Eyelid Laceration
History:
Healthy and normally developed 5- year old fell down the stairs – approximately 4 steps – and landed on her face. Acute pain and bleeding from her left upper eyelid but no problems with her vision. She did not pass out. She is up to date on all immunizations. No abuse/neglect concerns.
Findings:
5 year old girl, fell down the stairs and sustained an 8x2mm eyelid laceration. Closed with SteriStrips and then shown 8 months later.
Diagnosis:
7 mm horizontal laceration down to supraorbital rim in left lateral upper eyelid.
Differential Diagnoses:
Fracture and Concussion which have been ruled out.
Workup Required:
Plan:
The wound was cleaned with saline and closed with steri strips without local anesthesia.
Expertise Needed:
Emergency Room MD, PA, NP or RN.
Informed Consent:
Unpredictability of scar development and risk of reinjury in a 5-year old during healing are main concerns.
Treatment:
Wound gently cleaned with saline on sterile gauze and then dried by gentle dabbing with dry sterile gauze. Wound closed with ¼” flesh colored steri strips cut down to 10mm in length. Pick ups are used to apply the steri strips perpendicular to the laceration, first on one side, and the wound edges are then approximated by pulling on the steri strips before laying them down on the opposite side of the laceration. No need for prophylactic antibiotics.
Follow Up:
With Pediatrician in 7 days. Parents are given two sterile packs (sheets) of flesh colored steri strips and advised to replace them as they fall off for a total of 1 month. The replacement procedure is clean and not sterile.
