Prep
- Consent and explain
- Check allergies (lignocaine, chlorhexidine)
- Assess wound (depth, contamination, age)
- Sterile field, gloves
Local Anaesthetic
- Lignocaine 1%: 3mg/kg max (with adrenaline: 7mg/kg)
- Draw up, 25G needle
- Inject into wound edges (less painful)
- Wait 2-3 minutes
WARNING
No adrenaline in fingers, toes, nose, ears, penis
Execute
- Clean wound (saline)
- Irrigate if contaminated
- Select suture (face 5-0, limbs 4-0, trunk 3-0)
Simple Interrupted
- Enter 3-5mm from edge, exit in wound
- Cross, enter in wound, exit 3-5mm from edge
- Tie square knots (not too tight)
- Cut tails to 3-5mm
CAUTION
Evert wound edges - don't invert
Finish
- Clean, dry dressing
- Educate: keep dry 48h, return if red/hot/pus
- Removal: face 5d, limbs 7-10d, joints 10-14d
Checklist Complete