Lacerations are among the common injuries that occur in the course of a person’s life and usually heal without problems or complications. In the case of extensive lacerations or those that bleed very heavily and permanently, medical advice should be sought to ensure good wound care. This will also ensure optimal healing of the laceration.
What is a laceration?
A laceration is an injury to the skin that bleeds – usually profusely. These occur particularly frequently in areas of the body where the skin rests very tightly on the bone. Lacerations are often found on the head, elbow, or shin, i.e., anywhere where there is little or no cushioning layer of fat. The edges of the wound in a laceration are usually well perfused, but depending on the type of laceration, they may be badly torn or dirty.
Causes
A laceration occurs when a person’s skin hits a hard or blunt object, causing it to burst open. This is also called blunt force trauma. Children and young people are particularly likely to sustain a laceration as a result of learning new movements or sports activities and the associated falls. However, older people who can no longer walk or stand safely are also at risk for a laceration if they fall. Among other things, the cause of a fall in the elderly can be a stroke, which is why a laceration in this case must definitely be clarified.
Symptoms, complaints and signs
A laceration is usually caused by a strong external force. Probably the most obvious symptom of a laceration is profuse bleeding. Even small lacerations often develop a large flow of blood that must be stopped immediately. Severe pain, on the other hand, is not a typical symptom of a laceration. However, due to the high blood loss, significant dizziness may occur. Under certain circumstances, the blood loss can be so great that it even leads to a fainting spell. If the force is particularly strong, the underlying bone may even be damaged. If a fracture is present, this is of course associated with considerable pain. In many cases, medical and drug treatment is required, since a deep laceration cannot otherwise grow together properly. Sensory disturbances are also a common symptom associated with a laceration. This can include permanent numbness in some circumstances. A strong and long-lasting tingling sensation is also possible, so this is also a clear sign of an existing laceration. In general, lacerations should always be treated by a doctor to ensure a smooth recovery. Otherwise, there is a risk of ugly scars that will remain for years.
Diagnosis and course
A laceration can usually be diagnosed relatively clearly without medical assistance. Nevertheless, to assess the extent and depth of the laceration, it is advisable to ask a doctor for advice. Medical advice should be sought especially in the case of heavily bleeding or very extensive lacerations, such as those that occur particularly frequently on the skull. The doctor will first ask how the laceration occurred and then clarify how bad the injury is. Once appropriate treatment has been initiated, the chances of recovery are very good – provided the laceration does not become infected with germs. In some cases, a scar develops in the area of the injury after healing, which is especially the case with extensive or deep lacerations.
Complications
Lacerations primarily affect children who injure themselves while playing or riding a bike. However, adults also occasionally sustain a laceration. In healthy individuals, these injuries usually heal without causing complications. In any case, however, the wound should be cleaned thoroughly and then covered with a plaster or bandage, otherwise it could become infected. Caution is advised if dirt or soil has gotten into the wound and there is no vaccination against tetanus. Affected persons who have not been vaccinated against tetanus should in any case watch out for relevant symptoms. Anyone who suffers from pain and muscle stiffness in the head area or difficulty swallowing after an injury with an open wound must see a doctor immediately.Tetanus is life-threatening and must be treated as early as possible. People suffering from hemophilia run the risk of bleeding to death even from otherwise harmless injuries and should therefore consult a doctor as a precaution in the event of lacerations. Complications can also arise in people with severely weakened immune systems. In this case, there is a risk that germs that penetrate through the open wound are not eliminated by the body, but multiply and enter the organs. In these cases, there is a risk of blood poisoning (sepsis).
When should you go to the doctor?
A laceration is usually caused by a strong external force, such as a fall. It often occurs in the head area and is associated with heavy bleeding. A visit to the doctor is mandatory for an existing laceration, otherwise various complications may occur. An appropriate doctor can quickly stop the heavy bleeding and ensure proper closure of the wound. Bacteria and germs can thus not get into the wound, so that a dangerous infection can be avoided. If the affected person forgoes medical and drug care, the risk of infection is very high. Bacteria can cause an infection within a short period of time, resulting in the formation of pus. At the first sign of such an infection, a doctor should be consulted immediately. Otherwise, there is a risk of blood poisoning. Thus, a laceration can be treated quickly and effectively with medical and drug treatment. Without proper treatment, dangerous complications may occur.
Treatment and therapy
In the case of a laceration that is accompanied by heavy bleeding, the bleeding should first be stopped, which can be done with the help of a pressure bandage, for example. To avoid introducing germs into the laceration, it is strongly recommended to use sterile dressing material such as compresses. If the wound bleeds very heavily or if the edges of the laceration gape very widely, a visit to the doctor or hospital is necessary. There, the laceration will be medically examined and disinfected. In the case of very deep or large lacerations, it may be necessary for the doctor to staple or suture them in order to support optimal wound healing and prevent scarring. At the same time, the doctor will examine whether other injuries, such as broken bones, have occurred in the area of the laceration. The important tetanus protection will also be checked by the attending physician and refreshed if necessary. In the case of smaller, less bleeding lacerations, a visit to the doctor is not necessarily required. Nevertheless, it is essential to disinfect the laceration to prevent infection of the open area. If the laceration was caused by a fall on the head, a visit to the doctor or hospital is absolutely advisable in order to rule out a concussion as a result of the fall. There, appropriate care of the laceration is also guaranteed.
Prevention
Preventing a laceration is quite difficult, as almost everyone suffers one or more lacerations in the course of their lives. Using a helmet and well-fitting joint protectors helps protect vulnerable areas of the body, especially during sports activities. For older people, the use of walking aids such as a rollator is recommended to help them feel more confident when walking. In this way, at least an attempt can be made to prevent a laceration.
Aftercare
Aftercare measures are based on the treatment of the wound. If the laceration was sutured, the stitches from the wound will need to be removed after a few days. The doctor will inform the patient whether the stitches need to be removed at home or in the doctor’s office. Afterwards, the scar must be cared for. The laceration can be protected from contamination with a wound plaster for one to two weeks. Then, depending on the position of the laceration, a greasy cream or a gentle scar gel with active ingredients such as dimeticone or dexpanthenol can be applied. A care product from the drugstore or pharmacy is particularly recommended for redness, itching and a feeling of tension. Accompanying this, the scarring can be reduced by careful massages. If healing takes a positive course, the wound should quickly close completely and the scar should fade.The doctor must check the injury again to rule out inflammation or adhesions. Follow-up care is provided by the family doctor or by a dermatologist. For larger injuries, a clinic may need to be visited to remove the stitches and provide medical care for the scar. A healed laceration that does not cause discomfort does not require further follow-up examination.
What you can do yourself
A laceration does not necessarily need to be treated by a doctor. Smaller, especially not deep lacerations can also be treated in self-treatment. Self-help is also possible for medically treated lacerations, which can help the injured area heal more quickly. If a laceration is treated by the patient, the wound must first be cleaned of contamination and disinfected to prevent subsequent infection. The wound is then covered sterilely, either with a plaster or a bandage over a compress. If bleeding occurs, the dressing solution should be renewed in good time or pressure should first be applied to the wound until the bleeding has stopped before dressing. Elevating the affected extremity helps to stop the bleeding. If you want to be on the safe side, have your doctor check the wound again for infection or scarring. Self-care is also possible for a wound that has been treated by a physician and perhaps even stapled and sutured. This includes dressing changes recommended by the doctor and refraining from any action that may interfere with the healing process. This includes waterproof shielding of the wound when showering or bathing as well as consistent protection against contamination. In the case of lacerations near the eye, it is better to refrain from wearing makeup and applying pressure with glasses until the wound is closed and healed.
