Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ Surgical wounds.Traumatic wounds. +++ Absolute ++ Multiple comorbidities precluding safe intervention.Active infection.Foreign body (except surgical implants).Active bleeding. +++ Relative ++ Impaired healing (corticosteroids, malnutrition, radiation, chronic disease). ++ The wound should be fully exposed and at comfortable working distance from the surgeon.A light source is often necessary in the emergency department setting. ++ Wound edges should remain clean.Sutures should be removed several days (typical in face) or weeks following repair, depending on the location of the wound and characteristics of the tissue.Pain control with analgesics is appropriate.Antibiotics are not necessary for most wounds but may be recommended in contaminated wounds following closure. ++ Wound infection. Infected wounds, particularly those involving deep spaces, are typically opened to prevent systemic spread.Unfavorable scarring. Some scarring is expected, but hypertrophic scars, keloids, or wound contraction leading to functional limitation may occur, often without a known cause.Some wounds with unfavorable scarring may require scar revision.Standing cutaneous deformities ("dog ears") may be a result of individual wound length differences leading to excess tissue on one side of the wound, or occur in cases in which tissue rearrangement is necessary to achieve closure. These cutaneous deformities may persist and can often be addressed at primary closure.To remove a standing cutaneous deformity, the tissue leading to the deformity can be lifted away from the plane of tissue and resected in an elliptical fashion.If executed properly, the dimensions of the newly created ellipse will allow primary closure without a standing cutaneous deformity. GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessAnesthesiology 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessAnesthesiology Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options