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A laceration is a type of wound characterized by jagged, dirty, or bleeding edges. Usually caused by a sharp object, a laceration can affect the skin, underlying tissue, subcutaneous fat, tendon, muscle, and even bone.
Laceration repair typically involves treatment aimed at minimizing the risk of infection and scarring. More specifically, laceration repair seeks to accomplish four things :
1) Stop bleeding 2) Prevent infection 3) Preserve function and 4) Restore appearance.
Laceration repair may be necessary if the wound :
- Does not stop bleeding after the application of pressure
- Exceeds one-eighth of an inch in depth
- Exposes underlying tissues, fat, or bone
- Alters function in the surrounding area
- Has visible dirt or debris lodged in it
- Is located in a conspicuous area where scarring is undesirable
Depending on the degree of damage, laceration repair can involve treatments ranging from simple sutures to surgery. Generally, a doctor will inspect the wound to evaluate the extent of tissue, nerve, or other damage. In severe cases, such as when nerves or tendons have been injured, the laceration repair may necessitate reconstructive surgery .
Reconstructive Surgery for Laceration Repair
Reconstructive surgery for laceration repair generally falls into four categories:
- Direct closure , or stitches , is primarily used on wounds that are not very deep. The ultimate goal is to permanently close the wound and minimize scarring .
- Skin grafts are used on wounds too wide to be closed directly. The surgeon removes healthy skin from another area on the patient's body and covers the open wound with it .
- Tissue expansion is a technique used in cases where a significant amount of skin has been lost, creating an area too large to be covered with a small amount of skin grafted from the patient's body. This requires the surgeon to grow new tissue to cover the area. This is achieved by inserting a balloon under a healthy area of skin, slowly inflating it with salt water until the skin stretches to the required size. Eventually the wound can be repaired using the extra skin formed by the expansion process.
- Flap surgery involves the removal of living tissue , including its blood supply, from one area of the body and transplanting it to the area that needs it.
Reconstructive surgery is also used for laceration repair in instances where scarring of the wound caused a loss of mobility in muscles or joints .