You will see me state this a lot. The solution to pollution is dilution. I didn't coin the phrase, but it is something that all of us need to know. A few years ago, when I was developing the IRIG-8 wound irrigation device, I had to research everything I could find about wound irrigation. High...

Staplers-as with many things in the acute setting, price often trumps quality. Staplers for laceration management is no exception. We often are forced to use the cheap and wobbly 10 shot staplers. I have found these to be rather ineffective and I have to frequently remove staples and do them...

Visualization of the wound you are repairing is crucial. If you are struggling to see what you are repairing and whether or not the suture needle is in the right place, you are setting yourself up for problems.

It never fails, the treatment room doesn't have an overhead light or it's not...

Having a good pair of durable scissors or "trauma shears" will serve you well. If working in a busy ER, you will use these most every shift to remove clothing or bandages placed by EMS. They can also be used to cut fiberglass for splints. It never fails, you will need them when you don't have...

This may cause surgeons to have chest pain, but there is no need to wear sterile gloves when repairing a laceration. Let me say that again, you don't need sterile gloves to sew up a laceration. Think about it, the dirty skin just got cut by a dirty object. Using sterile gloves isn't going to make...

Nurses play an important role in caring for patients with lacerations. There is a lot of old dogma such as soaking wounds in betadine that need to be rethought. Some of these things just get passed down by older nurses and never get questioned. 

Develop protocols to empower your nurses to...

Urgent cares have flourished over the past 10 years. They stepped up to the plate and cared for scores of patients during the pandemic. Unfortunately, there is no formal residency program for "urgent care" and some UC clinicians may no thave had much training or experience with managing...

Primary care clinicians are the true engine of the healthcare system. Unfortunately, overly complex patients, 15 minute visits, prior authorizations, insurance hassles and administrative tasks eat away at the ability to work patients in for things such as lacerations.

Having worked in the ER and...

The most important tools we use for managing lacerations are the instruments that come in the "lac kit." These kits come from a variety of manufacturers and are commodity items that get purchased by a hospital, urgent care, or clinic with very little thought. To those making the purchases, cheap...

After years of experience, I have several things that I have to have when repairing certain lacerations. From time to time, I will write about these and why they are so important. If you have an essential tool, send me an email and I will try to include these on the blog. If not familiar with...