Skin Laceration

HISTORY:

Laceration ‍ ‍days ago

Location: ‍rightleft ‍ ‍handface

Event: ‍ ‍falldirect blow

Treatments tried: ‍none, ‍effectiveineffective

‍intense pain

‍heavy bleeding

‍swelling

‍bruising

‍redness

‍pus or discharge

‍fever, up to ‍°, over ‍ ‍hoursdays

Occupation: ‍

Work-related injury: ‍yesno

Tetanus vaccination: ‍up-to-dateincompleteunvaccinated



EXAM:

General appearance: ‍well-appearing

Skin: ‍no rash



ASSESSMENT:

‍Skin laceration ‍likelysuspectedpossible

DDx: ‍



PLAN:

- X-ray if foreign body or fracture suspected

Laceration repair:

- Local anesthesia with ‍lidocaine ‍cc ‍locally

- Cleaning and irrigation with normal saline

- Exploration of wound

- Closure with ‍suturesadhesive stripstissue adhesive

- Dressing with antibiotic ointment

- ‍Topical antibiotics

- ‍Oral antibiotics

- ‍Analgesics

- Tetanus vaccination

- Wound dressing

- Education on wound care

- Referral to plastic surgeon for complex lacerations

- Suture removal in ‍5710 days

- Follow-up in ‍ ‍daysweeks for wound check

- Return if signs of infection develop such as redness, swelling, pus, or fever