Laceration

Lacerations are traumatic injuries that involve rips or tears in your body’s tissues. While skin lacerations are the most common, these wounds can happen to tissues inside your body, too. They can even happen without the laceration affecting the outside of your body.

Lacerations are incredibly common. They can be as minor as an everyday paper cut or nick while shaving or as severe as life-threatening wounds that need emergency medical care.

Experts often classify lacerations in one of two ways:

• Where they are on your body, like hand or face lacerations
• What type of tissue they affect, like torn muscles or ligaments

Minor lacerations are easy to treat yourself. But it’s important to know when these wounds are more serious and need professional medical care.

What are the symptoms of lacerations?

The main symptoms of a laceration are pain and bleeding. If the laceration affects or passes through our skin, it will cause a visible opening in your skin’s surface. But if the laceration is internal only, like a torn muscle, you may have different symptoms, like bruising or swelling.

The type or location of tissue affected can change or intensify the symptoms that you experience. For example, your face or scalp will typically bleed very heavily because they’re packed full of capillaries. And lacerations to blood vessels, like veins and arteries, also bleed heavily.

And some symptoms are very specific to certain types of lacerations. For example, a nerve laceration can cause tingling, numbness, weakness or paralysis, or nerve pain.

What causes lacerations?

Lacerations can happen when something causes ripping or tearing of tissues in your body. Some of the most common causes include, but aren’t limited to, the following:

• Using knives or other sharp items
• Working with edged tools or objects
• Sports-related injuries
• Bites from animals or humans
• Falls or other types of blunt impacts
• Vehicle crashes
• Physical violence
• Skin tears related to bedsores (pressure injuries)
• Penetrating injuries that tear or rip tissues inside your body
• Rings or jewelry that snag or pull, tearing through skin or taking areas of skin with them

Lacerations usually involve one or more of the following:

• Sharp edges: This damages the skin’s outer layers, making it tear more easily.
• Blunt force: This can put too much pressure on the affected tissue, making it split, tear or burst. Blunt force injuries can cause lacerations inside your body without breaking your skin.
• Shearing: This is when tissue experiences movement forces in more than one direction, or when tissues next to each other pull apart. Shearing injuries can also cause internal lacerations without breaking skin.

Many lacerations involve more than one of the above, especially when the laceration is more severe. For example, lacerations can be very large when a tear happens with a lot of force, making the wound bigger. One specific example of this would be ring avulsions.

So, if you have a laceration that might involve multiple types of damage or injury, your best bet is to seek professional medical care. Erring on the side of caution can make a big difference in the long run.

What are the complications of lacerations?

Some of the most common complications of lacerations include:

• Infections: The risk of these goes up when wounds are larger and/or deeper. Infections are also more likely to happen with bites and when it takes longer to get treatment. And wound location matters, because infections are more likely with lacerations on your hands or feet.
• Scarring: This is also more likely with larger, deeper or slow-to-heal lacerations.
• Tissue-specific effects: Some complications are specific to the type of tissue injured. For example, permanent numbness or weakness is a possible complication of nerve lacerations.

The complications you might experience can be very specific to your case, health history and other factors. Your healthcare provider is the best person to tell you about the possible complications.

How are lacerations diagnosed?

Surface lacerations are easier to diagnose because a healthcare provider can see them and feel for nearby tissue changes. That makes a physical exam one of the most important parts of diagnosing lacerations.

When lacerations happen inside your body without a visible surface wound, a physical exam can still help with diagnosis. But it also usually takes tests like imaging scans, especially CT scans and magnetic resonance imaging (MRI).

You might need other tests depending on how your laceration happened, your health history and other factors. Your healthcare provider can tell you about possible tests and why they might help.

How are lacerations treated?

Laceration treatments range from simple home remedies to professional medical care. The type of treatment mainly depends on the laceration’s size, depth, location and cause.

Minor lacerations are treatable with simple cleaning and bandaging. But for more serious lacerations, the following treatments are possible:

• Wound closure: This can involve sutures, staples, adhesives, bandages, etc.
• Irrigation, cleaning and debridement: Irrigating and cleaning the wound removes debris or foreign substances. Debridement removes dead or diseased tissue from an injury to help it heal.
• Medications: Antibiotics to treat or prevent bacterial infections are one example. Others include numbing medications during procedures or drugs to help with pain during recovery.
• Specialized wound care: When you have wounds that are slow to heal, specialized techniques may be necessary. These include devices like wound drains or wound vacuums, hyperbaric oxygen therapy and more.
• Surgery: Lacerations that are deep or that affect connective tissue, like ligaments and tendons, may need surgery to repair.
• Immobilization: You might need immobilization, like wearing a splint or arm sling, to keep part of your body still. That can give skin or interior tissues time to rest and heal.

You might receive other treatments, too, depending on your health history and other factors. Your healthcare provider can tell you more about the treatment options for your case.

What can I expect if I have a laceration?

Lacerations are common, and most of the smaller and shallower ones heal quickly and easily. Even larger, deeper lacerations typically respond well if they get proper treatment right away.

But when lacerations don’t get proper treatment fast enough, it can take them longer to heal. This increases your risk of complications like infections and scarring. Your health history and any chronic conditions you have can also factor in. That means your healthcare provider is the best source of information about what you should expect with your case.

Can lacerations be prevented?

Lacerations usually happen unpredictably, so there’s no way to prevent them entirely. But there are several things you can do to reduce your risk of lacerations from common laceration-causing events:

• Wear seatbelts in moving vehicles.
• Use helmets and protective gear during work or leisure activities.
• Use personal protective equipment (PPE) whenever recommended.
• Use the right tool for the job (an example would be not using a kitchen knife in place of a can opener).
• Make sure tools are in good condition (for example, cutting tools should be sharp because dull blades are more likely to cause injuries).

When should I seek medical care?

You can self-treat minor lacerations. These injuries are minor when they’re:

• Short: They’re less than 1/2 inch (or 1.25 centimeters long).
• Shallow: They don’t go all the way through your skin, so you can’t see underlying fascia or subcutaneous fat beneath.
• Straight: They don’t have jagged or curved edges.
• Narrow: The edges are close together, so the wound can seal on its own or with simple bandaging treatments.
• Clean: Wounds that you can clean with soap and water are minor. If you can’t clean a wound, or if it’s from any kind of bite or rusty metal, it needs professional medical care.
• Able to clot: Wounds that don’t stop bleeding on their own or with direct pressure are more serious.
• Not on or in sensitive tissues or structures: If a wound affects your face, it’s more likely to need professional care.

When a laceration doesn’t meet any of these criteria, it needs professional medical care. That usually means care in a doctor’s office or an urgent care clinic-type setting.

But lacerations need immediate medical attention at an emergency room or hospital when they:

• Won’t stop bleeding even with direct pressure, especially wounds that involve or are close to a major blood vessel
• Are deep enough to see bones, muscles or organs
• Affect your eyes or eyelids directly
• Show signs of an infection or sepsis, including fever, swelling, oozing, or the wound area feeling warm to the touch or giving off a foul smell

What questions should I ask my healthcare provider?

Some laceration-related questions you can ask your healthcare provider include:

• How should I care for the wound while it heals?
• How long should it take to heal?
• What should I do if it doesn’t heal in that timeframe?
• What kind of symptoms mean I need immediate medical care?
• Will it scar, and can I do anything to reduce scarring?