Torn ragged wound. Lacerations: Understanding Types, Treatment, and When to Seek Medical Attention

07.08.202310.06.2023 by alexxlab

What is a laceration wound. How does it differ from other types of wounds. When should you seek medical attention for a laceration. How can you properly treat a laceration at home. What are the signs of infection in a laceration wound. Can lacerations heal without stitches.

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What Are Lacerations and How Do They Occur?

Lacerations are a common type of skin injury that can range from minor to severe. These wounds are characterized by torn or ragged edges in the skin, typically caused by blunt force trauma or contact with sharp objects. Understanding the nature of lacerations is crucial for proper treatment and care.

Lacerations form when the soft body tissue, particularly the top layer or layers of skin, are torn. Unlike clean cuts or incisions, lacerations often have irregular edges and can vary greatly in depth, length, and width. They can be:

Deep or shallow
Long or short
Wide or narrow

The severity of a laceration depends on various factors, including the force of impact, the object causing the injury, and the location on the body. While minor lacerations may be treated at home, deeper or more complex wounds often require professional medical attention.

Common Causes of Lacerations

Lacerations can occur in various situations and are often the result of accidents or trauma. Some common causes include:

Falls onto hard or rough surfaces
Impacts with blunt objects
Accidents involving machinery or tools
Sports injuries
Vehicle accidents
Encounters with sharp edges or broken glass

It’s important to note that while lacerations are often caused by blunt trauma, they can also result from sharp objects. The key distinction is the irregular nature of the wound edges, which sets lacerations apart from clean cuts or incisions.

Identifying the Signs and Symptoms of a Laceration

Recognizing a laceration is generally straightforward due to its visible nature and associated pain. However, understanding the specific signs and symptoms can help in assessing the severity of the wound and determining the appropriate course of action.

Key Indicators of a Laceration

Visible tear or break in the skin
Irregular or ragged wound edges
Bleeding, which may range from minimal to profuse
Sharp or intense pain at the site of injury
Possible exposure of underlying tissues (in severe cases)

The pain associated with a laceration is often immediate and can be quite intense due to the nerve endings present in the skin. The severity of pain and bleeding can provide clues about the depth and extent of the injury.

Assessing Laceration Severity

Determining the severity of a laceration is crucial for deciding whether professional medical care is necessary. Consider the following factors:

Depth of the wound
Amount of bleeding
Location on the body
Presence of foreign objects in the wound
Potential for infection
Exposure of underlying structures (muscle, fat, bone)

Deep lacerations that expose underlying tissues, continue to bleed heavily, or are located in sensitive areas like the face or joints typically require immediate medical attention. When in doubt, it’s always safer to consult a healthcare professional.

Differentiating Lacerations from Other Types of Wounds

While lacerations are a common type of wound, they are often confused with other forms of skin injuries. Understanding the differences can help in proper identification and treatment.

Lacerations vs. Cuts

The terms “laceration” and “cut” are often used interchangeably, but there are subtle differences:

Cuts typically refer to injuries caused by sharp objects, resulting in cleaner edges
Lacerations usually have more irregular, ragged edges due to tearing of the skin
Cuts are often more superficial, while lacerations can be deeper and more complex

In general, cuts are considered a milder form of laceration and may require less intensive treatment.

Lacerations vs. Puncture Wounds

Puncture wounds differ significantly from lacerations:

Puncture wounds are caused by pointed objects piercing the skin
They typically have a small entry point but can be deep
Lacerations involve tearing of the skin with visible openings
Puncture wounds carry a higher risk of infection due to their depth and small opening

Understanding these distinctions is crucial for proper wound care and determining when to seek medical attention.

Proper Treatment and Care for Lacerations

Proper treatment of lacerations is essential to promote healing, prevent infection, and minimize scarring. The approach to treatment depends on the severity of the wound.

First Aid for Minor Lacerations

For minor lacerations that can be treated at home, follow these steps:

Clean hands thoroughly before treating the wound
Stop the bleeding by applying gentle pressure with a clean cloth or sterile gauze
Clean the wound with cool running water and mild soap
Remove any visible debris or dirt
Apply an antibiotic ointment to prevent infection
Cover the wound with a sterile bandage or gauze
Change the dressing daily or when it becomes wet or dirty

Monitor the wound for signs of infection, such as increased redness, swelling, warmth, or discharge. If these symptoms occur, seek medical attention promptly.

When to Seek Medical Attention

Some lacerations require professional medical care. Seek immediate medical attention if:

The bleeding doesn’t stop after 10-15 minutes of direct pressure
The wound is deep, gaping, or has jagged edges
You can see muscle, fat, or bone
The laceration is on the face, near the eyes, or over a joint
The injury was caused by a dirty or rusty object
You haven’t had a tetanus shot in the last 5 years
There are signs of infection

Professional treatment may include thorough cleaning, closure with stitches or staples, and possibly antibiotics to prevent infection.

The Role of Stitches in Laceration Treatment

Stitches, also known as sutures, play a crucial role in the treatment of more severe lacerations. Understanding when stitches are necessary and their benefits can help in making informed decisions about wound care.

When Are Stitches Necessary?

Stitches are typically required in the following situations:

Deep lacerations that expose underlying tissues
Wounds longer than half an inch
Injuries with gaping edges that don’t easily come together
Lacerations on areas of high movement (like joints) or cosmetically important areas (like the face)
Wounds that continue to bleed despite direct pressure

A healthcare professional will assess the wound and determine if stitches are necessary based on these and other factors.

Benefits of Stitches in Laceration Treatment

While some lacerations can heal without stitches, there are several advantages to using them:

Faster healing: Stitches bring wound edges together, promoting quicker healing
Reduced scarring: Proper alignment of wound edges can minimize scar formation
Decreased risk of infection: Closing the wound helps prevent bacteria from entering
Better cosmetic outcome: Especially important for facial lacerations
Controlled healing: Prevents the wound from reopening during the healing process

It’s important to note that stitches are typically removed after 5-14 days, depending on the location and nature of the wound.

Preventing Complications and Promoting Proper Healing

Proper care during the healing process is essential to prevent complications and ensure optimal recovery from a laceration. Understanding potential risks and following best practices can significantly improve outcomes.

Recognizing Signs of Infection

Infection is a primary concern with any open wound. Be vigilant for the following signs:

Increased redness or warmth around the wound
Swelling that worsens after the first day
Pus or cloudy fluid draining from the wound
Foul odor
Fever or chills
Increasing pain or tenderness

If any of these symptoms occur, seek medical attention promptly. Early treatment of infections is crucial to prevent more serious complications.

Best Practices for Wound Care

To promote proper healing and minimize the risk of complications:

Keep the wound clean and dry
Change dressings regularly, especially if they become wet or dirty
Avoid picking at scabs or pulling off bandages prematurely
Protect the wound from further injury
Follow any specific care instructions provided by your healthcare provider
Maintain good overall health through proper nutrition and hydration
Avoid smoking, as it can impair wound healing

For wounds that required stitches, follow your doctor’s advice on when to return for removal and any activity restrictions during the healing process.

Long-Term Care and Scar Management

While proper initial treatment of lacerations is crucial, long-term care is equally important, especially when it comes to managing scars and preventing future complications.

Scar Formation and Management

Scar formation is a natural part of the healing process, but there are ways to minimize its appearance:

Keep the healed wound protected from sunlight, as UV exposure can darken scars
Apply silicone-based scar treatments as recommended by your healthcare provider
Gently massage the scar tissue to improve its appearance and flexibility
Consider over-the-counter scar-reducing creams or ointments
For significant scarring, consult a dermatologist about professional treatments

Remember that scar appearance continues to improve over time, often for up to a year or more after the initial injury.

Monitoring for Long-Term Complications

Even after a laceration has healed, it’s important to be aware of potential long-term issues:

Chronic pain or sensitivity at the injury site
Reduced range of motion if the laceration was near a joint
Keloid formation (excessive scar tissue growth)
Nerve damage resulting in numbness or tingling

If you experience any of these issues, consult with your healthcare provider for appropriate management strategies.

In conclusion, understanding the nature of lacerations, their proper treatment, and long-term care is essential for optimal healing and minimizing complications. By following best practices in wound care and being vigilant for signs of infection or other issues, you can ensure the best possible outcome for laceration injuries. Remember, when in doubt about the severity of a laceration or if you experience any concerning symptoms, it’s always best to seek professional medical advice.

