![]() ![]() The outcomes of laceration repair depend on the mechanism, location, and complexity. If they become infected, the pharmacist should make antibiotic recommendations to the clinician based on local resistance as well as custom and practice. Pharmacists can make antibiotic recommendations as well as for pain and perform medication reconciliation. Nursing can work with applying and/or changing wound dressings and administering medication for pain control and antimicrobial agents. ![]() ![]() If the nurse notices complications such as infection or dehiscence, they should refer the patient back to the clinician. These patients require education about wound care and dressing changes. There are many instances where a laceration may not be safe to close, and in such situations, a wound care nurse should be involved to follow the patient. Wounds with substantial concern about the cosmetic outcome nonsterile gloves has been examined by many studies, and found that due to the contaminated nature of lacerations at presentation, there is no statistical difference in infection with the use of nonsterile gloves. Steri-strips are another alternative for primary closure of lacerations with no tension and not overlying a joint, but due to the requirement of added adhesives such as benzoin, there is a risk of local skin reaction that reduces their functionality for lacerations care. The most significant concern for their use is the successful closure of the wound, which hinges on appropriate cleaning and preparation of the wound. The use of tissue adhesives can be an option when the laceration overlies an area with minimal tension and is easily approximated. Due to the higher risk of scarring, staples should only be used on thicker skin and when appropriate, follow up can be obtained for their removal. The use of staples for the closure of scalp lacerations is a quick and secure method of care. nonabsorbable suture materials in the external closure of lacerations produces similar infection rates and aesthetic outcomes over the long term. Current studies have shown that the selection of absorbable gut vs. The decision between absorbable and nonabsorbable sutures will depend on the depth and method planned for closure. The selection of repair material varies based on the location, depth, length, and width of the laceration. However, current research shows the concerns of local ischemia to be unsupported. The use of epinephrine with local anesthetic was previously cautioned in fingers, toes, nose, penis, and ears. If there is a concern for amide allergies, the use of ester anesthetics or preservative-free amides should be options as reactivity is thought to be due to the preservatives. The selection of local anesthetic is dependent on patient allergies, accessibility, and location of the injury. Necessary supplies required for any laceration repair include but are not limited to the local anesthetic drawn up with a small gauge needle (greater than 27 gauge), needle holders, forceps, scissors, gauze, and the appropriate closure device (suture, staple, glue) for the wound. The equipment required for the closure of lacerations can vary depending on the location and characteristics of the wound.
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