The Curse of the Keloid

​Each month, we try to bring you a case that is laced with unexpected care techniques. Our hope is that our procedural pearls help enhance your practice. Procedures rarely change over time, but new techniques and equipment may help you tackle new challenges. Once you have mastered simple procedures like incision and drainage and suturing and splinting, you can move on to more advanced procedures.​This month we dare you to think outside the box and combine all your skills to help this weird and wild patient. We've said it before, and we'll say it again: It may not be an emergency, but it's an emergency to your patient.A keloid removed from the hand of a 40-year-old Caucasian man. Photo by M. Roberts.This 40-year-old man of Irish descent has light skin and scars easily. He cut his hand several weeks earlier and ignored the need for suturing, causing the skin to form a large keloid. The original injury was a deep laceration that took a long time to heal by secondary intention. The result was significant pain and a cosmetic cruelty. It is unlikely that he will ever follow up with a specialist, and that is where you come into play.The hand is a complex combination of skin, muscle, tendon, ligament, nail, joint, and bone. The thin surface makes it prone to infection and scarring. There is a reason plastic surgery specialists spend many years studying and perfecting the art of hand repair.This is why your attention to hand injury cases, wound care, and healing is crucial. Pr...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs