A laceration is a cut or tear through the skin caused by a sharp object or blunt force. Good care means stopping the bleeding, looking for deeper injury, cleaning well and closing the wound in a way that lowers the risk of infection and scarring.
Key symptoms
- Bleeding and pain at the cut
- Numbness or weakness beyond the wound
- Trouble moving a finger or joint near the cut
- How it happened: glass, metal, bite, crush or a dirty object
What you find on exam
- Length, depth, edges and contamination of the wound
- Sensation, pulses and capillary refill beyond the wound
- Tendon function against resistance and through full range
- Explore the wound with good light and anesthesia for foreign bodies
- Check tetanus vaccine status
Tests
- X-ray for glass, metal or a possible fracture
- Ultrasound for wood or other objects not seen on X-ray
- Specialist review for tendon, nerve or joint injury
Treatment basics
- Direct pressure to stop the bleeding
- Local anesthesia with lidocaine, then irrigation with plenty of tap water or saline
- Close with sutures, staples, skin glue or strips based on site and tension
- Tetanus booster (Tdap or Td) if not up to date
- Antibiotics for bites, very dirty wounds or open fractures; plan suture removal
Red flags
- Bleeding that will not stop, or a pulsing or growing swelling
- Numbness, weakness or loss of tendon function
- Bite wounds, joint involvement or signs of infection
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Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.