News
Tips for Avoiding Athletic Injury This Fall 0
Fall sports are in full swing for schools all over the country, and people are moving in to the gyms to get into their fall fitness routines. Whether you’re attending games or hitting the gym, we’ve assembled some facts and tips to keep you informed and safer during this fall’s athletic activities so nobody needs to hear the word “suture.”
Facts and Tips for Kids’ Sports Safety
The Consumer Product Safety Commission’s 2013 statistics reported that:
- In children ages five to 18 years of age, roughly 881,700 injuries were football related.
- Close to 434,000 children received treatment for injuries on the soccer field.
- Cheerleading injuries numbered 99,884.
- There were over 94,000 injuries from volleyball.
It’s important for parents to know that the top injury in kids’ sports is that of overuse, though this type of injury is not well identified by youth, who subsequently don’t report pain to their parents or coaches. As such, these injuries can go undiagnosed for long periods of time, which can lead to more debilitating issues over time.
Tips for Safe Sports Participation
- Resist the temptation to over train. Alter any routines that create pain or physical discomfort.
Injury Prevention Tips for Parents
Many, if not all, of the above tips for your kids can be applied to your fitness routine. Here are a few more to keep you safe this fall.
- Don’t let a new gym membership push you to run a marathon. Allow yourself to work up to harder routines by only increasing an activity or work out by 10 percent each week.
- Keep your body healthy by balancing work outs to include areas like cardio, balance and flexibility, and strength.
- Sign up for lessons for any sport or activity you are trying for the first time ever or the first time in a while. A professional will make sure you are performing movements safely and properly.
- Pay attention to pain or muscle soreness that endures for more than a 48 hour timespan. If you feel an injury developing, or come on suddenly, stop the activity and apply ice immediately. Pain that persists after 48 ought to be discussed with a physician.
- Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared's Weekly Pearl of Wound Wisdom #4 - Dermabond vs. Sutures 0
Does this laceration really need sutures? For short (<4cm) lacerations literature supports the use of tissue adhesives, such as DERMABOND. After properly cleaning and preparing the wound, as discussed in previous Weekly Pearls of Wound Wisdom, determine if the wound has low or high tension against it. Wounds that are of a low tension tend to hold themselves in close approximation. High tension wounds will be gaping open and should be closed with sutures. Additional criteria for tissue adhesive use includes wounds that have low risk of infection, are linear in shape, and in a dry location. Tissue adhesive should not be used on hands, feet, or joints unless they are immobilized and able to stay dry for several days.
Clinically in our Emergency Medicine practice we typically do not use tissue adhesive to repair lacerations greater than one centimeter. Larger lacerations are more technically challenging to maintain a perfect cosmetic outcome. Tissue adhesive is applied in thin layers as the wound edges are held in appropriate cosmetic approximation. This should be done with no oozing of blood from the wound. The wound must be held stable for at least 10 seconds as the adhesive sets and obtains its tensile strength to secure the wound edges in place. Provider Prepared Laceration Repair kits equip you with the Dermabond Advanced Pen in your arsenal of wound repair tools. Click HERE to order today! Arrives within 3-4 business days.
Lipsett, SU. et al Minor wound repair with tissue adhesives. UpToDate Sep 2017.
Provider Prepared
Dr. Nate Whittaker, MD
- Dr. Nate Whittaker, MD Emergency Medicine Specialist
Intro to Treating Minor Facial Trauma 0
From dog bites to a scalp laceration and more, emergency situations are full of their fair share of trauma to the head, neck, and face. In such cases, there are certain ways to deal with these cosmetically sensitive injuries so that healing is most effective.
Essential Principles to Care for Facial Lacerations
Regarding Scalp Laceration
Treatment Goals: Get bleeding under control and assess the scalp laceration for injury to the galea, any foreign materials, as well as possible skull fractures. Once you are able to obtain hemostasis, the wound ought to be checked visually and with instruments. In the event that an injury is discovered in the galea or the fibrous tissue covering the skull has been damaged, it is necessary to repair the tissue.
Important Aspects: Infection is not of high concern in a scalp laceration, except in circumstances where the galea has sustained injury, making it of critical importance to correctly identify galeal injury. Significant cosmetic deformities can occur if this type of scalp layer injury is incorrectly addressed, as the frontalis muscle anchors to the galea. To prevent possible missed identification of galeal injury, palpation and visual assessment are necessary to differentiate between a skull fracture and damaged galea.
Treatment Tips:
- Scalp lacerations have a tendency to bleed profusely, making hemostasis essential in laceration repair and assessment of the wound for injury to the galeal or skull. One approach can be to apply direct pressure with a moist sponge and an elastic bandage for a timeframe of 30-60 minutes; you may also consider a direct injection of lidocaine with epinephrine. Should both techniques fail to produce the desired results, you may place a large figure-of-eight suture.
- When making repairs to the galea, use 3-0 or 4-0 absorbable sutures. A commonly employed method for suturing the galea is to use one layer of simple interrupted or vertical mattress sutures.
