Laceration Repair

A laceration is a tear, cut or opening of the skin caused by an injury or trauma. Laceration repair is the process of cleaning, preparing and closing the lacerated wound. Shallow and small lacerations that are not bleeding can be treated with antibiotic ointment, and may not need repair. However, deep lacerations that have fat, muscle, tendon or bone exposed, have jagged edges or are located around high stress regions (chest, hands, feet and joints) usually require medical repair.

Laceration repair may involve the following techniques:

Sutures: Suturing is a suitable method for treating wounds that require multiple-layer closure. The wound is cleaned and prepared. Depending upon the location of the wound, a suitable suture technique is selected. The ends of the suture are then secured with slip knots or tape. The wound is cleaned and dressed to avoid infection.

Tissue adhesive: Tissue adhesives are best suited for simple lacerations. They can be applied quickly and require no anesthesia or follow-ups. The technique involves irrigating the wound followed by drying the area with a sterile gauze and placing the tissue adhesive in a horizontal position to prevent runoff. Using gloved fingers, the edges of the wounds are held closed and the adhesive is applied in a thin layer over it. Three to four layers of the tissue adhesive are applied with a gap of about 30 seconds. Your doctor will instruct you not to use antibiotic and white petrolatum ointments as they can remove the tissue adhesive.

Stainless steel or absorbable staples: The wound is cleaned and the wound edges are aligned and secured with staples. The wound is then flushed with saline, dried and an antibiotic ointment is applied followed by a sterile dressing. These are used for lacerations in the scalp, neck, arms, torso, buttocks and legs.

Skin-closure strips: These are strips of adhesive material that are placed along the wound edges to help close the laceration. The strips may be used for shallow, clean lacerations that have straight edges.

Following the above procedures, you may be prescribed pain medication and antibiotics to prevent infections depending on the injury. Your doctor may also give you a tetanus injection to protect you from developing a serious bacterial infection called Tetanus.