Management of Lacerations


Acute Management



Management of the patient that will be admitted for surgery.

Intravenous Antibiotics Wound Dressing Posi Z-Splint (Position of Safe immobilisation Splint)

  1. Irrigate the wound with saline and remove all macroscopic debris
  2. Cover the wound with Jelonet (Vaseline gauze) type dressing. Cover the jelonet dressing with absorbing dressing (gauze/telfa/webril) soaked in Povidone Iodine to sterilise the wound until it is opened in theatre.
  3. Wrap this with any form of bandage.
  4. If it is a tendon or nerve injury, it is best to splint the forearm and hand in a POSI Z-splint.
  5. Prescribe IV antibiotics (Augmentin 1.2 g IVI tds), keep the patient fasted and prescribe elevation of the limb in the ward.


Definitive Management



Rehabilitation:

All injuries with structural involvement (nerve or tendon) will require intensive therapy that will entail the following time frames


The patient will need to engage actively in a therapy programme to achieve the best outcome, including graded active range of movement exercises, stretching, graded strengthening exercises, oedema and scar management.