Contraindications to epinepherine?
Intranasal or Oral midazolam 20 min prior to procedure
Hemostatis obtained?
Will patient need tetanus prophylaxis?
Consult advanced provider in wound repair
Sutures
Tissue adhesive
Patient to require sedation?
Patient to require anxiolysis?
Irrigate and clean area with clean tap water, apply topical antibiotics if indicated, sunscreen advice, consider delayed closure
Contraindications to LET
Risk for concerning foreign body?
Patient to benefit from regional nerve block?
Perform regional nerve block
Contraindications to LET?
Clean the area around the wound with providone-iodine or chlorhexidine. Do not scrub the wound itself with these solutions.
Inadequate analgesia?
Contraindications to midazolam
Contraindications to lidocaine with epinephrine
Wound irrigation and preparation. Start primary closure.
Wound closure tapes
Staples
Techniques to achieve hemostatis
Contraindications to tissue adhesive
Contraindications to nitrous oxide
Consider x-ray to identify radiopaque materials
Wound will need primary closure?
Hair removal
Hair apposition
Place LET 30-45 min prior to procedure
1% lidocaine field block
1% lidocaine with epinephrine field block