There are many types of lacerations and each one is a unique medical problem. A laceration can be classified as clean, clean contaminated, contaminated and dirty. Another important consideration of lacerations is where they are located. A small laceration on a limb can be considerably more difficult to treat medically than some large lacerations on the trunk. Another important consideration is the cause of the laceration. A bite wound can cause significant damage to underlying tissues that may not be obviously apparent on initial exam.
Typically, lacerations require some sort of analgesia and pain management to manage appropriately. A minimum database of blood work should be performed prior to administering any analgesics, sedatives, or anesthetics to reveal underlying medical conditions (related or unrelated to the injury) that may complicate medication administration. Radiographs are also indicated in some instances.
Once the blood work and physical exam have been performed, a peripheral intravenous catheter is sometime required to administer the medications and fluids to support hemodynamic stability while under sedation.
The laceration can then be managed surgically with different lavaging and suturing techniques. Oftentimes, drains and splints are needed to assist in wound management. There are times that a primary delayed closure is required along with closing of the wound by second intention.
Post operative antibiotics and pain medications are prescribed. Recheck exams are also recommended along with confinement as the wound heals.