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.
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Effects of Laceration Repair
The
four objectives of laceration repair are to discontinue
bleeding, prevent infection, preserve function and restore
appearance.
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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.
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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.
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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.
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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.
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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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Frequently Asked
Questions
Q:
What is a laceration?
A:
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.
Q:
What are the different types of sutures?
A:
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.
Q:
What is involved during cleansing of the wound?
A:
Cleansing
and preparing the wound for repair may entail irrigation,
hair removal and debridement of necrotic tissue.
Q:
What is debridement?
A:
Debridement is the act of eliminating any foreign material
and damaged or contaminated tissue from a wound to expose
surrounding healthy tissue.
Q:
What is irrigation?
A:
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.
Q: Are
there other alternatives to sutures?
A:
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.
Q:
Will there be noticeable scarring?
A:
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.
Q:
What is the usual outcome of a laceration repair procedure?
A:
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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