110 likes | 261 Views
Lacerations near the Eye. Priorities. Was the globe penetrated? Is there a foreign body? Was the orbit penetrated? Is there a globule of fat sticking out of a lid laceration? If so there may be a globe injury without posterior lid penetration.
E N D
Priorities • Was the globe penetrated? Is there a foreign body? • Was the orbit penetrated? Is there a globule of fat sticking out of a lid laceration? If so there may be a globe injury without posterior lid penetration. • Is there a vertical lid laceration, that if repaired may lead to a contracture, inability to close lids and chronic corneal ulcers?
Priorities • Is there a through and through laceration involving tarsal plate? Is there loss of more than 1/3 of lid margin? • Are important structures in lids involved?
When debriding eyebrow wound, angle cuts parallel to hair roots and follicles
Levator palpebrae muscle and lateral and medial ligaments must be intact for eye to close properly
Horizontal lid lacs, determine no orbit penetration, Levator intact, close with simple interrupteds
Most lid margin lacerations best consulted to eye or plastics, but