Dermatology-Online

Laceration

Definition - What is a laceration?

A laceration is a common injury, especially in children, where the blunt force of force causes the skin to burst. It is often caused by falls or accidents in places on the body where the skin is directly on the bone, e.g. on the forehead or on the shin.

The wound is superficial, but the edges of the skin are often irregular due to the bursting. It can also lead to heavy bleeding.

A laceration differs from a tear-crush wound in that it also affects deeper structures. This ruptures the subcutaneous tissue and muscles.

What accompanying symptoms should I watch out for?

In the case of a laceration, the blood vessels are usually ruptured and bleeding is profuse. The bleeding and bruising of the surrounding tissue can also cause swelling or bruising. These also lead to severe pain. If the surrounding tissue is injured, it can also lead to restricted mobility and sensory disorders.

Lacerations on the head often lead to a concussion

brief loss of consciousness,
Vomiting and
Memory loss (amnesia).

Therefore, if the bleeding cannot be stopped or if a concussion is suspected, the doctor or the hospital should be consulted.

What laceration do I have to see a doctor with?

Severely bleeding lacerations that cannot be breastfed should be checked by a doctor. It must be checked whether an artery has been injured and the doctor must sew up the wound if the bleeding persists.
In addition, large and heavily soiled wounds should be checked by a doctor and cleaned under sterile conditions. The doctor also closes the wound using sutures or staples.

In addition, lacerations on the head should always be checked by a doctor due to the risk of severe concussion or cerebral hemorrhage. In most cases, patients are kept in hospital for 24 hours for observation.

Therapy - what to do with a laceration?

When it comes to first aid for lacerations, stopping bleeding comes first. The wound should be compressed using strong pressure to stop the bleeding. If a first aid kit with sterile compresses and gauze bandages is already available, the wound should first be disinfected quickly and then bandaged so that the infection does not spread.

The pressure bandage should then be left on for some time until the bleeding has stopped. It is important to ensure that the blood supply to the fingers, toes or other parts of the body is not interrupted.

In addition, a doctor should be consulted who can inspect and treat the wound. With sufficient disinfection and hemostasis, the wound can then be closed. After the treatment, the part of the body should be spared for a while and checked by a doctor after a few days.

Read on below: First aid for wounds

Sew laceration

In most cases, lacerations in the emergency room are sutured as tension-free as possible by the doctor. With a good skin suture, the wound can be closed safely without leaving large scars.

However, the rule is that only wounds that are not older than 6 hours can be sewn. After 6 hours, the wound is first kept open and thoroughly disinfected because the risk of infection is too high.

Before sewing, a local anesthetic is usually injected around the edges of the wound so that the patient does not feel any pain when sewing. Depending on whether or not absorbable sutures have been used, the sutures must be removed after 7-10 days.

Find out more at: Skin seam

Staple laceration

An alternative to sewing is stapling or stapling lacerated wounds. In this process, stainless steel wound clips are pressed into the tissue with the help of a stapler. These hold the wound edges together. The stainless steel clamps can withstand great tension, so that the seam seldom tears.

The advantage over the seam is the faster working time. But here it comes to the formation of scars, so that surgical clips should not be used on the face if possible.

Special staple removers must be used for removal.

You might also be interested in: Scar care

Cling plaster for a laceration

A staple plaster, also called steristrips, are plasters that hold the wound edges together by applying tension. They serve as a support for sewn wounds. Due to their elasticity and strong adhesion, they can prevent the risk of scarring and ensure a well-closed wound so that it can heal without problems.
Since they are very skin-friendly and breathable, they are particularly popular for sports.

They are only used to support larger lacerations and are not an alternative to traditional sutures or staples.

Smaller lacerations that no longer bleed can be treated with the adhesive plaster. However, little stress should then be exerted on the affected area.

When can you glue a laceration?

A laceration can also be glued to certain parts of the body. It is important that these parts of the body are not under great and constant tension. This is the case for the face or head, for example.

A special tissue adhesive is used, which is applied to the wound edges.
The advantage is that neither seams nor staples have to be removed later, as the glue dissolves by itself after a while. The disadvantage, however, is that unsightly scarring is more common on glued wounds.

Healing time of a laceration

The healing time depends on

the localization,
the size and
the depth of the laceration as well
the health of the patient.

With good disinfection, treatment and good health, a laceration usually heals within two to three weeks. In most cases, additional care at home is sufficient. Only the removal of staples and sutures and a final check should be carried out by a general practitioner or resident surgeon.

Lacerations tend to heal more slowly in areas that are under heavy and constant stress. Examples of this are, for example, on the elbow or the knee. The deeper and heavier the wound, the longer the healing process.

In addition, a deeper and larger wound increases the risk of infection at the same time. An infected wound can take much longer to heal, as the inflammation must first be treated before the wound can be completely closed.Therefore, thorough cleaning and disinfection are important.

In patients with

Diabetes mellitus,
Vascular disease or
other diseases

wound healing may be impaired. The wound edges are not supplied with sufficient blood and cannot heal well. The wound edges often have to be repaired several times and, if necessary, necroses have to be removed. Closing the wound is then often difficult. In these patients, a laceration can take many weeks to heal.

What complications are there with a laceration?

A laceration can have serious consequences depending on the extent. Smaller wounds usually heal quickly. Large wounds can cause profuse blood loss, which can be particularly dangerous in children and the elderly. Immediate hemostasis is therefore essential.
Lacerations on the head can also lead to severe head injuries and cerebral hemorrhage.

