If you have a tear or cut in your skin, tissue and/or muscle, you may need laceration repair, which includes cleaning, preparing and closing the wound.
When Do You Need Laceration Repair?
If your cut looks shallow, small, clean and isn't bleeding, you may not need medical care. Antibiotic ointment and a bandage will be enough.
Wounds that may need medical repair have:
- Exposed muscle, fat, tendon or bone
- Dirt and debris in the wound, even after cleaning
- Feeling as if something is in the wound
- Bleeding continues after applying direct pressure for 10-15 minutes
- Jagged or uneven edges
- Depth more than 1/8 to 1/4 inch deep
- Location on area of high stress (joints, hands, feet, chest)
- Possible intense scarring
Not Sure? Visit the hospital.
How to Treat Your Cut at Home
To treat the laceration before you see the doctor:
- Apply direct pressure to the wound. Use gauze, a clean cloth, plastic bags, or, as a last resort, a clean hand. If your wound bleeds through the gauze or cloth, do not remove it. Add more gauze.
- If possible, elevate the wound above the heart. This will make it harder for blood to flow to the wound.
- Do not tie a tourniquet around an affected limb. This may cause more damage.
- If bleeding stops, let some water run over the wound. Tap water is safe to use.
- If muscle, tendon, bone, or organs are exposed, do not try to push them back into place.
- If you are feeling faint, lie down or sit with your head between your knees.
Laceration Repair: Treatment Options
At UVA Health, we offer the following methods to repair your wound.
Dermabond
This special glue holds a wound together. We can use Dermabond on your face, arms, legs and torso, but not for lacerations over joints, lisp, deep cuts or most hand and foot lacerations.
How Dermabond Works
We hold the cut shut for 60 seconds, while we apply three thin layers of Dermabond over the area. You may feel warmth as the glue sets. A bandage may be placed over the area over the wound.
- Dermabond will fall off in 5-10 days.
Do Not Try Glue At Home: This special glue sits on top of the laceration, not in it. Never try to repair a wound at home with regular glue; getting glue into wounds may prevent them from healing properly.
Steristrips
We can use these adhesive strips to close wounds that are clean, shallow, have straight edges and are easy to push closed.
- Steristrips will typically be removed after 5-10 days or fall off on their own.
Stitches
We use stitches for deep, bleeding wounds with jagged edges or exposed fat or muscle.
Getting Stitches
First, we clean the cut with iodine and cover the area with a surgical drape.
Then, if necessary, we sew stitches under the skin. Your body will absorb these; we won't need to remove them.
We will then stitch the wound shut, clean it with saline, apply antiseptic and cover with gauze or a bandage.
- Stitches will be removed after 5-14 days.
Staples
Staples work best for the scalp, neck, arms, legs, torso and buttocks. We clean your skin with iodine, close and align the wound, then staple the wound shut.
We will then wash the staples with saline, pat them dry, apply antibiotic, a clear acrylic dressing called Tegaderm, gauze and tape.
- Staples will be removed after 5-10 days.
Hair Tying for Scalp Lacerations
Sometimes, we can gather hair to pull a wound on the scalp shut. We then rubber band or glue the hair with Dermabond to keep the wound closed while it heals.
- Rubber bands will be cut from hair in 7-10 days.
Preparing for Laceration Repair
Once you are at the hospital, the doctor will likely do the following:
- Examine the wound
- Decide if you need a surgeon
- Ask about your medical history, allergies and how the wound occurred
- Discuss your pain tolerance and options for closing the laceration
- Explain the chosen procedure
Will I Need Anesthesia?
This depends on the type of laceration, for example:
- Local anesthesia is used for minor lacerations. This will numb the area around the wound.
- General anesthesia may be needed for severe lacerations. It will block pain and keeps you asleep.
In some cases, you will not need anesthesia.
What Are the Side Effects?
If you have a laceration repair, your doctor will review a list of possible complications, which may include:
- Infection
- Bleeding
- Noticeable scarring
- Poor wound closure
- Allergic reaction to anesthetic
The Risk of Tetanus
Wounds can put at risk of a tetanus infection, a bacterial infection from dirt, dust, saliva or feces.
We may give you a tetanus vaccination if:
- You have never received a total of at least three vaccination doses (routine childhood immunizations gives a dose at ages 2, 4, 6, and 15-18 months)
- It has been more than five years since your last tetanus immunization
- You are unsure of your tetanus status
Recovery After Laceration Repair
When you return home, ensure a smooth recovery:
- Avoid strenuous activities.
- Take antibiotics and pain medication as directed.
- Ask your doctor about when it is safe to shower, bathe or soak in water, and
- If you need to keep the incision area dry when showering, wrap the area with a plastic bag.
- After showering or bathing, pat the area dry. Do not rub the area. Also, do not apply hydrogen peroxide or iodine to the wound. This will damage tissue and slow healing.
- Do not pick at or scratch the wound.
- Do not try to remove the closure material yourself, as that could cause infection, scarring or reopening of the wound.
Scarring
All lacerations heal with scars. The degree of scarring varies and is influenced by:
- A personal history of excessive scar (keloids) formation
- Location, type and size of the wound
- Skill of the doctor
If a noticeable scar does result, plastic surgery may be used to decrease the scar’s appearance.
What to Watch With Your Wound
After arriving home, contact your doctor if any of the following occurs:
- Wound reopens
- Redness, warmth, swelling, drainage or excessive bleeding occurs at the wound site
- Signs of infection, including fever, chills or red streaks tracking up arm or leg
- Spasm or rigidity of muscles in jaw, neck, abdomen or an area near the wound
- Any other concerns
In case of an emergency, call for medical help right away.
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