Laceration Repair

Our doctors are fully equipped and experienced to repair most skin lacerations. Please contact our Beverly Hills office today at 310-299-8959 to have your cut or laceration evaluated and repaired.

Laceration repair and suturing of lacerations is performed to mend a tear or cut in the skin and or other tissue. It is imperative that you are evaluated by a physician if you have suffered a cut or laceration that looks deep and requires suturing or repair.

Sometimes there may be underlying damage to nerves, tissue or blood vessels that needs immediate evaluation by a trained physician.

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The main goals behind a repair of a laceration include:

  • Cessation of ongoing bleeding
  • Local anesthesia prior to wound closure
  • Restoration of cosmetic appearance & wound closure
  • Preservation of function
  • Prevention of bacterial infections
  • Cleaning and Debridement
  • Minimization of scarring

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.

As Seen On

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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:

  • Face
  • Eyelids
  • Eyebrow
  • Ear
  • Scalp laceration or scalp wounds ( In some cases this my need staples or referral to emergency room)
  • Hands and forearm
  • Legs
  • Chest
  • Buttocks
  • Back
  • Feet
  • and more

What are the types of suture techniques?

  • Simple interrupted suture: individual stitches are placed at regular intervals along the wound, with each knot being tied separately.
  • Continuous suture: a single thread is used to close the wound, with the thread being passed continuously through the edges of the wound.
  • Subcuticular suture: the suture thread is passed just under the skin’s surface, making the suture invisible.
  • Mattress suture: stitches are placed perpendicular to the wound edge, with one side being buried in the tissue and the other side being visible.
  • Horizontal mattress suture: similar to the mattress suture, but the stitches are placed at a 90-degree angle to the wound edge.
  • Buried suture: the stitches are placed under the skin’s surface and not visible.
  • Locking suture: the suture is tied with a special knot that locks in place, preventing it from unraveling.
  • Running suture: a continuous suture that is passed through the wound edges in a continuous manner, with the knot being tied only at the end of the suture.

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.

Are your physicians able to treat bite wounds

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.

Are you able to provide laceration repair for pediatric population?

Yes we are, but this is dependent on the age of your child. Younger children will not stay still at times and they may require an IV anesthetic to stay calm and still. IV anesthetic will need to be provided in emergency medicine setting or in an operating room. If your child is older and cooperative, local and topical anesthetics are used to numb the area prior to repair. At times a nerve block can be performed to numb up the area prior. We do work with several plastic surgeons in the area and can facilitate and setup the location for it to be performed.

Are your doctors available on nights and weekends for laceration repair?

Yes are doctors are available at nights and weekends for the assessment and management of wound care and sutures.

Follow up of Lacerations

It is imperative that on gets proper aftercare and followup to ensure the healing of a laceration and best cosmetic results. While it is traditionally recommended to keep wounds covered and dry for 24 hours, research has shown that uncovering the wound for routine bathing within the first 12 hours after closure does not increase the risk of infection. Applying topical antibiotic ointment to traumatic lacerations repaired with sutures can also lower the risk of infection. The best results are seen with an ointment containing bacitracin and neomycin, unless the patient has an allergy to antibiotics. While there is no evidence to support the use of prophylactic systemic antibiotics in simple non-bite wounds, keeping the wound moist can promote faster healing and prevent wound infections.

Occlusive and semi-occlusive dressings have been shown to be more effective in promoting healing, decreasing wound contamination, and increasing comfort compared to dry gauze dressings. The choice of moisture-retentive dressing should be based on the amount of draining that is expected. Patients with contaminated or high-risk wounds with rusty objects who have not had a tetanus booster for more than five years should receive a tetanus vaccine. Sutures should be removed after an appropriate interval depending on the location of the wound based on doctors recommendation. Our doctors will give you a date for suture removal when they close the laceration.

House Call Doctor for Laceration Repair

Our house call doctors, plastic surgeons or vascular surgeons are well equipped to evaluate and repair your laceration at your home, hotel or desired location. We are currently providing repair of cuts and wounds throughout the greater Los Angeles area.

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Worster B, Zawora MQ, Hsieh C. Common questions about wound care. Am Fam Physician. 2015;91(2):86-92

Jaindl M, Oberleitner G, Endler G, Thallinger C, Kovar FM. Management of bite wounds in children and adults—an analysis of over 5000 cases at a level I trauma centre. Wien Klin Wochenschr. 2016;128(9–10):367-375.

Edlich RF, Thacker JG, Buchanan L, Rodeheaver GT. Modern concepts of treatment of traumatic wounds. Adv Surg. 1979;13:169-197

Heal C, Buettner P, Raasch B, et al. Can sutures get wet? Prospective randomised controlled trial of wound management in general practice. BMJ. 2006;332(7549):1053-1056.

Author: David Nazarian, M.D.

Board Certified in Internal Medicine and Specialist in Concierge Medicine & Executive Health. Dr. Nazarian practices Integrative Medicine with focus on preventative medicine, anti-aging, hormone replacement therapy and IV Vitamin optimizations. Dr. David Nazarian, received his bachelor of sciences from the University of Los Angeles, California in Psychology and Biology. He obtained his Medical Doctorate degree from Sackler School of Medicine. He completed his medical residency at Huntington Memorial Hospital, a University of Southern California affiliate hospital. Once completed, he established a practice in the heart of Beverly Hills. Dr. Nazarian is a Diplomat of the American Board of Internal Medicine. He has received numerous awards and recognition as a top doctor in his field.