Lacerations: Definition, Diagnosis & Treatment | Portland Urgent Care

Lacerations are scary when they happen, especially if you do not know what to look for or how to handle a cut. Knowing what to look for and how to handle a laceration will help you to determine the correct form of treatment. Find out everything you need to know about lacerations to make the best decisions for you and your family.

What is a laceration wound?

A laceration wound refers to a skin wound without missing skin. Usually, lacerations are caused by sharp objects. These are one of the easiest medical conditions to diagnose and easy to treat. Lacerations form by tearing the soft body tissue, that is, the top layer or layers of skin. Furthermore, lacerations are irregular tear-like wounds often caused by blunt trauma.

Puncture wounds break more than soft tissue. Lacerations can be deep, shallow, long, short, wide, and even narrow. Minor lacerations do not usually require medical assistance as they can be treated at home with proper cleaning, ointments, and bandages. Also, minor lacerations will not bleed as much as deep lacerations.

Deeper lacerations may require stitches if they are deep, bleeding profusely, have jagged edges, or expose muscle or fat. Seek medical attention for deep lacerations, especially cuts that will not stop bleeding. Often lacerations are misused as incisions that are caused on purpose or have clearly defined edges.

What are the signs and symptoms of a laceration?

Lacerations are easy to spot as they refer to damage to the skin. As the skin has nerves, you will feel a sharp pain from a cut. Also, the cut skin will bleed and have a visible tear in the skin when the blood is out of the way. Often you will know when a laceration happens as it involves a cut or injury. The laceration victim will often scream in pain when the accident occurs, which is the first symptom of a cut.

How do you describe a laceration?

Describe a laceration as a defined tear in the tissue of the skin caused by either shearing or crushing force. Often, lacerations are a result of blunt trauma. A laceration can also be described as an incomplete separation of strong tissue elements such as blood vessels or nerves. Lacerations can be caused by both sharp or dull trauma.

What is the difference between a cut and a laceration?

Cuts and lacerations are often used interchangeably as both indicate damaged skin from a blunt or sharp object. However, a cut often refers to a mild laceration as cuts do not often require more than antibacterial ointment and a bandage. Lacerations may be deeper and require pressure to stop the bleeding and even stitches depending on the depth of the injury or exposure of other parts like bone, tendons, ligaments, or muscle.

How do you treat a wound laceration?

The first step to treat laceration is to stop the bleeding with pressure and gauze or bandage. Once the wound stops bleeding, clean the area to remove all dirt and debris. Clean by running cool water over the area and then use mild soap and water if possible. Dry with a sterile cloth.

Next, apply antibiotic ointment and cover the wound with a sterile gauze bandage and medical tape. For smaller lacerations, use a self-sticking bandage for the wound. Clean and replace bandages daily until the wound heals. For smaller cuts, you may be able to use skin closure strips. Avoid using liquid bandages for cuts without consulting a doctor first.

For deeper lacerations, go to the doctors for stitches. If you can see anything other than the first layer of skin, you also need to go to the doctor for proper treatment. If a cut measures larger than half an inch or has a large gaping wound, it probably requires stitches.

Moreover, the location of a wound may require stitches to stay shut, such as on a joint, face, near the eye, or in the genital area. Another indication that a laceration requires medical attention is a risk of infection or disease such as a rusty nail, a scratch or bite, or another potentially contaminated item. Finally, prolonged bleeding requires medical assistance.

After a few days, even if treating a minor laceration, you need to look for signs of infections or complications. Look for fever, chills, redness, swelling, white or yellow pus or drainage from the wound, or worsening pain. Do not wait to see a doctor if any of these symptoms occur; seek medical attention quickly.

Can a laceration heal without stitches?

Eventually, a laceration will heal on its own without stitches. However, stitches promote faster healing, keep the wound clean from bacteria and infection, and prevent scarring. Furthermore, stitches or staples can help to reduce blood loss and reduce future complications from the wound. Lacerations can sever toes or fingers, and these cannot heal well without stitches.

How long does it take for a laceration to heal?

Depending on the wound, it can take up to three months for the wound to fully heal. If you require stitches, the wound can heal faster in about six to eight weeks. Minor cuts and lacerations can heal in as little as two weeks, especially if the cut is very small.

