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Provider Prepared’s Weekly Pearl of Wound Wisdom #10 This dressing is not for salad!

Provider Prepared’s Weekly Pearl of Wound Wisdom #10 This dressing is not for salad! 0

After you have completed an excellent wound repair, the next part of wound management is the wound dressing. Advancements in medical technology have expanded the wound dressing options far beyond the days of regular web roll gauze. In fact, you’ll find more options for wound dressings than you will salad dressings at your favorite restaurant!

One very important detail to wound dressing is moisture. Historically it was felt that wounds should be exposed to the air and allowed to dry out. Recent studies have shown that occluded wounds heal up to 40 percent faster than non-occluded wounds.
Armstrong, DA et al. Basic principles of wound management. UpToDate Oct 2017.

Each wound has unique needs that should be taken into consideration for both dressing and dressing change regimen. Visit ProviderPrepared.com for the peace of mind you need for home wound care.

Provider Prepared
Nathan Whittaker, MD
  • Brandon Durfee
Provider Prepared's Weekly Pearl of Wound Wisdom #9 Give Pain the Finger!

Provider Prepared's Weekly Pearl of Wound Wisdom #9 Give Pain the Finger! 0

A 30-year-old male presents to the emergency department with a laceration to his left index finger. This occurred when he inadvertently cut his finger with a knife while cutting through a cardboard box. He has fairly significant 10 out of 10 pain associated with this injury.

Digital nerve blocks are a very effective means of managing the pain associated with wounds and other finger injuries. Digital nerve block anesthesia not only allows management of pain but provides appropriate local anesthetic to proceed with procedures such as wound repair, reduction of dislocations and fractures, removal of fingernails, and repair of amputations.

An appropriate basic technique for performing a digital nerve block is to utilize a dorsal approach. Under sterile technique a 27 or 25-gauge needle is introduced just distal to the MCP joint at the base of the proximal phalanx, at the lateral edge of the bone. As the needle tip enters subdermal tissue a wheal of 0.5-1 mL of anesthetic without epinephrine is injected. This will block the dorsal digital nerve. The needle is then passed along the lateral edge of the bone toward the palmar surface, to the subdermal tissue of the palmar surface an additional wheal of 0.5-1.5 mL of anesthesetic is injected. This will block the palmar digital nerve. This procedure is then repeated on the opposite side of the digit to obtain a complete digital nerve block.

Roberts, JA et al. Clinical Procedures in Emergency Medicine 2010. 523, 526

After performing a digital block to the patient's left index finger using 2% lidocaine without epinephrine, he had complete relief of his pain. The wound was then explored extensively, there was no deep tissue injury and a single layer repair was performed using Prolene 5-0 suture material. Provider Prepared laceration repair kits come equipped with all the tools you need to perform appropriate wound care for all your finger injuries! Also available is lidocaine to perform digital nerve blocks. Click HERE to see our variety of laceration repair kits!

Provider Prepared

Nathan Whittaker, M.D.

  • Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared’s Weekly Pearl of Wound Wisdom # 8 This will sting for just a second!

Provider Prepared’s Weekly Pearl of Wound Wisdom # 8 This will sting for just a second! 0

Wounds hurt, and wound repair hurts! Local anesthesia is best obtained by infiltration of the surrounding soft tissues with an anesthetic agent. Minimizing pain from the injection of local anesthetic is also important. With wounds that are not heavily contaminated, inserting the needle through the cut edges is less painful than through intact skin. Studies have shown that patients often do not feel any discomfort when 25 gauge or smaller needles are passed slowly through the cut wound edges.

Pain does occur when anesthetic volume distends the soft tissues. The number of needle sticks and the volume of anesthetic should be minimized as much as possible. Lidocaine is the most commonly used agent for local anesthesia. It has an onset time of 2-5 minutes and a duration of 1-2 hours. Lidocaine has an excellent clinical profile, with low allergenicity rates and minimal toxicity in appropriate volumes.

Roberts, JA et al. Clinical Procedures in Emergency Medicine 2010.490-492

Provider Prepared has your local anesthetic needs covered with Lidocaine available for licensed Healthcare Professionals! Check out our options for Laceration Repair Kits Here

Provider Prepared
Nathan Whittaker, MD
  • Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared’s Weekly Pearl of Wound Wisdom #7 Eversion is the in thing to do!

Provider Prepared’s Weekly Pearl of Wound Wisdom #7 Eversion is the in thing to do! 0

A 22 year old female presents to the Emergency Department for management of a laceration to the back of her hand. The wound was created after she accidentally struck it upon aluminum sheet metal while working. With her hand relaxed the skin edges invert into the wound margin.

