Lacerations in Portland, OR

A cut is a skin wound with a separation of connective tissue. None of the skin is missing, but it is separated. A laceration implies a torn or jagged wound that is usually deeper or wider and often needs stitches.

If you have any doubts at all, it’s always a good idea to play it safe, and seek medical attention for your laceration, especially if you cannot stop the bleeding, the wound edges are separated, or you cannot clean the wound adequately enough for it to heal properly. Plus, with any laceration, there is always the risk of infection, because sharp objects that usually cause them may be contaminated with bacteria or debris. If that is the case, your doctor will give you a tetanus vaccination or booster shot along with treatment.

Also, patients who have circulation problems or diabetics should always seek medical attention for open wounds, as they may require additional treatment to prevent infection.

You should see an orthopedic specialist for lacerations, because some lacerations may involve tendon and nerve damage. Sometimes these lacerations aren’t always immediately noticeable and can take days or weeks for such nerve or tendon damage to show up. Orthopedic specialists would be more apt to catch these and provide the immediate care you need.

Orthopedic specialists can also treat hand injuries that involve fingertip and nail bed lacerations. If these aren’t treated properly, these injuries can lead to hand function problems, permanent deformities, or even disability, as these are sensitive areas where bone and nerves are affected when exposed.

Come see us for quick-care orthopedic injury treatment for cost-effective care at medical office rates, not hospital rates. Don’t let lacerations become complications.

There are four basic considerations as to whether or not you may need stitches:

• Depth. Is the wound deep enough to see the subcutaneous tissue (yellowish fatty tissue)?
• Width. Can the wound be pulled closed easily?
• Location. Is the wound in a location of the body that stretches and moves a lot (e.g., a wound on a calf)?
• Tetanus vaccination. How long has it been since you had your last tetanus vaccination? It is recommended that you have one every 10 years. If you need one, especially after having a laceration, go see a doctor and have your wound evaluated for stitches.

Getting a laceration stitched is a good idea for several reasons:

• Stops bleeding
• Promotes quicker healing
• Keeps bacteria out of the wound
• Prevents infection
• Protects underlying tissue
• Reduces scarring

During your visit, your doctor will ask you several questions about your injury including

• When did it happen?
• How did it happen?
• Do you have any problems with weakness or numbness?
• Do you have any allergies to adhesive tapes?
• Do you have any pre-existing medical conditions, such as circulation problems or diabetes?

Your physical exam will include

• Separating the edges and looking at the wound
• Testing nerve, artery, and muscle function
• Checking for objects in the cut (such as embedded glass or wood)
• Examining your overall condition (such as whether you are pale from blood loss or anxiety)

If foreign objects or an underlying broken bone is suspected, an X-ray may be ordered.

Treatment for a laceration usually depends on how deep the cut is, but generally, the treatment process includes:

• Taking steps to stop the bleeding with direct pressure or the use of a blood pressure cuff
• Applying Medication to numb the area
  • Topical medicine
  • Direct injection of anesthetic into the wound
  • Injection into a regional nerve (nerve block)
• Cleaning the wound
  • Washing the skin with soap and water
  • Removing crusted blood with diluted hydrogen peroxide
  • Irrigating with saline at the wound site under high pressure to reduce bacterial contamination
• Repairing the wound
  • Minor cuts can be closed with special adhesive tapes (Steri-Strips) or tissue glue
  • Deeper cuts may need stitches to repair deep structures
• Applying bandages
  • Telfa or Vaseline gauze that doesn’t stick to your cut
  • Pressure bandages or splints that provide needed surface pressure or keeps an injury immobile

If you have sutures placed, your doctor may recommend that you have the wound checked 1 or 2 days after treatment, especially if there is a higher than 5 percent chance of infection or if changing the bandage is difficult.

Stitches may be removed at your doctor’s office anywhere between 4 and 14 days later. The actual time period depends on the location of the injury. For example, facial stitches are removed after 4 days and no later than 7 days, because healing occurs faster in this location of the body. Sutures in your hand may be left in 14 days or more because of slower healing and greater tension on the wound.

It is normal for a scar to look red and swollen after suture removal, and it can take up to 1 year for a scar to fade. In the meantime, there are several things you can do to minimize the possibility of scarring:

Infected wounds tend to scar more, so

• Keep an eye out for redness, swelling or other signs of infection and see a doctor
• Keep the wound covered and clean
• Avoid sun exposure as newly healed tissue burns more easily

Before consulting a specialist for scar revision, wait a year for the scar to fade.