The location of the wound can impact healing as well. If the injury is on your hand, foot, knee, or elbow, it may take longer to heal as the body part moves more often. Immobilizing and injury on these parts, while frustrating, can help the cut to heal faster.

How can I make my laceration heal faster?

The best way to help a laceration heal faster is to take proper care of the wound. Furthermore, if the cut requires stitches, then get stitches. Most importantly, keep the wound clean to prevent infection and covered to keep out dirt and debris. Avoid an unhealthy diet and drink more water to help provide the nutrients you need to heal properly. Try to eat food rich in vitamin C and antioxidants to help heal quickly. Lastly, avoid smoking and drugs of any sort to give yourself the best chance of healing.

How deep does a cut heal?

Lacerations heal in four stages. Stage one is stopping the bleeding, also called hemostasis. Adding pressure can help to stop blood flow as the blood clots to prevent blood loss and closes the wound by making a scab, which is stage two. At this stage, you may notice inflammation as well as that helps to heal.

Stage three involves rebuilding or growth as oxygen-rich red blood cells move to the injury and create new tissue. The last stage is maturation or strengthening, where the wound clots and heals. At this stage, you may notice itching or tightness around pink or stretched skin. From here, the body will continue to heal until the wound is gone or left with a scar. Over time, even deep cuts will heal, but stitches will help to reduce healing time.

How do you describe a deep laceration?

A deep laceration is a severe laceration. Describe a deep laceration by the size, size, shape, orientation, and margins. You could also describe a deep laceration as a gash as it implies a longer or deeper cut. Make sure to also describe if you can see bones, muscles, or other internal parts that should not be visible.

What is a severe laceration?

Severe lacerations are those that require stitches, are infected, or will not stop bleeding. Deep lacerations that expose internal parts are also severe. They may extend through more layers of tissue and cause significant pain. Do not hesitate to go to a doctor for a severe laceration. While minor cuts can be cared for at home, deep or severe cuts require medical attention.

Should I see a doctor for a laceration?

If, after applying pressure, the bleeding does not stop, then you need to see a doctor for a laceration. All severe lacerations require a doctor for treatment. Additionally, if you see signs of infection or if the laceration was caused by something that could cause infection, then seek medical attention. See a doctor also if the laceration is near the eye. Signs of shock warrant a visit to the doctors as well, including a weak pulse, clammy skin, or rapid breathing.

Signs of the wound reopening require a visit to the doctors as well. Furthermore, look for new or unexpected symptoms such as spasms, rigidity in the muscles, or near the wound. All of these symptoms may indicate complications that require professional care.

Why choose Portland Urgent Care for laceration treatment?

Portland Urgent Care works with a multitude of insurance companies to serve more customers. We also use a variety of integrated medical resources by combining both western and eastern medical healthcare which allows us to serve you the way your body needs.

We offer same-day and walk-in appointments for laceration for immediate care with the best doctors. Get a dedicated treatment plan to prevent infection and help lacerations heal quickly. From bandaging to stitches, we can do everything you need to help deal with the blood and pain to get you on the road to recovery.

Conclusion

Mild lacerations can be treated at home with antibiotic cream and a bandage. Deeper or severe lacerations that will not stop the bleed run the risk of infection or that are deep require medical attention. When in doubt, stop by Portland Urgent Care and let us look over your wound and help decide the best form of treatment to ensure a quick and safe recovery.

For more information on injuries, see our related blogs:

Common Causes & Effects of Neck Injuries

Neck Injury Treatment

Types of Back Injuries

How Do You Know If Your Back Injury Is Serious?

Types of Ankle Injuries

Common Types & Causes of Knee Injuries

How To Treat & Recover From Knee Injuries

Wrist Ligament Injuries

Wrist Injuries Causes & Treatment

Difference Between Sprains vs Strains

Lacerations | Stitches & Sutures | Go To Ortho

A laceration implies a torn or jagged wound that varies in length. If a laceration is longer than a ½ inch or deeper than a ¼ inch, it is best to have it checked out, as it may require stitches, sutures or staples to completely close and safely heal a laceration.

Is There A Difference Between a Cut and Laceration?

A cut is a skin wound with a separation of connective tissue. None of the skin is missing, but it is separated. A laceration implies a torn or jagged wound that is usually deeper or wider and often needs stitches.

