What Is Laceration?
A laceration is an irregular or jagged wound caused by tearing soft body tissue. The laceration is often contaminated with bacteria and debris from whatever object or article caused the cut. The minor cuts can be easily cared for at home, while deep cuts go beneath the skin through the fat or muscle layers and may require emergency medical help. The lacerations on the finger, toe, and hand are common and heal naturally. However, lacerations with fractures should be covered with gauze and antibiotic ointment. Healthcare professionals encounter lacerations regularly.
What Causes Laceration?
Lacerations are often caused by injury to a sharp object or impact from a blunt object. They can occur anywhere on the body. Most laceration cases have minimal tissue injury and fewer chances of infections. However, severe lacerations may go deep to the full thickness of the skin and deep to the subcutaneous tissues, underlying muscle, internal organs, and bone.
What Are the Symptoms of Laceration?
Lacerations commonly look like visible wounds through the skin that bleed and hurt. They can be of many different shapes and sizes. The clinical presentation of lacerations is variable and depends on location, depth, length, and width. The signs and symptoms that may accompany lacerations may include the following:
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The wound may bleed, hurt, bruise, or swell.
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In addition, lacerations in certain body areas, such as the scalp, may bleed.
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The wound may have edges that are close together or wide apart. In addition, there may be numbness around the wound and limited movement in an area below the wound.
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Severe pain, draining pus, and redness extending beyond the wound edges.
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Fever and chills.
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Excessive wound swelling.
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Underlying tissues such as fat, tendon, muscle, or bone are exposed in deep lacerations.
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Fainting at the sight of blood (a neurological reaction in which a reflex slowing of the heart causes low blood pressure and decreased heart rate called vasovagal syncope) and possible future scars.
How Is a Laceration Diagnosed?
A cut or laceration is one of the easiest medical conditions to diagnose. The doctor often reviews the history and physical examination of the wound and nearby structures to decide what treatment is needed.
The doctor will initially diagnose based on facts, such as:
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When and how the laceration occurred.
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Any issues like numbness or weakness, like no hand or finger sensation over the laceration.
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Presence of any other condition, such as diabetes which may require extra care and treatment.
Physical Examination Usually Includes the Following:
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Separating the wound edges and examining the wound.
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Testing nerve, artery, and muscle function.
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Checking for foreign objects in the cut (such as embedded glass, metal, or wood). An X-ray, ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI) may show foreign objects in the wound if a foreign object is suspected. The tests may also reveal damage to deeper tissues.
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Examining the person's overall condition (such as paleness from blood loss or anxiety).
When to Seek Immediate Care?
Call a healthcare professional immediately for the following conditions:
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Excessive bleeding or bleeding which does not subside even after ten minutes of direct and steady pressure over the wound. Generally, a laceration that needs stitches must be repaired within six hours of the injury, except for the cuts to the face and scalp, which usually can be repaired up to 24 hours after the injury.
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The stitches come apart.
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Fever or chills.
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The laceration is red, warm, or swollen.
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Red streaks around the wound or moving away from the wound.
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White or yellow discharge from the wound.
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Pain that worsens, even after treatment.
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The cut is deep and over the joint.
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The cut is from an animal or human bite.
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Deep puncture wound and the person has not had a recent tetanus shot.
How Is a Laceration Treated?
The treatment of laceration strategies includes relieving pain, restoring functions, and reducing scarring. Mild lacerations are usually cured with first aid treatment, such as applying a bandage. Healthcare professionals should examine moderate lacerations. The common treatments for moderate to severe lacerations include -
Pressure:
Direct and steady pressure is applied to the wound to stop bleeding.
Wound Cleaning:
Lacerations are then treated through irrigation with a sterile saline solution to remove dead tissue fragments and foreign debris and decrease infection. The doctor may give medicine to numb the area and reduce pain.
Wound Closure:
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Depending on the cut's extent or laceration severity, the wound is closed with stitches, staples, tissue glue, or a medical strip.
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Primary laceration healing typically occurs when the wound closure is done with skin adhesives, tissue tapes, or stitches. In contrast, secondary healing often occurs through the formation of granulation tissue (a covering of new connective tissue and tiny blood vessels or capillaries) over the left open wound, contraction (the process of drawing wound edges close to one another), and epithelialization.
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Infected wounds generally heal through secondary healing.
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Stitches may decrease the amount of scarring.
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Some lacerations may heal better without stitches.
Medications:
To reduce pain and inflammation, the healthcare professional may prescribe pain relievers like Acetaminophen, Ibuprofen, or Naproxen.
Surgery:
Surgery may be required to remove torn skin edges and close the laceration to promote healing. Microsurgery may help repair blood vessels; plastic surgery may help reduce scarring if the laceration is on the face.
What Is the Prognosis of the Laceration?
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Infection is the biggest threat to a laceration in the initial weeks, which causes severe pain, pus formation, redness in and around the wound, fever, chills, and excessive swelling.
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Inflammation caused due to wound healing and switches can result in minor redness in and around the wound, which is normal.
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Infected wounds can result in bigger scars which are of great concern.
What Are the Potential Complications of Lacerations?
Some of the common complications of cuts or lacerations include:
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Infections.
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Bleeding.
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Noticeable scarring.
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Poor wound closure.
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Allergic reaction to anesthesia
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Missed foreign bodies.
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Missed tendon injuries.
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Missed nerve injuries.
Conclusion:
Cuts and lacerations often happen, no matter how careful someone is. Most times, the lacerations are not too severe and heal naturally. However, severe lacerations may require emergency medical help and additional workup. Therefore, it is essential to know whether to treat them at home or go to the health care provider. In addition, proper management of lacerations is important to reduce the risk of bigger scar formation.
