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Laceration Repairs

Laceration repair is a medical procedure that cleans, prepares, and closes a wound to promote healing, reduce discomfort, and minimize the risk of scarring and infection. Whether caused by an injury, accident, or surgery, this treatment supports proper healing and helps minimize scarring. At Palo Alto Dermatology Institute in Palo Alto, California, our team of board-certified dermatologists provides expert care in laceration repair, utilizing advanced reconstruction techniques customized to each patient’s needs for optimal results. By properly addressing the wound, laceration repair not only restores the skin’s integrity but also supports optimal cosmetic and functional outcomes.

Often when presenting to the emergency room with a laceration, the laceration is closed with butterfly bandages, cyanoacrylate glue or simple suturing. However, most lacerations are jagged and may have partial tears with some devitalization of the skin edges.  It is common to just suture or glue this skin together but that can result in spread or widening scars since the torn tissue has poor healing at its edges.

Dr. Morganroth is often called by patients to repair a laceration instead of going to the emergency room. Dr. Morganroth will physically examine the laceration and evaluate the laceration for nerve and blood vessel injury.  If it is a dirty, deep, or complicated wound, he will recommend a tetanus shot that will be provided by the patient’s pediatrician or primary care physician. Local anesthesia will be used to prevent discomfort during the cleaning and repair of the laceration.

He uses the same techniques to repair lacerations that he uses in his facial reconstructions:

  • Multi-layered closure with both deep dissolving sutures and superficial sutures that are removed at one week or later
  • Trimming the dead skin edges so they are smooth and even thickness to reduce the width and thickness of the scar
  • Lacerations can be repaired one, two, or three days or any duration of time with a similar outcome
  • If a scar results, patients do not have to wait weeks or months for a scar repair in contrast to common misinformation
  • There is also an option to refine a laceration repair scar with vascular or resurfacing lasers six weeks after the repair

The best method of repair depends on the wound’s location, size, depth, and complexity. Dr. Morganroth’s goal is to prevent and reduce the risk of scarring.

Common techniques include:

  • Suturing (Stitches): Sutures involve the use of medical-grade thread to close a laceration. They are suitable for deep cuts or wounds under tension, such as those on joints or areas prone to movement. Sutures may be absorbable or non-absorbable, depending on the location and nature of the laceration. Dr, Morganroth always utilizes a multi-layer closure with dissolving sutures deep in the skin and superficial sutures or cyanoacrylate glue on the surface.
  • Staples: Staples are not Dr. Morganroth’s preferred closure technique, however staples are used elsewhere for larger, straight lacerations, especially on the scalp or trunk. They provide a quick and efficient way to close wounds while maintaining proper alignment of the skin edges.
  • Adhesive Strips (Steri-Strips): Adhesive strips are ideal for small, superficial lacerations or as an adjunct to sutures. They are non-invasive and can help hold the wound edges together as the skin heals naturally.
  • Skin Glue (Dermabond or cyanoacrylate glue): Medical-grade adhesive glue is often used for minor cuts after buried or deep dissolving sutures are placed, particularly in areas where cosmetic appearance is essential, such as the face. It seals the wound edges quickly and eliminates the need for superficial stitches or staples in certain cases.
  • Complex Repairs (Layered Sutures): For deeper or more intricate wounds, layered sutures are used to close different tissue layers. This technique is common in areas with significant tissue loss or lacerations that involve muscles, tendons, or blood vessels.

Each method offers unique advantages, and the choice depends on the specific needs of the wound and the patient’s overall condition. Proper laceration repair ensures a smoother recovery process and helps achieve the best possible outcome for both function and appearance.

After laceration repair it is important to keep the area clean and dry for the first days, and then gently washing with cool water and soap several times a day. You will receive complete instructions from your Palo Alto Dermatology Institute dermatologist.

Recovery from laceration repair varies depending on the severity of the wound and the repair method used. In general, patients can expect:

  • Initial Healing: The wound typically begins to heal within 7-10 days, with redness and swelling subsiding gradually.
  • Suture or Staple Removal: Non-absorbable sutures or staples are removed on a timeline that depends on the area of the laceration. If the laceration is on the face, the sutures will be removed within 7 days. Otherwise, the timeline depends on the location of the wound.  Absorbable sutures dissolve naturally.
  • Scar Maturation: Scars may initially appear pink or raised but typically fade and flatten over several months. Patients are advised to keep the area clean, apply sunscreen, and consider scar-reducing treatments if necessary. Scars will continue to mature for about 12 months.
  • Follow-Up Care: Regular follow-up visits ensure proper healing and minimize the risk of complications, such as infection or poor scar formation.  Scar that are red, irregular, visible, elevated or thickened may be candidates for vascular or fractional ablative laser resurfacing as early as 6 weeks after laceration repair.  Occasionally, multiple laser treatments are needed to obtain an optimal result.

At Palo Alto Dermatology Institute, our experts prioritize patient comfort and optimal outcomes. We take a personalized approach to laceration repair, addressing both functional needs and aesthetic goals. For expert care and advanced techniques in laceration repair, contact our office today to schedule a consultation.

References

  • Newman RK, Mahdy H. Laceration. [Updated 2022 Oct 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545166/
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