Laceration Repair

The main goals behind a repair of a laceration include:

How does laceration repair work?

Our healthcare providers will first evaluate your cut or laceration to see if ongoing bleeding can be controlled or this needs to be referred to the emergency department. Once they understand if this is a simple laceration or something that is more complex they can start the process. Some wounds and cuts do need a higher level of care that can only be provided in an emergency room or emergency medicine setting.

Cleaning & Prepping the laceration or wound for repair

Wound preparation is extremely important! First they will clean the wound thoroughly with soap and water to avoid infections and apply direct pressure to stop any bleeding. At times, local epinephrine is required to aid in the stopping of bleeds. They will then decide if your specific laceration requires sutures and which sutures would be appropriate for the kind of break in your skin that you have suffered. Sometimes special skin glue and taping is used to close skin tears without the use of sutures.

At the same time the specific tissue or skin laceration is evaluated for underlying tissue, vascular structure or nerve damage. If there appears to be nerve or vascular damage then our physicians will get in touch with the appropriate vascular surgeon or plastic surgeon to assist with the care of your injury. Many times a laceration does not involve underlying damage but it is imperative for future function to rule out underlying injury.

After the area is examined thoroughly the skin laceration is cleaned using sterile washes and antiseptics and foreign bodies and objects if present are removed. Once the wound or skin break is evaluated, the area is numbed by injection of local anesthetics such as lidocaine. Sometimes with deeper lacerations absorbable sutures are placed in the tissue to help bring the tissue and skin better together.

Sutures help bring the skin together so that it may heal properly with limited scarring and risk of infection. It is imperative that the wound or suture site is monitored and followed up for signs of infection. At times steri-strips are placed to reinforce the wound and keep it together.

Dermabond for laceration repair

Dermabond is a type of liquid tissue adhesive that is used to close and seal lacerations that may occur. Our physicians will use dermabond, which is a medical-grade super glue if you will, when possible. Dermabond is applied to the edges of the wound and is activated by a special light that causes the adhesive to harden.

Dermabond has several advantages over traditional sutures or staples for laceration management. It is quick and easy to apply, and can be used in place of sutures or staples for small or shallow lacerations. It also causes no pain or discomfort vs traditional wound closure methods such as sutures.

What area of the body do we perform laceration repair on?

It is all dependent on the severity of the cut or wound but in general we are able to perform laceration repair on the following areas of the body or soft tissue:

Are your physicians able to treat bite wounds?

Yes! Our physicians are able to treat bite wounds. Bite wounds are a bit trickier and require some special consideration. Bite wounds can become infected more easily. Cat bites have a higher risk of infection than dog or human bites. The longer there is a delay in repairing the wound, the higher the risk of infection becomes regardless of the type of suture material used.

There is limited evidence on the best timing for primary closure and antibiotic treatment. In studies, suturing improved the appearance of dog bite wounds, but did not affect the infection rate. Therefore, dog bite wounds, particularly those on the face, should be repaired. However, for cat bite wounds, which have a higher infection rate, primary closure may not be necessary, particularly if the wound is not located on the face or scalp. Wounds with a high risk of infection, such as cat bites, deep puncture wounds, or wounds longer than 3 cm, should be treated with prophylactic amoxicillin/clavulanate or Clindamycin for patients with a penicillin allergy.

Again in case and bit is different and one should consult their physician to make sure the proper care is provided for their specific situation.

Signs of infection at suture site include:

• Redness around suture site
• Lymph node drainage
• Scab which has increased in size
• Pain or swelling around site
• Blisters around wound

• Raised skin or tissue
• Delayed wound healing
• Pus or drainage from site
• Fever
• Spreading red streak

Traumatic wound or break in the skin can be closed with different sutures but most common used suture is nylon based. Sutures usually used for skin lacerations are non-absorbable and are usually removed in 7 to 10 days depending on the site of the laceration and mobility of the site. Cuts and wounds on the face where the skin is thinner for example will be removed sooner than sutures placed on places that incur more movement or have thicker skin.

Our doctors will place a dressing or adhesive bandage to the area as well as instruct you to place ointments with healing and anti-septic properties.

Some lacerations require oral antibiotics vs antibiotic ointments. Human or animal bite cuts and wounds are more likely to become infected and require oral antibiotics.  Our doctors may also require a tetanus vaccine if you have not recently had one or the object in which the cut occurred from was rusty or metal based.