Hello, med students. My name is Zach Olson, and thank you for downloading this episode of the EM Clerkship Podcast.

This month, we're going to be going through some wound care episodes.

On your clerkship evaluation forms, there is this category for procedural skills, something along those lines.

And from personal experience with filling these forms out, this is a hard category for

attendings and residents to grade because you don't get a lot of opportunities to prove yourself

with this.

And so you need to be ready to impress when you get the chance to do these procedures

during your clerkship.

For the vast majority of you, the procedures that you are going to be able to get your hands on

are the soft tissue type things. The big three are lacerations, abscesses, and burns.

And so that is where I want you to focus all of your brain energy.

Today, we are starting with the general approach to lacerations. Because this is probably the

most important one. This is going to be a two-part episode. We'll cover your evaluation and

presentation to the attending today. And then actually actually we'll cover the procedure itself next week.

But today, the most important thing that you kind of need to just understand about

laceration repair is this spectrum of should we repair or should we not repair the wound.

Because when we close a laceration and we suture it or whatever, it decreases the wound. Because when we close a laceration, when we suture it or whatever, it decreases

the scar. That's why we do it. But it actually increases the risk of infection. If we delay closing

the wound for a couple days, it'll make, sure, a slightly worse scar, but it'll decrease the risk of infection.

And some wounds, believe it or not, are best left just completely open.

You get a big scar, but such a lower risk of infection, that that's the decision we make.

And so the whole approach today is this balance.

...