Essential Steps in Laceration Repair
Open wounds can occur in a split second, regardless of where you are or what you happen to be doing. It is important to understand and follow appropriate procedures for finger laceration repair and other wound care, in order to avoid infection and promote proper healing.
Open Wound Types
Though it is common to hear wounds that require suturing referred to as “cuts, lacerations, tears” etc., this is not completely accurate. Open wounds and their particular causes can be found in greater detail below.
- Lacerations: Tear-like wounds that are irregular in nature, typically the result of blunt-force trauma. This term is commonly used incorrectly to describe what is actually an incision wound.
- Incisions/incised wounds: A cut in the skin and other tissue from objects with sharp edges, such as glass, a knife, or a razor.
- Abrasions: A wound, superficial in nature, in which the topmost skin layer (epidermis) has been grazed or scraped off, generally the result of a fall on a rough surface.
- Punctures: A wound to the skin or other tissue from an object like a nail or needle puncturing through the skin.
- Penetration wounds: The result of an object, like a knife, entering and exiting the skin.
Overview of Laceration Repair
A laceration is a type of wound consisting of skin, tissue, or muscle that has been torn open. These wounds may range from shallow, short, and narrow, to deep, long, and wide. Some lacerations are so minor in nature (minimal damage to tissues, no bleeding, etc.) that they never need medical attention, though ointment and bandaging may be applied for comfort and efficient healing. For the most part, however, lacerations will need to be repaired with appropriate medical care and procedures.
In general, lacerations are caused by something hitting the skin, or vice versa, with a great deal of force behind it. This can occur when a child accidentally runs into a door frame, or if you slam your finger in the car door. You may then require finger laceration repair, which would consist of proper wound preparation, cleansing, and closure.
Laceration Repair: Wound Cleansing
An essential element of laceration repair is the proper cleansing, in order to prevent the potential for infection to develop and for less noticeable scarring. Appropriate cleaning measures include washing the wound clean of dirt and debris, as well as disinfecting to remove any germs. Wound cleansing is universal for all laceration repair preparation, regardless of the repair technique that will be employed. Additional preparation can include removing any jagged tissue edges to reduce the appearance of scarring as the wound heals.
For lacerations of a more minor nature, individuals may clean the wound themselves with several different solutions, including antiseptic solution, sterile saline solution, or tap water. Infection risk from using tap water depends upon the water quality of your current environment.
In general, it is not necessary to use antibiotics to address open wounds that are clean; however, should the wound be contaminated, or a bacterial culture come back positive, antibiotics may be used.
No wound is ever to be closed if there is suspicion of infection. It is advised that open wounds receive cleaning twice daily, using soap and warm water, and should afterwards be bandaged with moist gauze, followed by dry gauze, and then protective bandaging.
Laceration Repair: Wound Closure
Great care must be taken in regard to understanding how old the wound is before closure is attempted. Wounds that have been open less than 12 hours may be prepared, cleansed, and closed using sutures or staples. Lacerations more than 24 hours old could be contaminated and ought not to be closed completely. Several techniques may be employed for the closing of the wound, including bandaging, staples, cyanoacrylate glue, and sutures.
To repair a tear incurred by slamming your finger in the car door, it is likely you would need finger laceration repair that includes sutures to close up the wound. Sutures, commonly referred to as “stitches,” are implemented to repair lacerations that are deep, expose muscle or fat, are bleeding, or have jagged edges. Before sutures are used, iodine is applied to the edges of the tissue and skin needing closure. A surgical drape may also be employed to maintain a sterile environment during the procedure.
For lacerations in which muscle and other underlying tissues are in need of repair, there may be multiple layers of sutures that need to be used before closing the wound. Sutures placed in tissues underneath the skin are made of absorbable materials and will not be removed.
- Dr. Nate Whittaker, MD Emergency Medicine Specialist