Laceration Repair
Definition
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.
Purpose
A laceration should be repaired if it:
- continues to bleed after application of pressure for ten to fifteen 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
Precautions
Lacerations are less likely to become infected if they are repaired soon after they occur. Many physicians will not repair a laceration that is more than eight hours old because the risk of infection is too great.
Description
Laceration repair mends a tear in the skin or other tissue. The procedure is similar to repairing a tear in clothing. Primary care physicians, emergency room physicians, and surgeons usually repair lacerations. The four goals of laceration repair are to stop bleeding, prevent infection, preserve function, and restore appearance. Insurance companies do pay for the procedure. Cost depends upon the severity and size of the laceration.
Before repairing the laceration, the physician thoroughly examines the wound and the underlying tendons or nerves. If nerves or tendons have been injured, a surgeon may be needed to complete the repair. The laceration is cleaned by removing any foreign material or debris. Removing foreign objects from penetrating wounds can sometimes cause bleeding, so 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.
Once 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 heal must be removed (debridement) to prevent infection. If the laceration is deep, several absorbable stitches (sutures) are placed in the tissue under the skin to help bring the tissue layers together. 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. A light dressing or an adhesive bandage is applied for 24-48 hours. In areas where a dressing is not feasible, an antibiotic ointment can be applied. 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, oral antibiotics may be prescribed.
