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Subject: Tangential Laceration Repair
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Instruments for simple, interrupted, skin suture placement are found in Appendix G and can be ordered through local surgical supply houses.
Suture materials can be ordered from Ethicon, Somerville, NJ (http://ecatalog.ethicon.com/EC_ECATALOG/ethicon/default.asp).
A suggested anesthesia tray that can be used for this procedure is listed in Appendix F.
Wounds with beveled (nonvertical) edges
Skin tears in elderly individuals
Severe bleeding disorders
Extreme illness that would make wound healing difficult
Cellulitis in the tissues to be incised
Conditions that may interfere with wound healing (collagen vascular diseases, smoking, renal insufficiency, diabetes mellitus, nutritional status, obesity, chemotherapeutic agents, and corticosteroids)
Disorders of collagen synthesis such as Ehlers-Danlos syndrome and Marfan syndrome that affect wound healing
Concurrent medications that may increase the likelihood of intraoperative bleeding (aspirin, other nonsteroidal anti-inflammatory drugs, warfarin)
PITFALL: If a tangential wound is approximated with a simple suture (i.e., equal bites through each wound edge), an inverted or depressed scar often results.
Pain, infection, and bleeding
Nonunion of skin edges
Incomplete excision of lesion