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by Rymaruk J
(Wound Repair)

Definition

Laceration repair is cleaning, preparing, and closing a wound. A wound is a tear or cut in the skin, tissue, and/or muscle. They can vary in length, depth, and width.

Laceration Wound of the Hand
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Reasons for Procedure

Small, shallow, and clean wounds may not need medical care. They may only need antibiotic ointment and a bandage.

A wound may need medical repair if it:

  • Exposes muscle, fat, tendon, or bone
  • Has dirt and debris in the wound
  • Feels as if something is in the wound
  • Bleeds after applying direct pressure for 10 to 15 minutes
  • Has jagged or uneven edges
  • Is more than 1/8 to 1/4 inch deep
  • Is in area of high stress (joints, hands, feet, chest)

Wounds may also need medical care if there is risk of tetanus. This is a bacterial infection from dirt, dust, or feces.

Medical care may also be used if there is a concern about scarring.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over any problems that could happen, such as:

  • Infection
  • Excess bleeding
  • Scarring
  • Poor wound closure
  • Problems from anesthesia

Things that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Long term diseases such as diabetes or obesity

What to Expect

Prior to Procedure

The doctor may meet with you to discuss tests that need to be done. If you are having surgery, the doctor may also talk to you about:

  • Anesthesia options
  • Any allergies you may have

Anesthesia

Anesthesia depends on the type of wound. For example:

  • Local anesthesia is used for minor wounds. It will numb the area.
  • General anesthesia may be needed for severe wounds. It will block pain and keep you asleep.

For some, anesthesia is not needed.

Description of Procedure

The wound and area around it will be cleaned and prepared. Hair around the area may be trimmed and smoothed away. Sterile water will be squirted into the wound. This will help wash away dirt and debris.

If necessary, some jagged edges will be cut away. This may help the wound close easier. Damaged or dead tissue will be removed to prevent infection.

The wound will be closed once it is clean. Options to close the wound may be:

Skin Glue

Skin glue is a special glue that holds a wound together. The wound will be held shut. Skin glue will be applied over the area in 3 coats. The wound will then be held in place for 60 seconds. A bandage may then be placed on the area over the wound.

Skin closure strips

Skin closure strips are adhesive strips that help close the wound. The doctor will align the edges of the wound. The strips will be applied across the wound.

Stitches

The wound will be stitched shut. After stitching, saline will be used to clean the area. Antiseptic ointment may also be applied. The stitches may be covered with a bandage. There are different types of stitches. Some stitches will need to be removed later. Other stitches are absorbed by the skin and will not need to be removed.

Staples

The wound edges will be closed and aligned. Staples will be placed along the wound. Saline will wash the staple line. An antibiotic ointment will be applied. The area will be bandaged.

Hair Tying

Hair tying is used for some scalp wounds. Hair will be gathered in a way that pulls the wound shut. The hair will then be rubber banded or held together with skin glue. This keeps the wound shut.

Tetanus Vaccination

Some wounds raise the risk of a tetanus infection. If needed, a tetanus vaccination may be given.

How Long Will It Take?

The length of time depends on the wound. It may take less than 15 minutes or more than an hour.

Will It Hurt?

This also depends on the wound. Severe wounds will be very painful. Pain medicine and home care will help.

Post-procedure Care

At the Care Center

The staff may give medicines to prevent pain and infection.

At Home

Recovery time varies—it depends on the wound. Proper wound care will be needed. Physical activities may be limited during recovery. Some may also need to delay their return to work.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • A wound that reopens
  • Redness, swelling, excess bleeding, or discharge from the wound
  • Signs of infection, such as fever or chills
  • Spasm or stiffness of muscles in the jaw, neck, belly, or an area near the wound
  • New or unexpected symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES

American Professional Wound Care Association  https://www.apwca.org 

Family Doctor—American Academy of Family Physicians  https://www.familydoctor.org 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Wounds Canada  https://www.woundscanada.ca 

References

Forsch RT, Little SH, et al. Laceration repair: a practical approach. Am Fam Physician. 2017;95(10):628-636. .

Tetanus. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/tetanus/index.html. Accessed September 30, 2021.

Laceration - emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/laceration-emergency-management. Accessed September 30, 2021.

Laceration management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/laceration-management. Accessed September 30, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 07/2021
  • Update Date: 09/30/2021