Motorcycle accident
Motorcycle accident resulting in partial skin avulsion and deep lacerations of the patients leg as it became pinned against the truck’s tailpipe. Appropriate treatment of lacerations is important to decrease the risk of excessive scar formation. The first step in the management of lacerations is hemostasis, or the termination of bleeding. Direct continuous manual pressure to the area of injury with sterile gauze is helpful for achieving hemostasis. Once bleeding has stopped, the wound may be explored to determine the severity and extent of involvement of bone, muscle, tendons, nerves, or blood vessels. Exploration may reveal the presence of foreign debris, such as concrete or sand, within the wound. Lacerations typically are treated through irrigation with a sterile saline solution, which helps to remove dead tissue fragments and foreign debris. The wound is then closed. The type of wound closure used depends on the extent and severity of the laceration. Delayed primary closure is often used for lacerations that are not considered to be clean enough for primary closure. The wound is left open to heal for 5 to 10 days in a moist wound-healing environment, and then it is sutured closed. Delayed primary closure decreases the risk of infection through achieving bacterial balance, and granulation tissue formation creates an optimal environment for the wound’s oxygen requirements. Antibiotics generally are not needed for the treatment of simple lacerations. A wound that has remained open for several hours or is heavily contaminated may require a 7–10-day course of antibiotics.
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