Pronounced: Lass-er-ae-shun repair
A laceration is a wound that occurs when skin, tissue, and/or muscle is torn or cut open. Lacerations may be deep or shallow, long or short, and wide or narrow. Laceration repair is the act of cleaning, preparing, and closing the wound.
Minor lacerations (shallow, small, not bleeding, and clean) may not require medical attention. Antibiotic ointment and a bandage may be all that is needed. Some lacerations do require repair. Reasons for seeking medical attention include:
Note: If you are not sure if a wound needs to be repaired, go to the hospital.
If you have a laceration repair, your doctor will review a list of possible complications, which may include:
To treat the laceration before you see the doctor:
Once you are at the hospital, the doctor will likely do the following:
This depends on the type of laceration, for example:
In some cases, no anesthesia is given.
The wound will be cleaned and prepared:
Dermabond is a special glue that holds a wound together. Dermabond is used on the face, arms, legs, and torso. It can also be used on lacerations smaller than 2-½ inches. It is not used for lips, lacerations that are over joints, deep lacerations, or most hand and foot lacerations. The doctor will hold the wound shut. Next, he will apply a thin layer of Dermabond. Warmth may be felt as the glue sets. Dermabond will be applied in three coats. The wound will then be held in place for 60 seconds. The doctor may place a bandage over the wound. In some cases, stitches may also be done.
Note: The glue acts like a protective coating. It is not placed in the wound or between the edges of the wound. Never try to repair a wound at home with glue. Getting glue into wounds may prevent them from healing properly.
These adhesive strips are used for minor lacerations that are:
The doctor will align the wound. The strips will be applied across the wound.
Sutures are used for wounds that are deep, bleeding, have jagged edges, or have fat or muscle exposed. The area will be cleaned with iodine, and a surgical drape may be positioned over the wound and taped to the skin. This will keep the area sterile.
If a laceration is deep and underlying tissue or muscle is also lacerated, stitches may be needed under the skin before the wound can be closed. This will rejoin muscle and tissue layers. The stitches used under the skin will be absorbed by the body. They will not need to be removed.
If a wound is not deep, or the suturing under the skin is finished, the wound will be stitched shut. Once the wound is closed, saline will be used to clean the area. A thin layer of antiseptic ointment may be applied, as well. A gauze pad may be placed over the stitches. Also, an elastic bandage or tape may be used to cover and protect them.
Staples are best suited for the scalp, neck, arms, legs, torso, and buttocks. Iodine will be applied to the skin surrounding the wound. The wound edges will be closed and aligned. Staples will be placed along the wound.
The doctor will use saline to cleanse the staple line. The area will be patted dry. An antibiotic ointment will be applied. Next, the doctor will apply a clear acrylic dressing called Tegaderm to the staple line. A gauze pad and tape will be used to secure the wound.
Hair tying is used for some scalp lacerations. Hair will be gathered in a way that pulls the wound shut. The hair will then be rubber banded or held together with dermabond so the wound remains shut. This technique follows the same principal as stitches without penetrating the skin.
This depends on the laceration. It may take less than 15 minutes or more than an hour.
This also depends on the laceration. Severe lacerations will be very painful. Ask your doctor about pain medicine.
Following the procedure, the staff may provide the following care to make you more comfortable and help your recovery:
When you return home, do the following to help ensure a smooth recovery:
Removal of wound closure material depends on the type of repair that you had:
Note: Do not try to remove the closure material. Removing materials yourself may lead to infection, scarring, or reopening of the wound.
All lacerations heal with scars. The degree of scarring varies and is influenced by:
After arriving home, contact your doctor if any of the following occurs:
In case of an emergency, CALL 911.
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org/
National Library of Medicine
http://www.nlm.nih.gov/
CANADIAN RESOURCES:
Canadian Association of Wound Care
http://www.cawc.net/
Skin Care Guide.ca
http://www.skincareguide.ca/
References:
Beam, J. W. Wound Cleansing: Water or Saline? J Athl Train. 2006;4(2):196-197.
Burns T, Worthington J. Using tissue adhesive for wound repair: a practical guide to Dermabond. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000301/1383.html. Published March 1, 2000. Accessed September 15, 2005.
Cuts and scrapes. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?objectid=FDEFD23A-F29F-47FB-9A7CD4CF4427D590. Updated June 2009. Accessed September 18, 2009.
Joyce, M. P. Routine Vaccine-Preventable Diseases - Tetanus. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/tetanus.aspx. Updated July 27, 2009. Accessed October 30, 2009.
Laceration. Allina Hospitals and Clinic website. Available at: http://www.medformation.com/ac/mm_qdis.nsf/qd/nd0730g.htm. Accessed September 15, 2005.
Ong, M. E. A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacerations (HAT study). Ann Emerg Med. 2002;40:19-26.
Perron AD, et al. The efficacy of cyanoacrylate-derived surgical adhesive for use in the repair of lacerations during competitive athletics. Am J Emerg Med. 2000; 18:261-263.
Quinn J, et al. Tissue adhesive versus suture wound repair at 1 year: randomized clinical trial correlating early, 3-month, and 1-year cosmetic outcome. Ann Emerg Med. 1998; 32:645-649.
Snell G. Laceration Repair: Procedures for Primary Care Physicians. St. Louis, MO: Mosby; 1994.
Wilson J, Kocurek K, Doty J. A systematic approach to laceration repair: tricks to ensure the desired cosmetic results. Postgraduate Medicine Online website. Available at: http://www.postgradmed.com/issues/2000/04_00/wilson.htm. Accessed September 15, 2005.
Last reviewed November 2009 by D. Steele Beasley, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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