We have finally reached the end of the laceration repair series. So far, it seems like nothing we do really matters. Eversion was a myth. Glue and steri-strips are as good as sutures. For that matter, for many lacerations we could probably just do nothing at all. The human body […]
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In part 4 of the laceration evidence series, we learned that wound eversion is probably dogma. In part 5, we learned that sutures probably offer no real benefit over skin glue or steri-strips in the majority of our patients. However, if you do decide to suture a laceration, how far […]
As discussed in the post “Does closure technique matter”, I rarely use sutures anymore. Tissue adhesives and/or steri-strips provide identical outcomes with much greater ease and less pain for patients. However, there are still a sizable minority of lacerations that seem to require sutures, which raises another question: should I […]
There are a lot of strong opinions about how lacerations should be repaired. There may be even more laceration repair techniques. This seems like a good spot for a ‘more than one way to skin a cat’ joke, but what we really want is evidence. Which laceration repair technique is […]
If you have attended medical school, one ‘fact’ I guartunee you have heard is that wound eversion is the key to good cosmetic repair of lacerations. Many studies I have read just assume that eversion is important, and search for the repair technique that results in the best eversion. In […]
One of the first times I was really introduced to ‘dogma busting’ was when I was told early in residency that sterile gloves were absolutely not needed when repairing lacerations in the emergency department, and there were RCTs to prove it. I have lived by that anti-dogma dogma since, and […]
In part 2 of the laceration evidence series, we are going to tackle all of the evidence around wound irrigation and cleansing. The value of irrigation seems pretty obvious. Traumatic wounds are contaminated, and we should do our best to clean them. “The solution to pollution is dilution.” Therefore most […]
This is the beginning of a long series looking at all the evidence around laceration repair in the emergency department. This evidence will also be covered in depth on the Emergency Medicine Cases Journal Jam podcast. We will look at preparation of wounds, including irrigation and the use of sterile […]
This is a guest post by Dr. Jason Zhou. Jason is a first-year Family Medicine resident at the University of Toronto. He grew up in Burnaby and attended UBC for his Bachelor’s of Science before moving to Toronto for medical school. Jason enjoys playing sports in his leisure time and […]