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Question: Trauma

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A child has a large galea aponeurotica laceration that is part of a scalp laceration. The provider sutured the scalp laceration but failed to close the galea.

The child is at risk of which of the following complications?
Wound Management

pemsou5_wp • January 1, 2019

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  1. Kelly January 2, 2019 - 5:36 pm Reply

    D) A and C
    The galea is a dense white layer that covers the periosteum of the skull. It serves as an insertion point for the frontalis and occipitalis muscles, and failure to repair large horizontal frontal lacerations can result in asymmetric facial expression. Failure to repair can also allow bacteria to more easily get to the loose connective tissue layer between the galea and periosteum, leading to increased risk of infection. Subgaleal hematoma is another potential complication of failure to repair. Leptomeningeal cysts are complications of skull fractures, mostly seen in young children < 3 years old. Many experts recommend repairing galeal lacerations 0.5cm or greater in size with 3-0 or 4-0 absorbable suture.

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