Name of the Procedure:

Repair, Intermediate, Wounds of Scalp, Axillae, Trunk and/or Extremities (Excluding Hands and Feet); 2.6 cm to 7.5 cm

Summary

Intermediate wound repair involves the method of suturing wounds that penetrate deeper than the superficial layer of the skin. This technique is used for wounds ranging from 2.6 cm to 7.5 cm on the scalp, armpits, trunk, and extremities, excluding hands and feet.

Purpose

This procedure addresses wounds that are deeper than the superficial layer of the skin, require layered closure, and consist of at least a single layer closure of deeper tissue and a single-layer closure of the top tissue layer.

Indications

• Moderate to complex lacerations
• Wounds with moderate contamination
• Injuries that require layered closure to ensure proper healing

Preparation

• Follow instructions regarding fasting or hydration if sedation or anesthesia is planned.
• Disclose all current medications and follow recommendations on which medication to continue or stop.
• Undergo any necessary blood tests or diagnostic imaging to evaluate the extent of the wound.

Procedure Description

1. The area around the wound is cleaned thoroughly.
2. Local anesthesia is injected to numb the region.
3. Debridement (removal) of dead or contaminated tissue may be performed.
4. The deeper layers of tissue are sutured first using absorbable sutures.
5. The superficial skin layer is then closed using non-absorbable sutures or staples.
6. The site is cleaned again, and a sterile dressing is applied.

Duration

The procedure typically takes between 30 to 60 minutes, depending on the complexity and number of wounds.

Setting

Usually performed in an outpatient clinic, emergency room, or minor procedure room in a hospital.

Personnel

• A surgeon or physician specializing in wound management
• Registered nurse or medical assistant
• Anesthesiologist or nurse anesthetist if sedation is required

Risks and Complications

• Infection
• Bleeding
• Scarring
• Adverse reaction to anesthesia
• Poor wound healing or dehiscence (wound reopening)

Benefits

• Proper wound closure
• Reduced risk of infection
• Minimized scarring
• Faster and more effective healing

Recovery

• Keep the wound clean and dry for the first 24-48 hours.
• Follow wound care instructions provided by the healthcare provider.
• Avoid strenuous activities that may stress the wound until it is adequately healed.
• Attend follow-up appointments to monitor healing and to remove sutures if necessary.

Alternatives

• Simple repair for minor wounds that don't require layered closure.
• Adhesive strips or tissue glue for small and superficial wounds.
• Skin grafts for larger wounds, if indicated.
• Each alternative has different healing times, scar appearance, and risk profiles.

Patient Experience

During the procedure, the patient will feel an initial prick from the local anesthesia injection, after which the area will become numb. They may feel pressure or movement but no pain during suturing. Post-procedure, mild discomfort, swelling, or bruising may occur, which can be managed with over-the-counter pain medications and proper wound care.