[Management and orientation of a hand laceration]

The good management and orientation of a hand laceration by the general physician is essential. Anatomical knowledge help to judge, after examination, the opportunity for surgery exploration with local anesthesia. Serious stakes are prognostic and economics. The conclusion identifies three clinical pictures : simple superf cial wound requiring a simple clinical control 2 days follow-up, the dubious wound that need to be sent to a specialized center, and the wound requiring care in an emergency hand unit. Extremely urgent wounds are devascularization, amputation and the pressure injection . Bites and wounds on a tendon way require surgical exploration. Bandage should be as simple as possible in order to allow early motion. No antibiotic is given preventively exept for bite, open fractures and/or delay of treatment. Outpatient surgery under loca anesthesia simplifies management.