Laceration Repair Clinic

A laceration is a tear or cut in the skin, tissue, and/or muscle. Lacerations can vary in location, length, depth, and width. Laceration repair is the act of cleaning, preparing, and closing the wound.

Lacerations can have many causes, including tripping, slip and fall accidents, motor vehicle accidents, sports injuries, work-related injuries, animal bite or mauling, scratches/scrapes/abrasions, stabbing, puncture wounds, gun shots, crush injuries, fights or other physical violence, bicycle accidents, fire, burns, open fractures, lesions, head injuries or any situation that can slash the skin and cause bleeding.

Lacerations that are shallow, small, clean and no longer bleeding may not need medical care. Antibiotic ointment and a bandage may be all that is needed. But, to be safe it is always recommended to get specialized medical advice.

Lacerations may need surgical repair if they exhibit any of the following characteristics:

• Exposed muscle, fat, tendon, or bone
• Dirt and debris in the wound
• Feeling as if something is within the laceration
• Bleeding continues after applying direct pressure
• Jagged or uneven edges
• Deep cut with exposed flesh
• Location on area of high stress (joints, hands, feet, chest)
• Facial injuries
• Dog or cat bites
• High risk for visible and unsightly scarring

Wounds may also need medical care if there is risk of tetanus. This is a bacterial infection from dirt, dust, or feces. A deep or contaminated wound increase your risk of tetanus.

While problems from laceration repair procedures are rare, all procedures have some risk. Your doctor will review potential problems, like:

• Infection
• Bleeding
• Noticeable scarring
• Poor wound closure
• Allergic reaction to anesthetic

How to treat the laceration before you seeing your plastic surgeon:

• Apply direct pressure to the wound. Use gauze or a clean cloth. If the wound bleeds through the gauze or cloth, do not remove it. Add more gauze.
• If possible, elevate the wound above the heart. This will make it harder for blood to flow to the wound. Do not tie a tourniquet around an affected limb. This may cause more damage.
• If bleeding stops, let some water run over the wound. Tap water is safe to use.
• If muscle, tendon, bone, or organs are exposed, do not try to push them back into place.
• If you are feeling faint, lie down or sit down and call for 911.

Once you have realized that you have injured the skin and possibly deeper tissues and structures, it is time to ask for help. It is important to seek medical attention right away. If you think you have a life-threatening emergency call 911.

If it is not a life-threatening emergency, then you may call the Laceration Repair Clinic. You will be asked some questions and given advice regarding your particular case. During your visit, the laceration will be examined, a medical history will be taken, and a treatment plan will be designed specifically for you.

The use of anesthesia depends on the type of laceration, for example:

• Local anesthesia is used for minor lacerations. This will numb the area around the wound.
• General Anesthesia

The wound will be cleaned and prepared. Hair that may interfere will be trimmed and smoothed away. Irrigation with sterile water will be placed into the wound. This will help wash away dirt and debris. An antiseptic will be used to clean to surface around the laceration.

If necessary, jagged edges of the skin will be cut away. This may help the laceration close more easily and evenly. Damaged or dead tissue will be removed to prevent infection. The laceration will be closed once the wound is clean. There are several options to help close the wound:

• Simple repairs can be done with skin glue, adhesive strips, staples, etc. More complex repairs require stitches.
• Stitches are used for wounds that are deep, bleeding, have jagged edges, or have fat or muscle exposed. The area will be cleaned with an antiseptic. A surgical drape may be positioned over the wound. This will keep the area sterile.
• If a laceration is deep, stitches may be needed under the skin. The stitches used under the skin will be absorbed by the body. They will not need to be removed. The wound will then 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. An elastic bandage or tape may be placed over the gauze to cover and protect them.

Some wounds may put you at a higher risk for a tetanus infection. A tetanus vaccination may be given if:

• You have never received a total of at least 3 vaccination doses—routine childhood immunizations are at ages 2, 4, 6, and/or 15-18 months
• It has been more than 5 years since your last tetanus immunization
• You are unsure of your tetanus status

Following the procedure, the staff may provide the following care to make you more comfortable and help your recovery. This will include pain medications or antibiotics.

When you return home:

• Avoid strenuous activities.
• Take antibiotics and pain medication as directed.
• Follow instructions about when it is safe to shower, bathe, or soak in water.
• If you need to keep the incision area dry when showering, wrap the area with a plastic bag.
• After showering or bathing, pat the area dry. Do not rub the area. Also, do not apply hydrogen peroxide or iodine to the wound. This will damage tissue and slow healing.
• Do not pick at or scratch the wound. This may lead to poor healing.

Note: Do not try to remove the closure material. Removing stitches yourself may lead to infection, scarring, or reopening of the wound.

All lacerations heal with scars, thus seeking out a Board Certified Plastic Surgeon at the Laceration Repair Clinic will ensure minimal scarring and the best long term outcome.

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

• Wound reopens
• Redness, warmth, swelling, drainage or excessive bleeding occurs at the wound site.
• Signs of infection, including fever, chills, or red streaks tracking up arm or leg.
• Spasm or rigidity of muscles in jaw, neck, abdomen, or an area near the wound
• New or unexpected symptoms