How Do You Know When Medical Care Is Necessary?

If you have any doubts at all, it’s always a good idea to play it safe, and seek medical attention for your laceration, especially if you cannot stop the bleeding, the wound edges are separated, or you cannot clean the wound adequately enough for it to heal properly. Plus, with any laceration, there is always the risk of infection, because sharp objects that usually cause them may be contaminated with bacteria or debris. If that is the case, your doctor will give you a tetanus vaccination or booster shot along with treatment.

Also, patients who have circulation problems or diabetics should always seek medical attention for open wounds, as they may require additional treatment to prevent infection.

Why Should You See Orthopedic Specialists for Lacerations?

You should see an orthopedic specialist for lacerations, because some lacerations may involve tendon and nerve damage. Sometimes these lacerations aren’t always immediately noticeable and can take days or weeks for such nerve or tendon damage to show up. Orthopedic specialists would be more apt to catch these and provide the immediate care you need.

Orthopedic specialists can also treat hand injuries that involve fingertip and nail bed lacerations. If these aren’t treated properly, these injuries can lead to hand function problems, permanent deformities or even a disability, as these are sensitive areas where bone and nerves are affected when exposed.

Come to see us for quick-care orthopedic injury treatment for cost-effective care at medical office rates, not hospital rates. Don’t let lacerations become complications.

How Do You Know If You Need Stitches?

There are four basic considerations as to whether or not you may need stitches:

Depth. Is the wound deep enough to see the subcutaneous tissue (yellowish fatty tissue)?
Width. Can the wound be pulled closed easily?
Location. Is the wound in a location of the body that stretches and moves a lot (e.g., a wound on a calf)?
Tetanus vaccination. How long has it been since you had your last tetanus vaccination? It is recommended that you have one every 10 years. If you need one, especially after having a laceration, go see a doctor and have your wound evaluated for stitches.

What Are the Benefits of Getting Stitches?

Getting a laceration stitched is a good idea for several reasons:

Stops bleeding
Promotes quicker healing
Keeps bacteria out of the wound
Prevents infection
Protects underlying tissue
Reduces scarring

What Types of Exams and Tests Are Done for Lacerations?

During your visit, your doctor will ask you several questions about your injury including:

When did it happen?
How did it happen?
Do you have any problems with weakness or numbness?
Do you have any allergies to adhesive tapes?
Do you have any pre-existing medical conditions, such as circulation problems or diabetes?

Your physical exam will include:

Separating the edges and looking at the wound
Testing nerve, artery, and muscle function
Checking for objects in the cut (such as embedded glass or wood)
Examining your overall condition (such as whether you are pale from blood loss or anxiety)

If foreign objects or an underlying broken bone is suspected, an X-ray may be ordered.

How Do You Treat a Laceration?

Treatment for a laceration usually depends on how deep the cut is, but generally, the treatment process includes:

Taking steps to stop the bleeding with direct pressure or the use of a blood pressure cuff
Applying Medication to numb the area
Topical medicine
Direct injection of anesthetic into the wound
Injection into a regional nerve (nerve block)
Cleaning the wound
Washing the skin with soap and water
Removing crusted blood with diluted hydrogen peroxide
Irrigating with saline at the wound site under high pressure to reduce bacterial contamination
Repairing the wound
Minor cuts can be closed with special adhesive tapes (Steri-Strips) or tissue glue
Deeper cuts may need stitches to repair deep structures
Applying bandages
Telfa or Vaseline gauze that doesn’t stick to your cut
Pressure bandages or splints that provide needed surface pressure or keeps an injury immobile

Is Follow-Up Care Required?

If you have sutures placed, your doctor may recommend that you have the wound checked 1 or 2 days after treatment, especially if there is a higher than 5% chance of infection or if changing the bandage is difficult.

Stitches may be removed at your doctor’s office anywhere between 4 and 14 days later. The actual time period depends on the location of the injury. For example, facial stitches are removed after 4 days and no later than 7 days, because healing occurs faster in this location of the body. Sutures in your hand may be left in 14 days or more because of slower healing and greater tension on the wound.

What Can You Do Minimize Scarring?

