14 / 242
Resident Manual of Trauma to the Face, Head, and Neck
12
D. Fundamentals of Wound Closure.............................................194
1. Prepare Wound........................................................................194
2. Close Tissues............................................................................194
3. Avoid Undertaking Local Flaps in the “Primary” Setting. 196
IV. Informed Consent
...............................................................................196
V. Operative Management by Location
............................................. 197
A. Scalp................................................................................................. 197
B. Forehead.......................................................................................... 197
C. Auricle..............................................................................................198
1. Superficial Lacerations...........................................................198
2. Cartilage Lacerations.............................................................198
3. Approximation of the Helix and Antihelix .......................199
4. Lacerations Involving the Free Edges of the Pinna..........199
5. Hematomas and Seromas.....................................................199
6. Perichondrial Coaptation to the Cartilage Framework..... 199
7. Segmental Avulsion of the Pinna........................................199
8. Cartilage Banking...................................................................200
9. Total and Near-Total Auricular Avulsion..........................200
D. Periorbita........................................................................................200
1. Ophthalmology Consultation..............................................200
2. Irrigation...................................................................................200
3. Delayed Closure in Operating Room.................................200
4. Lid Laceration..........................................................................200
5. Posterior Lamella Lacerations.............................................200
6. Anterior Lamella Lacerations...............................................201
7. Lacrimal Canalicular Injury...................................................201
8. Canthal Injuries........................................................................201
9. Closure at the Lid Margin......................................................201
10. Lid Margin and Proximal Anterior Lamella Sutures........201
11. Superior Lid Lacerations........................................................201
12. Visible Orbital Fat....................................................................201
E. Nose................................................................................................. 202
1. Nasal Soft Tissue Injuries..................................................... 202
2. Extensive Nasal Vestibule Injuries..................................... 202
3. Septal Hematomas................................................................ 202
4. Severe Septal Mucosal Lacerations or Hematomas ..... 203
5. Extensive Soft Tissue Undermining................................... 203
F. Lips................................................................................................... 203
1. Wound Examination.............................................................. 203
2. Wound Closure....................................................................... 203
3. Reapproximation of Landmarks.......................................... 203
G. Cheeks. ...........................................................................................204