SPECIFIC LACERATIONS: Lip

Initial stitch at border       Repair in layers: mucosa, muscle        Suture skin last

SPECIFIC LACERATION: Tongue

SPECIFIC LACERATIONS: Ear

• Use folds of ear as landmarks
• Use absorbable suture for cartilage
• Support pinna on both sides with gauze

SPECIFIC LACERATIONS: Eyelid

Initial suture for precise alignment Closure in layers: absorbable suture

HAND: Treatment of Lacerations

• Check circulation, sensation, motor function
• Gently examine wound using aseptic technique to determine if clean or contaminated: contaminated wound contains foreign material, crushed or dead tissue
• Debride, lavage all wounds in operating theatre or emergency area
• Administer tetanus toxoid, antibiotics if indicated
• Stop bleeding by compression with sterile gauze; if necessary, extend wound, being careful not to cross skin creases in palm, digits
• Close wounds only when clean, using suture, spontaneous healing or skin grafts
• Debride, lavage all wounds in operating theatre or emergency area
• If contaminated, delay closure until after second debridement
• Wounds <1 cm will granulate spontaneously

Cover with sterile gauze (A) Apply plaster splint to hold wrist in 20o extension, fingertips exposed Elevate limb for first week to reduce oedema (B) Begin active exercises as soon as possible Inspect wound in 2-3 days to remove drains

SPECIFIC LACERATIONS: Tendons