It is normal for a scar to look red and swollen after suture removal, and it can take up to 1 year for a scar to fade. In the meantime, there are several things you can do to minimize the possibility of scarring:

Infected wounds tend to scar more, so

Keep an eye out for redness, swelling or other signs of infection and see a doctor
Keep the wound covered and clean
Avoid sun exposure as newly healed tissue burns more easily

Before consulting a specialist for scar revision, wait a year for the scar to fade.

Come See Us

At Go To Ortho, we treat lacerations on all areas of the body including the fingers, feet, arms, and face. Please come to see us for quick-care orthopedic injury treatment for cost-effective care at medical office rates, not hospital rates.

Laceration – causes, symptoms, diagnosis and treatment

Laceration is an injury to the skin or mucous membrane resulting from exposure that exceeds the ability of tissues to stretch. The cause of the occurrence is contact with a hard blunt object, “catching” on the skin and soft tissues. The laceration has uneven edges, significant detachment and scalping of the skin are often observed. Accompanied by bleeding, damage to muscles, nerves and blood vessels is possible. The diagnosis is exposed taking into account the anamnesis and a clinical picture. Surgical treatment.

General information

Laceration is a violation of the integrity of the skin, mucous membranes and soft tissues, resulting from a rupture under the influence of a solid object. In most cases, it is located within the skin and subcutaneous tissue. Sometimes there is damage to muscles, blood vessels and nerves. Violation of the integrity of internal organs is extremely rare. A laceration can be an isolated injury or be combined with other injuries: fractures of the bones of the limbs, fracture of the spine, chest injury, TBI, fracture of the pelvis, kidney injury, rupture of the bladder and blunt trauma to the abdomen. Treatment of fresh lacerated wounds is carried out by traumatologists, infected – by surgeons.

Laceration

Causes

A laceration may occur in domestic accidents, motor vehicle accidents, criminal incidents, falls from heights, and industrial accidents. In summer residents, as a rule, it occurs during careless work with garden tools. Cyclists, motorcyclists, hunters, fishermen and hard manual laborers are often affected. It is often observed in children, especially in the summer.

Pathogenesis

Distinctive features of lacerated wounds are irregular patchwork edges, significant tissue damage in the walls of the wound channel, tissue exfoliation, skin scalping areas. The formation of a tissue defect due to their complete separation is possible. The depth of the wound channel, as a rule, is insignificant, while the affected area can reach large sizes in length and width. Bleeding is less than with incised wounds. Fabrics are often heavily contaminated, which is facilitated by the mechanism of injury: damage from a dirty garden tool, a fall from a bicycle or motorcycle onto asphalt or gravel, a fall on pieces of coal while working in a mine, etc.

Types of lacerations are crushed, bruised and scalped injuries. With crushed and bruised wounds, extensive destruction and necrosis of tissues is observed. Scalped wounds are characterized by partial or complete detachment of the skin from the underlying tissues without significant destruction. Scalped injuries of the scalp can occur when hair gets into moving mechanisms, scalped wounds of the lower and upper extremities – when it gets under the wheels of vehicles or into rotating mechanisms. Injuries caused by contact with moving machinery can also cause open fractures and traumatic amputations.

Due to the large area of damage and tissue necrosis, lacerations heal worse and suppurate more often than incised ones. Healing by secondary intention or under a scab is characteristic. Healing by primary intention is possible in favorable circumstances: with a small amount of damage, a relatively small area of necrosis, the absence of gross defects in the skin and soft tissues, slight microbial contamination, and a good state of the immune system.

Infection in lacerations develops faster than in stab or cut wounds. The first signs of infection (edema, hyperemia of the edges, sanious or mucous discharge) can be detected within a few hours after the injury, while in cut wounds, the infection usually develops about a day after the injury. This necessitates early medical attention and further worsens the prognosis.

The wound process proceeds in three stages. At the stage of inflammation, necrotic tissues are destroyed and removed from the wound along with pus. Initially, the surrounding tissues swell, the lumen of the canal narrows or disappears, and blood clots and dead areas are “squeezed” out. Then the inflammation becomes purulent. The remaining dead tissue is melted. A demarcation shaft is formed around the damage zone, separating necrotic tissues from healthy ones.

