|Laceration Wound of the Hand|
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Reasons for Procedure
- Exposed muscle, fat, tendon, or bone
- Dirt and debris in the wound, may remain even after cleaning
- Feeling as if something is in the laceration, even if you cannot see any debris
- Bleeding continues after applying direct pressure for 10-15 minutes
- Jagged or uneven edges
- Depth more than 1/8 to 1/4 inch deep
- Location on area of high stress (joints, hands, feet, chest)
- Noticeable scarring
- Poor wound closure
- Allergic reaction to anesthetic
What to Expect
Prior to Procedure
- Apply direct pressure to the wound. Use gauze, a clean cloth, plastic bags, or, as a last resort, a clean hand. If the wound bleeds through the gauze or cloth, do not remove it. Add more gauze.
- If possible, elevate the wound above the heart. This will make it harder for blood to flow to the wound. Do not tie a tourniquet around an affected limb. This may cause more damage.
- If bleeding stops, let some water run over the wound. Tap water is safe to use.
- If muscle, tendon, bone, or organs are exposed, do not try to push them back into place.
- If you are feeling faint, lie down or sit with your head between your knees.
- Examine the wound
- Decide if a surgeon is needed
- Ask about your medical history, allergies, and how the wound occurred
- Discuss your pain tolerance and options for closing the laceration
- Explain the procedure
- Local anesthesia is used for minor lacerations. This will numb the area around the wound.
- General anesthesia may be needed for severe lacerations. It will block pain and keeps you asleep.
Description of Procedure
- You have never received a total of at least three vaccination doses. (routine childhood immunizations gives a dose at ages 2, 4, 6, and 15-18 months)
- It has been more than five years since your last tetanus immunization.
- You are unsure of your tetanus status.
How Long Will It Take?
How Much Will It Hurt?
- Give you pain medicine and antibiotics.
- Give you a tetanus booster.
- Avoid strenuous activities.
- Take antibiotics and pain medication as directed.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
- If you need to keep the incision area dry when showering, wrap the area with a plastic bag.
- After showering or bathing, pat the area dry. Do not rub the area. Also, do not apply hydrogen peroxide or iodine to the wound. This will damage tissue and slow healing.
- Do not pick at or scratch the wound. This may lead to poor healing.
- Dermabond will fall off in 5-10 days.
- Steristrips will typically be removed after 5-10 days, or they will fall off on their own.
- Stitches will be removed after 5-14 days.
- Staples will be removed after 5-10 days.
- Rubber bands will be cut from hair in 7-10 days.
- A personal history of excessive scar (keloids) formation
- Location, type, and size of the wound
- Skill of the doctor
Call Your Doctor
- Wound reopens
- Redness, warmth, swelling, drainage or excessive bleeding occurs at the wound site.
- Signs of infection, including fever, chills, or red streaks tracking up arm or leg
- Spasm or rigidity of muscles in jaw, neck, abdomen, or an area near the wound
- Any other concerns
American Academy of Family Physicians http://www.familydoctor.org
National Library of Medicine http://www.nlm.nih.gov
Canadian Association of Wound Care http://www.cawc.net
Skin Care Guide.ca http://www.skincareguide.ca
Beam, J. W. Wound Cleansing: Water or Saline? J Athl Train . 2006;4(2):196-197.
Burns T, Worthington J. Using tissue adhesive for wound repair: a practical guide to Dermabond. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000301/1383.html. Published March 1, 2000. Accessed December 28, 2012.
Joyce MP. Routine Vaccine-Preventable Diseases - Tetanus. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/tetanus.aspx. Updated July 1, 2011. Accessed December 28, 2012.
Laceration management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated September 14, 2012. Accessed December 28, 2012.
- Reviewer: Marcin Chwistek, MD
- Review Date: 12/2013 -
- Update Date: 01/15/2014 -