Repair of Lacerations

A laceration is a wound caused by a sharp object producing edges that may be jagged, dirty, or bleeding. Lacerations most often affect the skin, but any tissue may be lacerated, including subcutaneous fat, tendon, muscle, or bone.After occurring lacerations, they should be repaired very soon in order to avoid get infected. A Laceration is repaired so that wound can heal quickly, risks of infection can be minimized and to avoid premature splitting of sutures (dehiscence), and poor cosmetic result.

It is wise to repair a laceration when it:
  • Continues to bleed after application of pressure for 10-15 minutes.
  • Is more than one-eighth to one-fourth inch deep.
  • Exposes fat, muscle, tendon, or bone.
  • Causes a change in function surrounding the area of the laceration.
  • Is dirty or has visible debris in it.
  • Is located in an area where an unsightly scar is undesirable.

Procedure

Laceration is repaired to stop bleeding, prevent infection, preserve function, and restore appearance. Laceration repair involves the following steps:

  • Wound assessment: First, the laceration is cleaned by removing any foreign material or remains. It is done very carefully as removing foreign material from wound can cause bleeding. If hair is located in or around the wound, it is usually removed to minimize contamination and allow for good visibility of the wound. After removing the foreign element, the wound is irrigated with saline solution and a disinfectant. An antibacterial agent may be applied.
  • Wound preparation:Now, the affected area is anesthetized by physician by local injection or lidocaine.
  • Wound Closure: Wound is closed by placing the stitches. If the laceration is deep, several absorbable stitches (sutures) are placed in the tissue under the skin to help bring the tissue layers together. The physician may trim edges that are jagged or extremely uneven. Tissue that is too damaged to heal must be removed (debridement) to prevent infection. Suturing also helps eliminate any pockets where tissue fluid or blood can accumulate. The skin wound is closed with sutures. Suture material used on the surface of a wound is usually non-absorbable and will have to be removed later. If the laceration is the result of a human or animal bite, if it is very dirty, or if the patient has a medical condition that alters wound healing, a broad-spectrum antibiotic may be

Aftercare

The laceration is kept clean and dry for at least 24 hours after the repair. Light bathing is generally permitted after 24 hours if the wound is not soaked. The physician will provide directions for any special wound care. Sutures are removed three to 14 days after the repair is completed. Timing of suture removal depends on the location of the laceration and physician preference. The repair should be examined frequently for signs of infection, which include redness, swelling, tenderness, drainage from the wound, red streaks in the skin surrounding the repair, chills, or fever. If any of these occur, the physician should be contacted immediately.

Risks

The most serious risk associated with laceration repair is infection. Risk of infection depends on the nature of the wound and the type of injury sustained. Infection risks are increased in wounds that are contaminated with soil or fecal matter, are the result of bites, have been open longer than one hour, or are located on the extremities or on the region between the thighs, genitalia, or other areas where opposing skin surfaces touch and may rub.

Normal Results

All lacerations will heal with a scar. Wounds that are repaired with sutures are less likely to develop scars that are unsightly, but it cannot be predicted how wounds will heal and who will develop unsightly scars. Plastic surgery can improve the appearance of many scars.

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