Lacerations

🧭 When to suspect

A laceration is a break in the skin caused by trauma. The clinical task in primary care is rarely the cut itself but what lies beneath and around it: the mechanism of injury predicts the risk of contamination, a retained foreign body, and injury to nerves, tendons, vessels or joints, and it dictates whether the wound can be closed at all.

Three questions frame every assessment: is there a deep-structure or vascular injury needing emergency care; is the wound clean and recent enough to close; and is tetanus (and, for bites, infection) prophylaxis required. A deceptively small wound – a puncture, a knuckle wound after a punch, or a cat bite – can carry far more risk than its appearance suggests.

Suspect a complicated laceration whenever the injury is high-energy, the wound is over a joint or the hand, the patient cannot fully move or feel the part distal to it, or the history does not fit the injury.

Source: NICE