Brief overview
- What to do in case of a laceration? First aid: stop heavy bleeding with pressure bandage, rinse wound with cool tap water, disinfect (if a suitable agent is available), bring edges of small lacerations outside the face together with staple plaster (suture strips)
- Laceration risks: Wound infection (incl. tetanus infection), scarring, concussion in case of head laceration.
- When to see a doctor? for large/gaping wounds, for facial lacerations, for heavily contaminated wounds and/or lacerated wound edges, for suppurating wounds, for heavily bleeding wounds, for missing or unknown tetanus vaccine protection, for vomiting, nausea, unconsciousness
Caution.
- When treating a laceration, refrain from using home remedies such as flour, butter, onion juice, or superglue. These substances have no place on or in the wound!
- Do not use hydrogen peroxide (hydrogen superoxide) or iodine tinctures to clean wounds. Hydrogen peroxide can penetrate tissue crevices and alter the red blood pigment in such a way that vascular occlusions due to blood clots occur. Iodine, in turn, can cause severe allergic reactions.
- Do not treat the laceration with healing ointment, powder or spray plaster, as this will delay healing!
Laceration: What to do?
First, you should remain calm, even if a laceration sometimes flows a lot of blood. Calm the injured person, then give first aid and treat the wound. This is how you proceed:
- Rinse or dab the laceration: Wash off the blood with cool tap water. If this is not possible, dab the wound with a clean cloth or piece of gauze. Only then can you estimate how large the wound is.
- Disinfect the wound: Now disinfect the wound with a non-alcoholic disinfectant from the pharmacy.
- Stop bleeding: If the laceration is bleeding heavily, you should apply a pressure bandage. However, be careful not to cut off the blood supply to the affected part of the body!
- Small laceration outside the face: If a laceration on the scalp, legs or arms is less than 5 millimeters apart and is barely contaminated, you can treat it yourself. Once the bleeding has subsided, carefully push the edges of the wound together. Then stick staple plasters (suture strips) over the wound.
- Cool bump under laceration: If a bump develops in addition to the laceration, you should cool it. Do not place cooling pads or ice cubes directly on the skin, however, but wrap them in a clean piece of cloth. Otherwise there is a risk of local frostbite.
Laceration: Avoid water
As long as the wound is not yet closed, no water should get onto the wound. Therefore, cover the laceration with a waterproof plaster when showering for about a week. However, it is not always possible to apply a shower plaster, for example not in the case of a laceration on the hairy head. You can only wash your hair again once the wound has closed.
If the laceration is very large and had to be stitched, stapled or glued, you should follow the doctor’s instructions regarding contact with water.
Laceration: healing time
Lacerations usually heal within two to three weeks. If they are located in highly stressed areas of the skin, such as around joints, the wound may take longer to heal.
How long you are affected by a laceration to the head depends on whether you have also suffered a concussion. If so, a few days of bed rest or even hospitalization may be necessary.
Laceration: Risks
The doctor can only staple, suture or glue a laceration within six hours. After that, he must leave the wound open because otherwise the risk of infection would be too high. An infected wound takes longer to heal and can leave unsightly scars. In addition, some infections, such as tetanus and blood poisoning (sepsis), carry risks that are sometimes life-threatening.
Tetanus infection
Be sure to get a tetanus vaccination for lacerations or other injuries if you do not have effective protection or do not know your vaccination status.
Blood poisoning (sepsis)
Untreated, infected wounds can cause blood poisoning (sepsis). In this case, germs spread through the bloodstream in the body and trigger a complex inflammatory reaction. Signs include high fever, confusion, accelerated breathing, rapid heartbeat, and pale or gray skin color. If left untreated, sepsis leads to organ damage and cardiovascular failure!
Concussion
A violent bump or blow to the head can leave not only a laceration, but also a concussion. Therefore, the injured person should be closely monitored for 48 hours for signs of concussion. These include memory lapses, nausea, vomiting, headache, dizziness or loss of consciousness.
Laceration: When to see a doctor?
- The casualty feels very weak, turns white as a sheet and has cold sweat on his forehead (place him in the shock position until the emergency physician arrives!).
- The casualty has a laceration to the head and was unconscious immediately after the accident (risk of concussion or cerebral hemorrhage!).
- If there is a laceration to the head, vomiting, nausea, memory lapses, or increasing drowsiness will occur within 48 hours of the injury (also signs of concussion or bleeding).
- The injured person develops a fever and other symptoms such as confusion, shortness of breath, rapid pulse or bluish discolored skin (first signs of blood poisoning = sepsis!) a few days after sustaining the laceration.
- The injured person with the laceration has no current tetanus protection and develops symptoms such as muscle cramps and difficulty swallowing after a few days or weeks.
Off to the general practitioner or pediatrician is called in the following cases:
- You are taking anticoagulants or immunosuppressants (immunosuppressants such as cortisone).
- The laceration is deep or gapes more than 5 mm apart.
- The wound edges are ragged and not smooth.
- The laceration is on the face.
- The bone under the laceration is also injured.
- The wound is heavily soiled.
- You are suffering from circulatory problems, such as diabetes.
- The laceration is festering, the wound has become infected.
- The wound hurts more than at the beginning, the skin around the wound swells, warms up and reddens (sign that the laceration has become infected).
- You have a fever (another sign of a wound infection).
- You feel numbness near the wound that does not go away even after a few days. Then nerves could be damaged.
- The wound has not healed even after two to three weeks.
Laceration: examinations at the doctor
- When and how did you sustain the laceration?
- For lacerations to the head, were you unconscious after the injury? Did you have to vomit was/are you nauseous? Are you drowsy or experiencing a severe headache?
- Are there any other injuries?
- Has the appearance of the laceration changed? If so, how (swelling, redness, pus formation, etc.)?
- Are there any pre-existing conditions (e.g., diabetes, which can worsen wound healing)?
- Are you (or your child) taking any medications (e.g., cortisone or other drugs that suppress the immune system)?
- Has a fever occurred?
- When was the last tetanus vaccination?
Laceration: treatment by the doctor
The doctor cleans the wound carefully with saline solution or water. If the wound is still bleeding heavily, he stops the bleeding with a pressure bandage. The doctor can treat smaller lacerations with staple plasters or skin glue.
If the injury is larger or to the face and six hours have not yet passed, the doctor will stitch or staple the laceration. An anesthetic injected into the wound area will suppress the pain during this process. If needed, the patient is then given a pain medication.
If more than six hours have passed, the wound remains open and is not sutured, glued or stapled. The physician irrigates the laceration and applies a dressing.
The doctor also checks for tetanus vaccination protection. If it has been more than ten years since the last tetanus shot (more than five years for children), a booster is necessary.
Laceration: Aftercare
If self-dissolving stitches were used to suture the laceration, they do not need to be removed. Otherwise, the doctor will remove stitches, suture strips and skin glue from the face after four to six days, from the arms and legs after ten to fourteen days, and from the joints possibly after three weeks.
If the laceration leaves a scar, you can care for it with an ointment containing panthenol. In addition, you should protect the scar from the sun.
