laceration

A laceration is a tear or disruption of tissue caused by trauma, often resulting in irregular, jagged wound edges. Lacerations can involve skin and deeper structures such as subcutaneous tissue, fascia, muscle, or tendons. They differ from incisions, which are clean, straight cuts made by a sharp object, and from avulsions, where tissue is torn away from its base.

Common causes include blunt impact that tears tissue and sharp objects that pries tissue apart. They frequently occur on the hands, fingers, face, and legs. Clinical presentation varies with depth and contamination and may include bleeding, pain, tissue loss, and visible structures beneath the surface. A careful examination assesses wound depth, neurovascular status distal to the injury, and the presence of foreign material or additional injuries. Tetanus vaccination status should be reviewed.

Management begins with controlling bleeding and preventing contamination. Wounds are cleaned with saline, and devitalized tissue is debrided as needed. The decision to close the wound depends on cleanliness, tissue viability, and contamination. Primary closure with sutures, staples, or adhesive may be appropriate for clean, well-approximated wounds; for contaminated or high-tissue-loss wounds, delayed closure or healing by secondary intention may be preferred. Antibiotics are not routinely required and are reserved for heavily contaminated wounds, bites, punctures, or patients at high risk of infection. Tetanus prophylaxis should be updated if indicated.

Aftercare includes dressing changes, wound monitoring for signs of infection, and gradual return to activity as healing allows. Potential complications include infection, wound dehiscence, poor cosmetic outcome, and injury to underlying nerves or vessels. Prevention focuses on protective measures and safe handling of sharp instruments.