Definition – What is a laceration?
A laceration is a common injury, especially in children, where blunt force is used to split the skin. It is often caused by falls or accidents in places on the body where the skin is in direct contact with the bone, e.g. the forehead or shin. The wound is superficial, but the edges of the skin are often irregular due to the bursting.
Heavy bleeding can also occur. A burst wound differs from a crush injury in that it also affects deeper structures. This results in the tearing of the subcutis and muscle.
What accompanying symptoms do I have to watch out for?
In the case of a laceration, the tearing of the vessels usually causes a heavy bleeding. Bleeding and bruising of the surrounding tissue can also cause swelling or bruising. These also lead to severe pain.
If the surrounding tissue is injured, movement and sensory disturbances can also occur. In the case of lacerations to the head, a concussion often occurs. If bleeding is not stopped or a concussion is suspected, the patient should consult his or her family doctor or hospital.
What kind of laceration do I need to see a doctor with?
Heavily bleeding lacerations that cannot be breastfed should be checked by a doctor. It must be checked whether an artery has been injured and the doctor must sew up the wound if bleeding continues. In addition, large and heavily contaminated wounds should be checked by a doctor and cleaned under sterile conditions.
The doctor also closes the wound with sutures or staples. In addition, burst wounds to the head should always be checked by a physician due to the risk of a severe concussion or cerebral hemorrhage. In most cases, patients are kept in hospital for 24 hours for observation.
Therapy – What to do in case of a laceration?
In first aid for burst wounds, hemostasis is the first priority. To stop bleeding, the wound should be compressed by applying strong pressure. If a first aid kit with sterile compresses and gauze bandages is already available, the wound should first be quickly disinfected and then bandaged to prevent infection from spreading.
Then the pressure dressing should be kept on for some time until the bleeding is stopped. It is important to ensure that the blood supply to the fingers, toes or other parts of the body is not interrupted. A doctor should also be consulted to inspect and treat the wound.
The wound can then be closed if there is sufficient disinfection and hemostasis. After the treatment the body part should be spared for some time and checked by a doctor after a few days. In most cases, burst wounds in the emergency room are sutured by the doctor with as little tension as possible.
With good skin sutures, the wound can be closed securely without leaving large scars. However, only wounds that are no older than 6 hours can be sutured. After 6 hours, the wound is first kept open and thoroughly disinfected, as the risk of infection is too high.
Before suturing, a local anaesthetic is usually injected around the edges of the wound so that the patient does not feel any pain when suturing. Depending on whether or not absorbable suture material was used, the stitches must be removed after 7-10 days. An alternative to suturing is the stapling or stapling of lacerations.
For this purpose, stainless steel staples are pressed into the tissue with the help of a stapler. These hold the wound edges together. The stainless steel staples can withstand high tension, so that the suture rarely tears.
The advantage over the suture is the faster working time. However, scarring does occur here, so if possible, staples should not be used on the face. Special staple removers must be used for removal.
Staple plasters, also called Steristrips, are plasters that hold the wound edges together by applying a tension. They serve as support for sutured wounds. Due to their elasticity and strong adhesion, they can prevent the risk of scarring and ensure a well closed wound so that they can heal without any problems.
As they are very skin-friendly and breathable, they are especially popular for sports. They are only used for support in the case of larger lacerations and are not an alternative to traditional sutures or staples.Smaller lacerations that no longer bleed can, however, be treated with the patch. However, little stress may then be exerted on the affected area.
A laceration can also be dressed with adhesive on certain parts of the body. It is important that these parts of the body are not under great and constant tension. This is for example the case with the face or head.
A special tissue adhesive is used, which is applied to the edges of the wound. The advantage is that neither stitches nor staples have to be removed later, as the adhesive dissolves by itself after a while. The disadvantage, however, is that glued wounds often cause unsightly scarring.
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