Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Fundamentals of Surgical Practice
The Surgical Patient
Approach to the surgical patient
The paediatric patient
Surgical Techniques
Tissue Handling
Suture and suture technique
Prophylaxis
Basic Surgical Procedures
Wound management
Specific lacerations and wounds
Burns
Foreign bodies
Cellulitis and abscess
Excision and biopsies
Specific Lacerations and Wounds
 


> BLOOD VESSELS, NERVES AND TENDONS
> FACIAL LACERATIONS
> LIP LACERATIONS
> WOUNDS OF THE TONGUE
> EAR AND NOSE LACERATIONS
>

NOSE BLEEDS (EPISTAXIS)

> OCULAR TRAUMA
> OPEN FRACTURES
> TENDON LACERATIONS
> ANIMAL BITES



LIP LACERATIONS

Small lacerations of the buccal mucosa do not require suturing. Advise the patient to rinse the mouth frequently, particularly after meals. Local anaesthesia is adequate for lacerations that do require suturing. For good cosmesis, proper anatomical alignment of the vermillion border is essential. To achieve this alignment, place the first stitch at the border (Figure 5.8). This region may be distorted by the swelling caused by local anaesthetic or blanched by adrenaline, so to assure accuracy, premark the vermillion border with a pen.

Figure 5.8
Figure 5.8



After the initial suture is inserted, repair the rest of the wound in layers, starting with the mucosa and progressing to the muscles and finally the skin (Figures 5.9, 5.10). Use interrupted 4/0 or 3/0 absorbable suture for the inner layers and 4/0 or 5/0 monofilament non-absorbable suture in the skin.

Figure 5.9
Figure 5.9
Figure 5.10
Figure 5.10

> BLOOD VESSELS, NERVES AND TENDONS
> FACIAL LACERATIONS
> LIP LACERATIONS
> WOUNDS OF THE TONGUE
> EAR AND NOSE LACERATIONS
>

NOSE BLEEDS (EPISTAXIS)

> OCULAR TRAUMA
> OPEN FRACTURES
> TENDON LACERATIONS
> ANIMAL BITES


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