If the wound is not cleaned properly, infection can result. An infected wound causes pain and burning and requires immediate antibiotic therapy. An untreated, infected wound can lead to fever and ultimately sepsis.

Scar after a laceration

Small lacerations that have been treated with plasters usually do not leave large scars. Even when treating large wounds with sutures, there is no unsightly scarring with good wound closure.
It is important that the wound edges are closed exactly one above the other and that no skin bulges develop. In addition, the further blood supply to the wound edges should be maintained.

When treating lacerations with glue, scarring can occur more frequently, which is why this is often only applied to areas that are not visible.

What causes a laceration?

Lacerations are one of the most common injuries. Children, the elderly and athletes are particularly affected. Children often fall or hit from running and playing. Impact on the floor or against a heater, for example, quickly results in a laceration.

Older people are at risk because their balance can no longer be well developed and they tend to fall. Due to the thinner and more sensitive skin, lacerations, broken bones and bruises occur more quickly.

Sports such as boxing, football, rugby etc. are also predestined for lacerations. Falling objects or traffic accidents can also lead to lacerations.

also read: The most common sports injuries

Diagnosis of a laceration

In most cases, a doctor should be consulted if there is a laceration. Often there is heavy bleeding that needs to be stopped quickly.

The laceration can usually be diagnosed by its typical appearance alone. The image of a laceration usually shows a gaping wound with irregular wound edges and pocket formation.

Through cleaning and inspection, the doctor can distinguish the laceration from a tear-crush wound. In order to be able to rule out possible complications or further injuries, such as bone fractures or organ damage, further examinations should be carried out, such as x-rays, ultrasound or computed tomography (CT).

What is the difference between lacerations and lacerations?

Both lacerations and lacerations are the result of blunt force. As a rule, they are difficult to distinguish from one another. In both cases, the wound ruptures and the wound edges are torn.

The difference between these wounds is that in the case of lacerations only the skin flakes and in the case of lacerations the deeper tissue is also affected. An indirect pulling effect tears open the fatty tissue and muscles under the skin.
Torn wounds often occur in combination with bruises.

Read more on the topic: Lacerated wound

Laceration on the head

Lacerations on the head are one of the most common injuries. Particular caution is required on the head.
Depending on the cause of the laceration, a concussion often occurs. The patients often complain of headaches, vomiting, sensitivity to light, drowsiness and short memory gaps. In addition, a brief loss of consciousness can occur. The symptoms often only appear a long time after the accident. Therefore, the patients are usually taken to the hospital and stay there for one night in order to be able to control further effects. Computed tomography (CT) is also often performed to rule out bleeding in the brain.

In addition, there is often profuse bleeding from head laceration.
Treatment of a head laceration should be done within 6 hours. It is first cleaned and disinfected and then usually sewn up with several stitches. In addition, the tetanus protection should be checked.

also read: Tetanus

Laceration on the forehead

A laceration on the forehead is very common, especially in children. If they fall, they fall with their foreheads on the ground or hit their heads on objects. Table edges or door frames are predestined for this.

The treatment of a laceration on the forehead is similar to that on the head. Here, too, there is a high risk of concussion and the patient should come to a hospital for observation for 24 hours.

The laceration should be thoroughly cleaned, disinfected and inspected. If it is less than 6 hours old, it is closed with single button sutures. These can be removed by the doctor or surgeon.
In the case of small children or small wounds, the wound can alternatively be closed using cling plasters or wound adhesive.

If the last tetanus vaccination is more than 5 years old, a new vaccination should be given.

Laceration on the lip

A laceration on the lip happens relatively quickly. Often it is the result of a violent confrontation or a fall from a bicycle. Since the mucous membrane of the lip is very thin, the skin bursts quickly. At the same time, the lip is also very well supplied with blood, so that there is heavy bleeding, pain and swelling of the lip.

When treating the wound, care must be taken to ensure that the blood actually comes out of the wound on the lips. Because often injuries to the teeth or the tongue are also the cause of heavy blood from the mouth. Therefore, a visit to the dentist is recommended if you suspect affected teeth.

After the bleeding has stopped by applying pressure, the wound must be cleaned and the extent inspected. In most cases, lacerations on the lip are relatively small and a small suture is sufficient. After that, the wound should be cooled with ice to reduce swelling. Further care can be provided from home.

If burning, itching, or pain occurs during the course, a doctor should be consulted, as an infection could be suspected.

Laceration on the chin

A laceration on the chin is particularly common in children. It is often the result of a bicycle fall or other falls while playing.
Since the distance from the skin to the bone is very small here, lacerations often occur, which usually bleed heavily. Other symptoms may include chin pain, headache, and burning sensation.

Serious falls can also injure the jaw. If the pain persists or movement restrictions occur in the jaw, a doctor should be consulted. In contrast to lacerations on the forehead and head, a concussion is less likely.

When falling on the ground, the wound is often soiled by gravel or other dirt. Important cleaning and disinfection are important to prevent later infection. As a rule, lacerations on the chin are closed with a seam due to the increased tension that prevails on the skin. Glue or adhesive plasters cannot guarantee a sufficient seal.

Laceration on the eye

Lacerations on the eye are often the result of a physical argument or a sports accident.
In most cases this results in profuse bleeding and swelling of the eyelid. The swelling is often so severe that the ability to see in the eye is severely restricted. At the same time, a large bruise often forms around the eye, often referred to as a "violet". Again, there is a risk of concussion and internal bleeding.

The eye should also be examined by an ophthalmologist.
The wound is usually sewn with several stitches and covered with a plaster.