- Once underlying tissue laceration repair has been made, a SKIN STAPLER may be used on the overlying tissue of the scalp, though you may choose to use the hair apposition technique. This approach twists hair from opposite sides of the laceration together using a hemostat, after which skin glue may be used to stop unraveling from occurring.
- Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared's Weekly Pearl of Wound Wisdom #3 - Which suture should I use? 0
With a wound that is prepared for suturing, what suture should I use? Typically nonabsorbable suture is your first choice for sutures that will be on the outside of the skin. Nylon is the suture material of preference. It has a strength and workability that allows its use for any wound. For more complex wounds requiring sutures under the skin, a good absorbable suture material, such as polyglactin, is recommended.
Lin, BR et all. EMRAP April 2017:17:4(2).
Remember when choosing suture size, the larger the number, the smaller the suture thread. Any Facial lacerations should be closed with a small suture size, such as 6-0. Lacerations on hands and arms are usually managed well with 5-0; gaping wounds may need 4-0. Wounds on the lower extremities generally need larger 4-0 sized suture. Provider Prepared Laceration kits give you autonomy of suture choice, with Ethilon (nylon) 4-0, 5-0 and 6-0 sizes. You also have the option for Vicryl (polyglactin) 4-0 or 5-0 sizes. Get your SUTURES HERE TODAY, so you are ready for your next home laceration repair.
Provider Prepared
Nathan Whittaker, MD- Dr. Nate Whittaker, MD Emergency Medicine Specialist
Don’t Superglue Lacerations—Use DERMABOND! Here’s Why 1
Ever had a patient come in with a laceration that was best addressed using DERMABOND, and they made a joke about how they could’ve saved themselves a lot of trouble by just supergluing the cut themselves? You’re not alone—essentially, gluing the skin looks the same to the patient, regardless of the container that it comes out of. To help you help your patients understand the difference between super gluing a laceration and using Derma Bond, we’ve created this fact list.
This type of glue is not Derma Bond, but rather the type of cyanoacrylate glue (think Krazy Glue) that you can buy at your local grocery or office supply store. It has the potential to create a burn. Why doesn’t this same scenario occur in medical-grade skin glues? It’s all in the chemical structure. Medical-grade skin glues like Derma Bond feature longer alkyl chains than non-medical grade super glues, which means don’t polymerize as quickly and they give off less heat.
In a case report of the 2013 Journal of Emergency Medicine, Derma Bond was utilized to repair a tongue laceration in a seven-year-old. His caregiver was unwilling to accept any other technique to repair the wound, so the physician took time to ensure ingesting the 2-octyl cyanoacrylate was safe before applying it. Again, the long alkyl chains of medical-grade skin glue made this possible, as it allows the glue to degrade more slowly, which means patients are less exposed to by-products of the glue. Though use for intraoral and mucosal surface lacerations isn’t cleared for approval on the packaging itself, the effective healing of the seven-year-old’s tongue, along with other reports, suggest that Derma Bond can be used to successfully treat wounds in difficult areas such as the mouth.
Cyanoacrylate glues all feature a bacteriostatic effect, and though biochemists have attempted to understand exactly why this is, they aren’t totally sure why. However, the antimicrobial properties of cyanoacrylate glue, after it has polymerized and formed a barrier, is impacted by whether or not the glue cracks and therefore compromises the barrier or seal. Medical-grade glues are created to be more flexible, as the human body moves around far more than say a broken cup or plate, and therefore the antimicrobial properties of Derma Bond may very well be above that of dollar store glue.
So, the next time your patient—or a friend or family member—bring up the possibility of just supergluing their skin back together, be sure to bring up long alkyl chains and all the perks that come with using medical-grade skin glue like Dermabond. Click HERE to get yours today. Arrives within 3-4 business days.- Dr. Nate Whittaker, MD Emergency Medicine Specialist
Provider Prepared’s Weekly Pearl of Wound Wisdom #2 - Creating a Sterile Field 0
With a wound that has been cleared of all foreign debris and copiously irrigated, the next step is cleansing the skin for closure of the wound. This includes sterilizing the skin and establishing a sterile field. Using either a betadine or chlorhexidine surgical scrub solution, begin at the wound margins and work outward in a ‘triple pass’ fashion.
Studies have shown no significant infection rate difference between betadine or chlorhexidine in wound preparation. One important detail regarding betadine--part of its bacteriolysis action is dependent upon allowing it to dry. With the skin sterilized, the sterile field is further established with application of a sterile drape. Provider Prepared makes wound preparation a breeze with included betadine and a sterile drape in our Laceration Repair Kits. Click to get yours today! Arrives to you in 3-4 business days.
Shinar, ZA et al. Laceration Wound Preparation EMRAP 2017 Mar 17:3(3).
Provider Prepared
Dr. Nate Whittaker, MD Emergency Medicine Specialist
- Dr. Nate Whittaker, MD Emergency Medicine Specialist