After complete cleaning, the regeneration (recovery) phase begins, during which granulation tissue forms on the canal walls. Granulations gradually fill the entire defect and become denser. Then comes the phase of epithelialization, culminating in the formation of a scar. With extensive soft tissue defects, self-healing becomes impossible, it is necessary to close the granulations with the help of skin grafting. The duration of each phase of healing depends on the size of the injury, the degree of bacterial contamination, the amount of necrotic tissue, the presence of other traumatic injuries and somatic diseases, etc.

Symptoms of a laceration

When injured, pain occurs. The degree of dysfunction depends on the size, location and characteristics of the wound. An external examination reveals an irregularly shaped defect with uneven, often crushed edges. At the bottom of the defect, fatty tissue is visible, less often – muscles and fragments of tendons. Abundant contamination with earth, gravel, coal and other components that have been in contact with tissues at the time of injury is possible. Sometimes pieces of clothing, metal, wood, etc. are visible in the wound.

In some cases, large scalped skin flaps are formed (skin hangs from the edge of the wound), detachment, complete crushing or detachment of individual sections is observed. Hemorrhages and hematomas are often formed around the lacerated wound. Bleeding, as a rule, capillary or mixed, insignificant due to tissue crushing. If large vessels are damaged, bleeding is profuse, blood can pour out not only outside, but also in the area of detachment.

If the tendons are damaged, loss of function of the corresponding fingers is revealed. With compression or (less often) violation of the integrity of the nerves, disorders of sensitivity and movement are noted. With open fractures, deformation and pathological mobility are detected, bone fragments are sometimes visible in the wound. A particularly severe picture is observed in traumatic amputations: the distal part of the torn off segment has uneven edges with hanging pieces of skin, protruding fragments of bones, muscles and tendons.

The general condition of the patient depends on the nature of the laceration. With minor injuries, the condition remains satisfactory, with extensive injuries, traumatic shock may develop due to both blood loss and trauma-related neuropsychic stress, as well as severe pain that occurs when large areas of the skin are damaged. Characterized by excitement, followed by lethargy and apathy. Initially, the patient is anxious, frightened, sometimes aggressive, cries, screams, complains of pain. The pupils are dilated, there is tachycardia, rapid breathing, clammy sweat, tremors and muscle twitching. Then the patient becomes lethargic, drowsy, indifferent. The skin is pale, lips with a bluish tinge, while maintaining tachycardia, there is a drop in blood pressure. In severe cases, loss of consciousness is possible.

Diagnosis

Diagnosis is established during a consultation with a traumatologist when contacting a trauma center or hospital emergency room. When determining the type of injury, the anamnesis and appearance of the wound are taken into account. If there is a suspicion of damage to the vessel, an examination by a vascular surgeon is required, with signs of a loss of nerve function, a consultation with a neurosurgeon is required.

Treatment of a laceration

Treatment of minor injuries is carried out in an emergency room or outpatient surgery. Fresh wounds are washed abundantly, if possible, non-viable tissues are excised, sutured and drained. With successful healing, the sutures are removed for 8-10 days. Infected wounds are washed, expanded or opened if necessary, pus and non-viable tissues are removed and drained without suturing.

Patients with extensive fresh lacerations are hospitalized in the Department of Traumatology and Orthopedics. In traumatic shock, anti-shock measures are taken. The tactics of treatment are chosen taking into account the characteristics of the damage. If possible, PHO is performed under local anesthesia or general anesthesia, if not possible, they are washed and dressed with furacilin. The scalped areas of the skin are sutured, having previously applied perforations for a better outflow of fluid. With a significant tension of the edges on the sides, laxative incisions are made. The wound is drained. In the postoperative period, antibiotics and analgesics are prescribed.

In case of extensive suppuration, hospitalization in a surgical hospital is indicated. The wound is treated, if necessary, purulent streaks are opened, necrotic tissues are excised, washed and drained. Antibacterial therapy is carried out taking into account the sensitivity of the pathogen. To stimulate necrolysis, proteolytic enzymes are used, which also have anti-edematous and anti-inflammatory effects. Vacuum treatment, laser and ultrasound treatment, cryogenic exposure and other methods are used to accelerate wound cleansing.

In the healing phase, general strengthening treatment is prescribed, careful dressings are performed using antibacterial and indifferent ointments that improve tissue trophism. In the presence of a large defect, after cleansing the wound and the appearance of granulations, secondary sutures are applied and free skin grafting or plastic surgery is performed with a displaced flap.