Stitches or not
A 13 year old girl was taken to the emergency room on her vacation after a surfing accident in witch the fin underneath the board sliced open her upper left leg. Lukily there was no arterial bleed, but it took more than 2 hours to get her to the hospital. She got 13 stitches and a drain was placed, but in the amount of time the edges of the wound got too dry to heal properly. When the stitches were removed a week later, the wound opened up again. It got infected and eventually it took 2 months to heal. Would you have stitched her up at the E.R. too or would you have let the wound heal from the inside out. The photograph shown is that of the wound 3 weeks after removal of the stitches.
Since it’s infected and older than 6h it has to be treated as a secondary which means letting it heal from the inside. It should be cleaned on a daily basis with an antiseptic solution and dressed with sterile bandages.
Of course it takes a while and the risk of infection is greater, but even with debridément and a thorough wash the wound could still be infected and the it would be enclosed. I would still choose healing by secondary I guess. Of course I would have stitched the wound up when she first came to A&E, but with a three week old wound yes
