Laceration Repair for Emergency Physicians
Correspondence should be addressed to Shannon Toohey, MD, MAEd at stoohey@uci.edu
DOI: https://doi.org/10.21980/J8TP7K
ABSTRACT:
Audience:
This TBL is appropriate for medical students and all levels of residents.
Introduction:
Lacerations are one of the most common chief complaints presenting to the emergency department, representing 8.2% of ED visits.1 Wound management is one of the emergency medicine milestones.2 As such, it is an essential skill to cover when training emergency physicians. Historically, training programs correlate competency with quantity of procedures, with little focus on the quality.3
Objectives:
By the end of this educational session, the learner will:
- Understand indications and contraindications for suture repair of lacerations.
- Compare when various types of wound repair are appropriate: such as sutures, staples, tissue adhesive and tissue tape, as well as what size of suture material is appropriate depending on the location of the laceration on the body.
- List the appropriate types and sizes of suture for various locations and types of lacerations.
- Understand the definitions of the three types of wound closure (primary, secondary and delayed primary) and when they are appropriate.
- Understand the basics of local anesthetic including which anesthetic to use and the maximum dose for each.
- Understand when sutures should be removed.
- List various suturing techniques and their indications.
- Improve comfort levels in performing various suturing techniques including: simple interrupted, horizontal mattress, vertical mattress, and corner repair. If desired, instructors can individually assess the learner sutures using the attached complete validated suture checklist to show proficiency in these techniques. Please see the brief wrap-up section at the end of the manuscript.
Method:
This is an mTBL (modified team based learning) session.
Topics:
Wound repair, lacerations, suturing.
