Lacerations of the hand
Tendons and nerves near lacerations have been cut until proved otherwise, particularly if glass is involved.
Underlying damage is easily missed - look carefully for appropriate physical signs & refer to A/E dept:
- all but the most minor injuries
- children, when assessment is difficult
- vascular, tendon and nerve injuries
- likely fractures
- wounds requiring immediate surgical treatment
Review later if the patient is drunk (but record details for follow-up in case of failure to attend).
Delayed closure may be necessary if there is extensive tissue damage, contamination or delay.
ref: N Lawrence et al, HB Emergencies in Gen Pract 2e, 1997
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