Suturing Wounds¶

Scalp laceration Suturing¶

starts from Sub orbital to occipiital protubrance
Stellate lacerations are common in this region
- because the scalp is vulnerable to blunt trauma but also because its superficial fascial layer is inelastic and frimly adherent to the skin.
profuse bleeding as sclap SQ is fibrous so vessels cannot constrict
Below galealoose connective tissue contains emissary veins that drain through diploic vessels of the skull into the venous sinuses of the cranial hemispheres.
- risk meningitis on imporver wound care

Wounds that gape open signify a laceration extending beneath the galea layer

suturing
place a wide, tight rubber band or Penrose drain around the scalp from the forehead to the occiput
averting galea and hemaostasis of Blood vessel - risk crushing and necrosis
local pressure with Epinephrine

single sutures including skin, SQ fascia, and the galea
periosteum does not need to be sutured
seperate galea suture risk infection - except in large laceration - inverted stitch (with an absorbable 3-0 or 4-0 suture) will bury the knot beneath the galea.
simple interrupted or vertical mattress stitches using nonabsorbable 3-0 nylon or polypropylene suture on a large needle. - leave 2cm end for removal - no need bandage after suture - compression dressing only if bleeding persists - wash the hair after 2 hours
Easy method for Superficial scalp laceration reapir HAT[hair apposition technique ]

only used for superficial laceration as it only pulls superfical layers together
10 cm in length wound
irregular wounds
< 3cm long hair
contineous bleeding

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