| Wound Description/repair | Length___?(in cm) | 
| Location: | NVT intact? | 
| Depth of Laceration:• • • |  Shape• • • | 
| Contamination:• • • | Irrigated?• • • | 
| Wound Prepped with: | Anesthesia used:• • • | 
| Foreign material removed | Debrided? | 
| Wound explored? | Wound repaired with:• • • | 
| Skin closed with• • • | SubQ sutures?• • • | 

