What is Laceration Repair?

Laceration repair restores a tear in the skin or other tissue. The process is similar to mending a tear in clothing. Primary care physicians, emergency room physicians, and surgeons commonly repair lacerations.

Effects of Laceration Repair

The four objectives of laceration repair are to discontinue bleeding, prevent infection, preserve function and restore appearance.

Candidates for Laceration Repair

Minor lacerations (shallow, small, not bleeding, and clean) may not necessitate medical attention. Antibiotic ointment and a bandage may be all that is required. On the other hand, most lacerations do need repair especially if at least one of the following factors is present:

  • Muscle, fat, tendon, or bone is exposed.
  • Dirt and debris can be seen in the wound.
  • Bleeding continues even after applying direct pressure for 10 to 15 minutes.
  • The edges of the wound are jagged or uneven.
  • Wound is more than 1/8 to 1/4 inch deep.
  • Edges of the wound cannot easily be moved together or aligned.
  • The wound is located at an area of high stress (e.g. joints, hands, feet, chest)
  • Decrease risk of unsightly scarring.

Lacerations are less probable to become infected if they are fixed soon after they occur. A lot of physicians will not repair a laceration that is more than eight hours old since the risk of infection is too great.

Your Consultation

Prior to laceration repair, the physician will carefully examine the wound and the underlying tendons or nerves. If nerves or tendons have been injured, a surgeon may be required to do the repair. The laceration is cleaned by getting rid of any foreign material or debris. Removing foreign objects from penetrating wounds can occasionally cause bleeding, thus this type of wound must be cleaned very carefully. The wound is then irrigated with saline solution and a disinfectant. The disinfecting agent may be mild soap or a commercial preparation. An antibacterial agent may be applied after.

The Laceration Repair Procedure

As soon as the wound has been cleansed, the physician anesthetizes the area of the repair by injecting a local anesthetic. The physician may trim edges that are jagged or extremely uneven. Tissue that is too damaged to nurse back to health must be removed (debridement) to prevent infection. If the laceration is deep, a number of absorbable stitches (sutures) are placed in the tissue under the skin to assist in bringing the tissue layers together. Suturing also facilitates in eradicating any pockets where tissue fluid or blood can build up. The skin wound is closed with sutures. Suture material employed on the surface of a wound is usually non-absorbable and will have to be removed afterwards. A light dressing or an adhesive bandage is applied for 24 to 48 hours. In sections where a dressing is not possible, an antibiotic ointment can be applied. If the laceration is the outcome of a human or animal bite, if it is very dirty, or if the patient has a medical condition that alters wound healing, oral antibiotics may be prescribed.

Recovery

The laceration should be kept clean and dry for no less than 24 hours subsequent to the repair. Light bathing is usually allowable after 24 hours if the wound is not soaked. The physician will give directions for any special wound care. Sutures are removed 3 to 14 days after the repair is finished. Timing of suture removal depends on the location of the laceration and physician preference.

The repair should be observed frequently for signs of infection, which consist of redness, swelling, tenderness, drainage from the wound, red streaks in the skin surrounding the repair, chills, or fever. If any of these should arise, the physician should be contacted right away.

Risks

Infection is the most common complication of any laceration repair. Risk of infection can be reduced by cleansing the wound meticulously. Wounds from bites or dirty objects or wounds that have a great deal of dirt in them are most likely to become infected.

It is expected that all lacerations will mend with a scar. Wounds that are repaired with sutures are less possible to develop scars that are unattractive, but no one can foresee how wounds will heal and who will develop unsightly scars. Plastic surgery can improve the look of a lot of scars.

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FAQs

What is a laceration?

A laceration is a wound brought about by a sharp object producing edges that may be jagged, dirty or bleeding. Lacerations most frequently affect the skin, but any tissue may be lacerated, including subcutaneous fat, tendon, muscle or bone.

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What are the different types of sutures?

Absorbable sutures, the ones used for subcutaneous and two-layer closures, are normally not removed but are permitted to “absorb”; they lose their tensile strength within 60 days. Given their high inclination for infection, absorbable sutures should only be used in clean wounds. Non-absorbable sutures are utilized mainly for epidermal skin closure and are intended to be removed in 5 to 10 days. A few unique types of absorbable sutures (e.g., rapidly absorbable catgut) can be used for skin closure in special circumstances, such as when a patient is not projected to return for suture removal because of the distance involved or a lack of cooperation.

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What is involved during cleansing of the wound?

Cleansing and preparing the wound for repair may entail irrigation, hair removal and debridement of necrotic tissue.

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What is debridement?

Debridement is the act of eliminating any foreign material and damaged or contaminated tissue from a wound to expose surrounding healthy tissue.

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What is irrigation?

Lacerations are preferably irrigated with a sterile solution such as normal saline. Application of a moderate-pressure irrigation device is best. This is promptly carried out by placing several holes in the lid of an unopened bottle of sterile solution with a large-bore needle or by using a 30- to 60-cc syringe with splash cup.

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Are there other alternatives to sutures?

Dermal adhesives and staples are good options to sutures, particularly in certain circumstances. Dermal adhesives should not be used over joints; on hands, feet, lips, or mucosa; on infected, puncture, or stellate wounds; or in patients with poor circulation or a propensity to form keloids.

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Will there be noticeable scarring?

All lacerations heal with scars of varying visibility. Noticeable scaring may be the outcome of the way the body mended itself, attempting to fix the wound without medical care, or the doctor’s skill level and choices. Reduce your risk of acute scarring by allowing a doctor or surgeon to repair the wound, and by allowing the wound to heal without picking or rubbing it.

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What is the usual outcome of a laceration repair procedure?

Wounds start to heal at once, though visible signs of healing may take a few days to a number of weeks to become obvious. Younger individuals may heal more rapidly than older individuals, and healthier individuals may mend faster than individuals with illnesses. Absolute healing will not be complete for six months.

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