Resident Manual of Trauma to the Face, Head and Neck

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

12

Resident Manual of Trauma to the Face, Head, and Neck