In which areas is the use of lidocaine with epinephrine contraindicated?

The use of lidocaine with epinephrine is contraindicated in areas with poor blood supply because the presence of epinephrine, a vasoconstrictor, can significantly reduce blood flow to already compromised tissues. When blood supply is limited, the risk of tissue necrosis increases, as the vasoconstriction may further deprive the area of essential oxygen and nutrients. This is particularly critical in regions such as fingers, toes, ears, and certain surgical sites where circulation is already impaired.

In options related to open wounds, mucous membranes, and infected skin, while there may be concerns regarding the absorption or potential effects, the primary contraindication is the risk associated with compromised blood flow in specific anatomical areas. Hence, the correct context for understanding the contraindications of using lidocaine with epinephrine primarily focuses on managing the potential for tissue ischemia in areas where blood flow is inadequate.