creation date: 2025-08-06 15:12
tags: Interventions
Laceration Repair
Preparation
Cleaning
Regional Anesthesia
Anesthetic used for laceration repair are most commonly:
- Lidocaine
- Lidocaine with epinephrine
The benefits of added epinephrine are:
- Better local hemostasis (due to vasoconstrictive effect)
- Increased duration of anesthesia (1.3-4-fold increase)
- Increases maximum dosing
Disadvantages of added epinephrine include:
- Potential ischemic complications at end-artery areas (recent evidence does not demonstrate this but caution still advised)
- Possible systemic cardiovascular effects
Maximum dosing:
- Without epi: 5 mg/kg
- With epi: 7 mg/kg
Lidocaine 1%: 1g/100mL = 10mg/mL
- Without epi: 0.5mL/kg
- With epi: 0.7mL/kg
Administration:
- Use 25-30G needle
- “Don’t” bend the needle with bevel up if angle if difficult
Suture Material
Percutaneous can use absorbable or monofilament, depending on capacity for removal. Deep sutures must use absorbable.
Options ranges from 7-0 (thinnest) to 3-0 (thickest):
- 5-0, 4-0 generally good
- 6-0 if face (consider 7-0 on eyelid)
- 4-0 on thicker skin (consider 3-0 on foot/sole)
Suturing
Suturing techniques used can be found here.
Follow-up
Duration before removal
| Body part | Number of days |
|---|---|
| Face | 5 |
| Trunk, scalp | 7 |
| Extremities | 7-10 |
| Extension surfaces | 14 |
References
Tools / Guidelines
Closing The Gap (lacerationrepair.com)