The best wound healing occurs when the wound margins are everted, keeping the skin surface up and out of the wound margin. An additional obstacle to wound repair is tension across the wound. Eversion of the wound margin is an appropriate method to allow good wound edge alignment; and is an important surrogate marker for tension reduction.
Placing horizontal mattress sutures are a very effective way to provide wound eversion. Single simple interrupted sutures placed in a ‘water flask’ shape will also provide a reasonable amount of eversion.
Lin, BR et al. EMRAP April 2017:17:4(1-2)

The dorsal hand laceration was well everted with a central horizontal mattress suture, flanked by simple interrupted sutures.  Have your Emergency Department suture supplies available at home with a Provider Prepared suture kit!

Provider Prepared
Nathan Whittaker, MD



  • Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared's Holiday Healthcare Professional Gift Guide

Provider Prepared's Holiday Healthcare Professional Gift Guide 0

Have a Medical Professional on your gift list? Here is your gift guide for your Medical Professional that has everything. Give the gift of preparedness, peace of mind, and autonomy to your Professional! Here is a list of our top 7 gift ideas for 2017:

- Dermabond Advanced Pen $39.99

Every Healthcare Professional wants to help their friends and family with any wound. With Dermabond Advanced Pen they will be prepared for all those wounds that don't require sutures! A perfect addition to any First Aid Kit!

- Lidocaine $8.99

Is your special Healthcare Professional already prepared with the tools of the trade, but lacks injectable anesthetic? We have lidocaine available as the perfect addition to your prepared home. No more painful wound repairs on the dinning room table! Be prepared to properly manage any wound with local anesthetic.

- Skin Stapler with Staple Removal Kit $19.99

One of the best items for your Healthcare Professional to have in their arsenal of wound care tools!  Skin staples have a wide array of utility in wound management. With the included Staple Removal Kit your Professional is prepared for both the initial wound repair and the follow up for staple removal.

- The Essentials Suturing Kit $74.99

Provider Prepared has assemble a suture kit with all the basic essentials for simple suturing. This kit is a great gift for that Healthcare Professional that wants to be prepared for wound care on the go. Lightweight and versatile for wound care anywhere!

- Complete Laceration Repair Kit $199.99

This kit is assembled with all the tools of an Emergency Department Suture cart. Your Healthcare Professional will love the ability to manage wounds from scalp lacerations to skin tears; facial wounds to complex finger injuries.

- Expanded Complete Laceration Repair Kit $373.99

Shopping for the Healthcare Professional that has to have it all and then some? Provider Prepared had them in mind with this kit! More skin staplers, more Dermabond and included premium plastics suture. This kit is the ultimate in autonomy for your Professional to be prepared to handle any wound with exact precision.

 - Dermabond/Stapler/Steri-strip Laceration Repair Kit $155.99

Have a Healthcare Professional that needs a gift but doesn't suture? This kit is the perfect gift! All the tools of an Emergency Department Suture cart, but with out the needle and thread. Appropriately manage all your wounds that don't require suturing with perfection!

Provider Prepared has your Healthcare Professional gifts covered with all these top gift ideas plus more!

  • Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared’s Weekly Pearl of Wound Wisdom #5 -A case for debridement

Provider Prepared’s Weekly Pearl of Wound Wisdom #5 -A case for debridement 0

A 23 year old male presents to the Emergency Department after being involved in a motorcycle accident. He has extensive laceration to the left forearm. The accident occurred within a couple hours of the street having new ‘chip seal’ applied to the road surface. The laceration is heavily contaminated with rock, dirt, and dust; all secured to the subcutaneous tissues by a layer of fresh tar.

With a wound that is heavily contaminated with foreign material that can not be cleansed with irrigation, sharp excisional debridement is an appropriate option. Debridement of the epidermal and dermal layers should be completed using a scalpel, rather than scissors. This prevents the crimping of these tissues which can cause vascular compromise to the wound edge, and thus delayed healing. Subcutaneous adipose tissue is appropriately debrided with scissors. The crimping action of scissors at this level does not affect wound healing.

Roberts, JA et al. Clinical Procedures in Emergency Medicine 2010. 571-572

After multiple valiant attempts of vigorous irrigation, the tar within the forearm laceration remains intact. Sharp debridement utilizing a #15 blade effectively removed the contaminated tissue allowing proper wound cleansing. Tackle all of your wound debridement tasks with Provider Prepared Laceration kits equipped with a scalpel and sharp scissors!

Provider Prepared

Nathan Whittaker, MD
  • Dr. Nate Whittaker, MD Emergency Medicine Specialist