Podcast
Questions and Answers
Why is thorough debridement important in the management of abrasions?
Why is thorough debridement important in the management of abrasions?
To prevent 'traumatic tattooing' from foreign materials.
What initial management steps are recommended for a patient presenting with a contusion?
What initial management steps are recommended for a patient presenting with a contusion?
Ensure no ongoing bleeding if swelling is located in an area that could compromise the airway.
What clinical findings in a child should raise suspicion for potential physical abuse when assessing bruises?
What clinical findings in a child should raise suspicion for potential physical abuse when assessing bruises?
Multiple bruises in clusters or patterns.
Why is approximating the vermillion border a critical step when suturing lip lacerations?
Why is approximating the vermillion border a critical step when suturing lip lacerations?
In the management of avulsions, what determines whether a minor injury can be treated as per lacerations, or if more severe interventions are needed?
In the management of avulsions, what determines whether a minor injury can be treated as per lacerations, or if more severe interventions are needed?
When managing abrasions, why is a patient advised to avoid excessive sunlight exposure for several months post-injury?
When managing abrasions, why is a patient advised to avoid excessive sunlight exposure for several months post-injury?
What is the key difference between a contusion and an abrasion in terms of skin integrity?
What is the key difference between a contusion and an abrasion in terms of skin integrity?
Why might radiographs be necessary when managing deep wounds, particularly lacerations?
Why might radiographs be necessary when managing deep wounds, particularly lacerations?
Can you explain why the location of a bruise might suggest an underlying bony fracture?
Can you explain why the location of a bruise might suggest an underlying bony fracture?
What are the common causes for avulsion injuries?
What are the common causes for avulsion injuries?
In the context of managing intraoral lacerations, what size suture material is typically recommended?
In the context of managing intraoral lacerations, what size suture material is typically recommended?
How does the management of deeper cleaning/debridement of abrasion wounds differ from routine cleaning?
How does the management of deeper cleaning/debridement of abrasion wounds differ from routine cleaning?
When would referral to maxfax be necessary in the context of contusions?
When would referral to maxfax be necessary in the context of contusions?
Describe the key characteristic that distinguishes an avulsion from a laceration.
Describe the key characteristic that distinguishes an avulsion from a laceration.
Outline the initial step in managing facial lacerations, as per the provided text.
Outline the initial step in managing facial lacerations, as per the provided text.
Why is thorough debridement important when managing abrasions?
Why is thorough debridement important when managing abrasions?
What should be done if a swelling develops in an area that could compromise the airway due to a contusion?
What should be done if a swelling develops in an area that could compromise the airway due to a contusion?
When suturing lip lacerations, what specific anatomical landmark requires careful attention?
When suturing lip lacerations, what specific anatomical landmark requires careful attention?
What is the primary concern when a contusion indicates an underlying bony fracture?
What is the primary concern when a contusion indicates an underlying bony fracture?
Why should patients avoid excessive sunlight after experiencing an abrasion?
Why should patients avoid excessive sunlight after experiencing an abrasion?
In the management of avulsions, why is careful exploration under magnification important?
In the management of avulsions, why is careful exploration under magnification important?
List three common locations for abrasions.
List three common locations for abrasions.
What size suture is typically used for intraoral lacerations?
What size suture is typically used for intraoral lacerations?
What findings would raise suspicion for possible physical abuse when assessing bruising on a child?
What findings would raise suspicion for possible physical abuse when assessing bruising on a child?
What are the primary causes for avulsion injuries?
What are the primary causes for avulsion injuries?
Flashcards
Abrasion
Abrasion
Superficial skin wounds from scraping, affecting the epithelial and papillary layers.
Abrasion Treatment
Abrasion Treatment
Wounds that require thorough cleaning to prevent 'traumatic tattooing'.
Contusion (Bruise)
Contusion (Bruise)
Skin discoloration due to blunt trauma, with subcutaneous or submucosal bleeding.
Laceration
Laceration
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Avulsion
Avulsion
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Avulsion Cause
Avulsion Cause
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Avulsion Treatment
Avulsion Treatment
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Common abrasion sites
Common abrasion sites
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Post-abrasion sunlight advice
Post-abrasion sunlight advice
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Bruise location significance
Bruise location significance
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Lip laceration suture concern
Lip laceration suture concern
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Multi-layer lacerations
Multi-layer lacerations
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Study Notes
- This is a summary of treating soft tissue injuries to the mouth and surrounding areas
Abrasion ("scrape")
- Abrasions are the most superficial wounds to the skin
- These occur when skin collides with a rough surface, scraping the epithelial and papillary layers of the dermis
- The exposed reticular layer is raw and painful
- Thorough debridement is needed to prevent traumatic tattooing that can result from foreign materials becoming embedded in the wound
- Common injury sites include the lips, chin, and nose
- When treating, examine the area under local anesthesia, then cleanse and debride using chlorhexidine (CHX) or iodine solution.
- Refer to maxillofacial surgery if deeper cleaning or debridement is needed
- Following the removal of all foreign materials, wounds may be left open or covered with a bandage
- Advise patients to avoid excessive sunlight for the first 6 months post injury to prevent hyperpigmentation
Contusion ("bruise")
- Bruises or contusions form from blunt trauma which results in subcutaneous or submucosal hemorrhage without breaking the skin
- The location of the bruise can suggest an underlying bony fracture
- Bruising is common in older, mobile children, but is rare in infants and those under 6 months of age
- Multiple bruises in clusters or patterns may indicate physical abuse and should be investigated
- If swelling is located in an area that could compromise the airway (floor of mouth or tongue), ensure there is no ongoing bleeding
- Otherwise, contusions and bruising generally do not require any treatment
- Refer to maxillofacial surgery if bruising indicates an underlying bony fracture
Laceration ("cut")
- Lacerations involve cuts that affect epithelial and subepithelial tissues
- Facial lacerations often need suturing, potentially under local or general anesthetic; referral to maxillofacial surgery is often necessary
- Intraoral lacerations may not need sutures, depending on the case
- Examine lacerations under local anesthesia
- For deep wounds, radiographs may be required to check for foreign bodies, which should be removed with excavators and tweezers
- When suturing lip lacerations, approximate the vermillion border carefully to ensure proper alignment
- Deep lacerations require suturing in layers
- Cleanse the wound with copious saline and achieve hemostasis before suturing
- Use 4-0 sutures for intraoral closures and 5- or 6-Vicryl sutures for lips
Avulsion ("tissue loss")
- Avulsion refers to tissue loss resulting from an injury, causing full-thickness loss
- Common causes include dog bites, bicycling accidents, and skateboarding injuries
- Referral to maxillofacial surgery is generally recommended in such cases
- Wounds need careful exploration under magnification, as well as thorough debridement
- Minor avulsion injuries can be treated similarly to lacerations
- More severe injuries may need local flaps or skin grafts, depending on the extent of the injury, employing a staged approach to reconstruction for optimal results
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