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Tetanus Vaccines: A Case Study

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It is important to know how and when the laceration was sustained. Patients with wounds of more than 24 hours are not candidates of incision repair with sutures (Ursatine & Coates, 2011, p. 157). Also, knowing the patient’s coexisting conditions and degree of contamination (dirty wounds, bites, presence of a foreign body) is important to determine the possible use of antibiotic prophylaxis (Ursatine & Coates, 2011, p. 158). Lastly, ask the parents about patient’s current tetanus status is needed to determine if patient needs to receive the tetanus vaccine (Tetanus-Diphptheria-Pertussis vaccine [Tdap]) (Ursatine & Coates, 2011, p. 157). Furthermore, ask the parents if they would prefer to have a plastic surgeon repair …show more content…

157, 165). Second, have the parents sign a written consent prior to initiating the procedure. Next, gather the following equipment: 1) surgical sterile preparation (Betadine or Hiblicens); 2) Ruler (in centimeters); 3) If the wound is contaminated, have an irrigation device (splash shield, 30-mL syringe with an 18-gauge angiocatheter); 4) Local anesthetic such as 1% or 2% lidocaine with or without epinephrine with 27-gauge 1 1/4 -inch needle, or topical lidocaine-epinephrine-tetracaine (LET); 5) Sterile drapes applied over the lesion; 6) Sterile 4x4 gauze for hemostasis; 7) Sterile gloves; 8) Appropriate suture; 9) Supplementary dressings such as SteriStrips and/or Tegaderm; 10) Normal saline for irrigation and a 11) Sterile laceration tray with 4 ½-inch needle holder, curved or straight iris scissors, a mosquito hemostat, suture scissors, Adson forceps with teeth and a skin hook (Ursatine & Coates, 2011, pp. 157, 159). Moreover, perform a thorough handwashing prior to starting the …show more content…

159). Usually, an injection into the dermis of 1% or 2% lidocaine with (provides increased hemostasis) or without epinephrine, or LET topical anesthetic in liquid or gel formation are good options for local anesthesia (Ursatine & Coates, 2011, pp. 157, 159). After the wound is anesthetized, assess for foreign bodies and deep tissue layer damage (Ursatine & Coates, 2011, p. 159). Then, irrigate the wound with at least 200 ml of sterile normal saline and an irrigation device of choice (Ursatine & Coates, 2011, p. 159). Make sure that bleeding is controlled prior to wound closure, and all dead spaces are eliminated to avoid the accumulation of blood and tissue fluid (Ursatine & Coates, 2011, p. 159). Furthermore, have the tissue accurately approximated to each other with minimal skin tension and have both ends match on each side to prevent distortion of the forehead when the wound is healed (Ursatine & Coates, 2011, p.

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