A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:

• A. replace the avulsed flap to its original position and cover it with a sterile dressing.
• B. carefully probe the wound to determine if the bleeding is venous or arterial.
• C. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing.
• D. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing

Answer: (A)

Replacing the avulsed skin flap to its original position and covering it with a sterile dressing is the best approach because it preserves tissue viability. By reapplying the flap, you maintain the tissue’s blood supply as much as possible, increase the chances of healing with better cosmetic and functional outcomes, and protect the exposed tissue from contamination. Keep the flap moist and avoid letting it dry out while securing it in place.

Probing the wound to determine bleeding type isn’t necessary and can cause further tissue damage. Removing the avulsed flap is counterproductive because it sacrifices viable tissue. Irrigation alone, while sometimes appropriate, does not address the critical step of preserving and repositioning the avulsed tissue.