The Daily PANCE and PANRE Question 9 ReelDx Bonus (Hand Laceration)

The Daily PANCE and PANRE Question 9 ReelDx Bonus (Hand Laceration)

REEL-DX-ENHANCED-PAID-MEMBERS-ONLY

Acanthosis Nigricans

Patient will present as → a 5-year-old with pain between thumb and index finger; bleeding

Areas of tension – such as over joints – usually require more tensile strength than a tissue adhesive can supply

  • There is no statistically significant difference in infection risk between using sterile gloves and using clean non-sterile gloves for repair of simple lacerations
  • The use of epinephrine is not contraindicated in the hands; it reduces the need for the use of tourniquets and large volumes of anesthetic and provides better and longer pain control during digital procedures

History and physical exam

"Some simple cuts on the palmar surface of the hand or foot heal well, both with regard to function and cosmetic outcome, regardless of whether sutures are used or not. One option would be to 'wash and wear' this cut (no suture needed), as it will heal well if covered and kept clean. Consider openly discussing options with parents using shared decision-making strategies."
  • Local anesthesia with or without sedation depending on patient cooperation
  • Clean wound and remove foreign bodies
  • Reapproximate wound with simple interrupted sutures
  • Follow up to remove suture is 7-10 days for the upper extremity

PANCE-AND-PANRE-MUSCULOSKELETAL-BOARD-REVIEW-EXAMComprehensive 126 Question Musculoskeletal Exam (Members Only)

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