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About Brian Lin, MD

UCSF Assistant Professor of Emergency Medicine
Kaiser Permanente Hospital, San Francisco, CA
Founder and author, LacerationRepair.com
11 09, 2017

Extensor Tendon Lacerations to the Foot

2017-09-11T03:28:42+00:00

A young man is brought into an emergency department after an electric lawn edger cut through his work boot and into the dorsum of his right foot. He has a clearly contaminated 5 cm x 1 cm laceration on the lateral side, and an underlying tendon is exposed. Sensation is diminished around the wound and he is unable to actively extend his 5th toe past a neutral position. How would you diagnose and repair his extensor tendon injury?

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5 11, 2015

Trick of the Trade: Dermal Avulsion Injuries 2.0

2016-11-11T19:39:55+00:00

Take a shortened, piece of rubber tourniquet and encircle the finger, then clamp it with a needle driver.This year I published a Novel, Simple Method for Achieving Hemostasis of Fingertip Dermal Avulsion Injuries in the Journal of Emergency Medicine 1  a technique I’ve used in my local ED for several years. In brief, this involves achieving hemostasis over a fingertip skin avulsion by using a tourniquet followed by tissue adhesive glue. After bringing the technique to press and sharing this video, I’ve received great tips from peers and subsequently refined it with some additional ideas.  Thus I present for the first time on ALiEM: Dermal Avulsion Injuries 2.0.

 

 

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16 08, 2014

Trick of the Trade: V-to-Y flap laceration repair for tension wounds

2016-11-11T19:22:28+00:00

Laceration repairYou see a patient with a large V-shaped laceration under tension requiring suture repair. Resist the temptation to simply pull the edges together and close the laceration with simple interrupted or running sutures. Excessive tension on a flap edge during the healing process can compromise its blood supply. This causes ischemia to the healing tissue, which in turn makes that flap edge more likely to dehisce, necrose, and become infected.

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