$Unique_ID{BRK01435}
$Pretitle{Special Procedures and Laboratory Tests, Skin and Subcutaneous
Tissue}
$Title{New Anesthetic Technique For Open Cuts}
$Subject{laceration repair local anesthetic}
$Volume{P-20, L-20}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


New Anesthetic Technique For Open Cuts


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QUESTION:  When I took my youngster to the emergency room for some stitches in
an open cut on the arm, I was permitted to stay in the room during the repair
as I worked as a nurse before my marriage.  However I was a bit surprised at
the physicians technique which did not use the injection of a local anesthetic
before the sutures, but rather a soak with some solution to numb the pain.  I
guess I should have asked about it when I was there, but I didn't and wonder
if you can explain what this technique is all about.  It certainly seemed to
work fine.  Thank you.

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ANSWER:  There is no stopping progress and this technique does seem to be the
answer to a mother's (and physician's) prayer when a youngster must be treated
for an open laceration.  It consists of soaking the open wound with a topical
solution called TAC which is made up of 0.5 percent tetracaine, 1:2000
adrenaline, and 11.8 percent cocaine.  It is considered to be as effective a
pain killer as the traditional lidocaine injection, but does away with the
need of additional needle sticks for an already frightened child.  This
permits the physician to establish a calming and soothing relationship with
the young patient, without proving any new additional pain that can often
destroy any confidence at the very outset of an emergency visit.  The trick in
using this technique is to use sterile cotton balls saturated with TAC (rather
than gauze pads) which allow the liquid to penetrate into the wound.  The dose
is 1 ml of solution for every 1 cm of laceration with a maximum of 10 ml.  The
parent can be of valuable assistance and help to hold the soaked cotton balls
on the wound (while wearing rubber gloves to prevent numbing the hand as
well!) for about ten minutes.  Cleaning a wound prepared in this manner is
easier, and the surgical repair is swifter as the edges of the wound have not
been altered as may happen in the case of an injection.  Most important of all
is that the child may exit the procedure with more smiles than tears, and
reduced anxiety if this frequent childhood emergency recurs at another time.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
