Urgent Care Urgent Care for Lacerations and Wound Care 1 — Questions and Answers
Question 1: Which wound closure method is most appropriate for a clean, linear laceration on the forearm that is 3 cm long and less than 6 hours old?
- Healing by secondary intention
- Primary closure with sutures (Correct answer)
- Wound packing with gauze
- Topical antibiotic only
Correct answer: Primary closure with sutures
Clean lacerations less than 6–8 hours old are ideal candidates for primary closure with sutures to minimize scarring and infection risk.
Question 2: What is the recommended tetanus booster interval for an adult with a clean minor wound who was last vaccinated 6 years ago?
- No booster needed (Correct answer)
- Booster required now
- Td booster and TIG required
- Full primary series needed
Correct answer: No booster needed
Adults with a clean minor wound whose last tetanus booster was within 10 years do not require a booster.
Question 3: Which sign in a wound is most indicative of early infection requiring antibiotic therapy?
- Serous drainage
- Mild bruising around wound edges
- Purulent discharge with surrounding erythema (Correct answer)
- Slight wound edge swelling on day one
Correct answer: Purulent discharge with surrounding erythema
Purulent discharge with surrounding erythema are classic signs of wound infection warranting antibiotic treatment.
Question 4: A patient presents with a dog bite to the hand. What is the most appropriate management regarding antibiotics?
- No antibiotics needed for dog bites
- Prophylactic amoxicillin-clavulanate for 3–5 days (Correct answer)
- Prophylactic cephalexin for 7 days
- Topical mupirocin only
Correct answer: Prophylactic amoxicillin-clavulanate for 3–5 days
Dog bites to the hand carry a high infection risk, and amoxicillin-clavulanate is the first-line prophylactic antibiotic covering Pasteurella and anaerobes.
Question 5: Which anatomical location is generally considered a contraindication to wound closure with tissue adhesive (skin glue)?
- Scalp lacerations
- Hand lacerations near joints (Correct answer)
- Facial lacerations in adults
- Trunk lacerations
Correct answer: Hand lacerations near joints
Wounds over joints are subject to repeated movement and stress, which causes tissue adhesive to fail and is a contraindication to its use.
Question 6: What is the correct order of wound irrigation steps for a contaminated laceration in urgent care?
- Irrigate, then anesthetize, then explore
- Anesthetize, then irrigate with normal saline under pressure, then explore (Correct answer)
- Explore first, then irrigate, then anesthetize
- Apply antibiotic ointment, then irrigate, then close
Correct answer: Anesthetize, then irrigate with normal saline under pressure, then explore
The proper sequence is anesthesia first for patient comfort, followed by high-pressure saline irrigation, then thorough wound exploration.
Urgent Care Urgent Care for Lacerations and Wound Care 1
Which wound closure method is most appropriate for a clean, linear laceration on the forearm that is 3 cm long and less than 6 hours old?