Test Your Knowledge of Wound Repair (Postscript 1 of 2)

Q: Click to see the answer

Answer: D. Tissue adhesive is an appropriate closure method for a laceration that is located over the bony prominence of the infraorbital rim and is not gaping. Primary closure with tissue adhesive is never appropriate for puncture wounds due to the inherent infection risks associated with these wounds. Wounds that continue to bleed cannot be adequately closed with tissue adhesive, and an ineffective, partially congealed bloody coagulum is produced when tissue adhesive is applied to oozing wounds. Tissue adhesive is an inappropriate choice for intraoral wounds due to the infection risks posed by normal bacterial flora. Image courtesy of Patrick O'Malley, MD/ The Laceration Course

Evidence-Based Urgent Care Postscript — Acute Traumatic Wounds: Evaluation, Cleansing, and Repair in Urgent Care | August 2022

For which of the following wounds is tissue adhesive an appropriate choice for closure?

A. Puncture wound of foot that is no longer bleeding

B. Supraorbital facial laceration that continues to ooze after LET application

C. 1-cm intraoral lip laceration

D. Non-gaping laceration over bony prominence of infraorbital rim

Click to see the answer

Answer: D. Tissue adhesive is an appropriate closure method for a laceration that is located over the bony prominence of the infraorbital rim and is not gaping. Primary closure with tissue adhesive is never appropriate for puncture wounds due to the inherent infection risks associated with these wounds. Wounds that continue to bleed cannot be adequately closed with tissue adhesive, and an ineffective, partially congealed bloody coagulum is produced when tissue adhesive is applied to oozing wounds. Tissue adhesive is an inappropriate choice for intraoral wounds due to the infection risks posed by normal bacterial flora.