Diagnosis

A laceration is always preceded by the application of mechanical force. After a thorough inspection of the wound edges and the depth of the wound, a diagnosis of a laceration can be made. The wound and wound edges are irregular. The depth of the wound typically reveals tissue bridges caused by uneven application of force to the skin. Lacerations and crush injuries are often combined and cannot be clearly distinguished from each other.

Associated symptoms of a laceration

The skin is sensitively supplied by many nerves. If these are damaged by a sudden tearing of the skin, strong, initially stabbing pains arise, which can sometimes cause general symptoms such as dizziness, drop in blood pressure or even fainting. This is followed by pulsating pain in the area of the wound. Crack wounds can bleed very heavily, especially if deeper skin sections are also affected. In addition, there is swelling around the wound as fluid collects in the damaged tissue.

Treatment/Therapy

The first goal of wound care is hemostasis. First, pressure should be applied to the wound. To do this, a sterile compress is placed on the wound and a pressure bandage is applied over it.

Then a doctor should be consulted. Once the bleeding has been stopped by the bandage, an X-ray is taken if a fracture is suspected. Then the bandage is removed and the wound is examined.

The wound is cleaned of coarse dirt and disinfected. Depending on the size and location, the wound may need to be stitched or stapled. For smaller injuries, it is sufficient to fix the edges of the wound with adhesive plasters.

Before the wound is stitched, a local anaesthetic is injected into the tissue around the wound under local anaesthetic. After a short application time, the wound is again thoroughly cleaned in depth and then sterilely covered. The wound is then sutured under sterile conditions.

Depending on how deep the wound is, deeper layers of skin may have to be sutured separately first. At the end the uppermost skin layer is then sutured together. In the case of lacerations, the edges of the wound often have to be straightened in advance by cutting off protruding skin corners.

The skin is elastic, the straightened wound edges can then be pulled together. At the end, a plaster and bandage is applied. The area should then be cooled, raised and protected.

In addition, the wound should be kept dry and the dressing changed regularly until the wound has healed. In addition, the patient’s tetanus vaccination status is checked for each skin injury, especially if the wound is dirty, and a tetanus vaccination is administered if the vaccination protection is unclear or insufficient. Otherwise a tetanus spasm may occur.

In any case a doctor should be consulted if the laceration is deeper or longer than 1 cm. It is to be assumed that the wound will not heal on its own, as the edges of the wound cannot be placed together and must be fixed by the doctor with sutures, staples or plasters. A doctor should also be contacted in case of gross contamination or heavy bleeding. Also if there is a suspicion of concomitant injuries such as a fracture.