connors K, Terndrup TE. Nasal versus oral midazolam for sedation of anxious children undergoing laceration repair. Ann Emerg Med 1994;24:1074–9.

    Article  PubMed  CAS  Google Scholar 

  15. Shane SA, Fuchs SM, Khine H. Efficacy of rectal midazolam for the sedation of preschool children undergoing laceration repair. Ann Emerg Med 1994;24:1065–73.

    Article  PubMed  CAS  Google Scholar 

  16. Schutzman SA, Burg J, Liebelt E, et al. Oral transmucosal fentanyl citrate for the premedication of children undergoing laceration repair. Ann Emerg Med 1994;24:1059–64.

    Article  PubMed  CAS  Google Scholar 

  17. Clinical considerations in the use of fentanyl oralet. North Chicago, IL: Abbott Laboratories, 1995:1–16.

    Google Scholar 

  18. Gamis AS, Knapp JF, Glenski JA. Nitrous oxide analgesia in a pediatric emergency department. Ann Emerg Med 1989;18: 177–81.

    Article  PubMed  CAS  Google Scholar 

  19. Moy RL, Lee A, Zolka A. Commonly used suture materials in skin surgery. Am Fam Physician 1991;44:2123–8.

    PubMed  CAS  Google Scholar 

  20. Epperson WJ. Suture selection. In: Pfenninger JL, Fowler GC, editors. Procedures for primary care physicians. St Louis: Mosby, 1994:3–6.

    Google Scholar 

  21. Moy RL, Waldman B, Hein DW. A review of sutures and suturing techniques. J Dermatol Surg Oncol 1992;18:785–95.

    PubMed  CAS  Google Scholar 

  22. Jones JS, Gartner M, Drew G, Pack S. The shorthand vertical mattress stitch: evaluation of a new suture technique. Am J Emerg Med 1993;11:483–5.

    Article  PubMed  CAS  Google Scholar 

  23. Ditmars DM Jr. Finger tip and nail bed injuries. Occup Med 1989;4:449–61.

    PubMed  Google Scholar 

  24. Edlich RF, Thacker JG, Silloway RF, Morgan RF, Rodeheaver GT. Scientific basis of skin staple closure. In: Haval Mutaz B,editor. Advances in plastic and reconstructive surgery. Chicago: Year Book, 1986:233–71.

    Google Scholar 

  25. Osmond MH, Klassen TP, Quinn JV. Economic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations. J Pediatr 1995;126(6):892–5.

    Article  PubMed  CAS  Google Scholar 

  26. Quinn JV, Drzewiecki A, Li MM, et al. A randomized, controlled trial comparing tissue adhesive with suturing in the repair of pediatric facial lacerations. Ann Emerg Med 1993;22: 1130–5.

    Article  PubMed  CAS  Google Scholar 

  27. Applebaum JS, Zalut T, Applebaum D. The use of tissue adhesive for traumatic laceration repair in the emergency department. Ann Emerg Med 1993;22:1190–2.

    Article  PubMed  CAS  Google Scholar 

  28. Fisher AA. Reactions to cyanoacrylate adhesives: “instant glue.” Cutis 1995:18–22,46,58.

    Google Scholar 

  29. Lewis KT, Stiles M. Management of cat and dog bites. Am Fam Physician 1995;52:479–85.

    PubMed  CAS  Google Scholar 

  30. Centers for Disease Control. Morb Mortal Wkly Rep MMWR 1991 Aug 8;40(RR-10):1–28.

    Google Scholar 

  31. Richardson JP, Knight AL. The management and prevention of tetanus. J Emerg Med 1993;11:737–42.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Bryan Campbell
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  2. George F. Snell
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Editor information

Editors and Affiliations

  1. Department of Family Medicine, Oregon Health Sciences University, Portland, OR, 97201, USA

    Robert B. Taylor M.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA

    Alan K. David M.D. (The Fred Lazarus, Jr., Professor and Director) (The Fred Lazarus, Jr., Professor and Director)

  3. Department of Family Medicine, St. John’s Mercy Medical Center, St. Louis, MO, 63141, USA

    Thomas A. Johnson Jr. M.D. (Chairman) (Chairman)

  4. Department of Family Medicine, University of Mississippi School of Medicine, Jackson, MS, 39216, USA

    D. Melessa Phillips M.D. (Professor and Chairman) (Professor and Chairman)

  5. Department of Family Medicine, University of California—Irvine College of Medicine, Orange, CA, 92697, USA

    Joseph E. Scherger M.D., M.P.H. (Associate Dean for Primary Care and Chair) (Associate Dean for Primary Care and Chair)

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© 1998 Springer Science+Business Media New York

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Campbell, B., Snell, G.F. (1998). Care of Acute Lacerations. In: Taylor, R.B., David, A.K., Johnson, T.A., Phillips, D.M., Scherger, J.E. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2947-4_49

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  • DOI: https://doi.org/10.1007/978-1-4757-2947-4_49

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2949-8

  • Online ISBN: 978-1-4757-2947-4

  • eBook Packages: Springer Book Archive

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