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Skin Laceration
HISTORY:
Laceration
days
ago
Location:
right
left
hand
face
Event:
fall
direct blow
Treatments tried:
none
,
effective
ineffective
intense pain
heavy bleeding
swelling
bruising
redness
pus or discharge
fever
Other elements:
diabetes
immunodeficiency
Occupation:
Work-related injury:
yes
no
Tetanus vaccination:
up-to-date
incomplete
unvaccinated
EXAM:
General appearance:
well-appearing
Skin:
cm laceration,
linear
jagged edges
,
superficial
deep
,
clean
contaminated
,
active bleeding
no bleeding
,
erythema
, located on
ASSESSMENT:
Skin laceration
likely
suspected
possible
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
sutures
adhesive strips
tissue 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
5
7
10
days
- Follow-up in
days
weeks
for wound check
- Return if signs of infection develop such as redness, swelling, pus, or fever