Provider Prepared’s Weekly Pearl of Wound Wisdom #16 Leg vs Tiller!

Provider Prepared’s Weekly Pearl of Wound Wisdom #16 Leg vs Tiller!
A 72 year old male with diabetes presents to the Emergency Department for management of a lower leg wound. The large, complex laceration was created about 30 hours prior while rototilling his garden. The rototiller skipped off of a rock causing the tiller tines to impact his lower leg. The wound was heavily contaminated with dirt that he rinsed out in a shower last night.

Delayed primary closure is the type of closure that should be used for wounds that are older than 24 hours that have had extensive contamination and were insufficiently cleansed. Additionally, wounds older than 24 hours associated with diabetes, advanced age, smoking, renal impairment, poor nutrition, obesity, and chronic steroid therapy should have delayed primary closure considered as their means of management.
Brancato, JO et al. Minor wound preparation and irrigation. UpToDate December 2017.

This 72 year old patient had his wound thoroughly cleansed and dressed in a sterile fashion. He was started on 10 days of cephalexin and five days later returned for wound closure. The wound margins were debrided and then closed with horizontal mattress sutures. 14 days later, sutures were removed from a well healed wound with no complications.

Provider Prepared has all your wound care needs available now! Visit us for the peace of mind and integrity of being prepared at home and on the go.

Provider Prepared
Nathan Whittaker, MD

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