Lacerations

🧭 When to suspect

A laceration is a break in the skin caused by trauma. The concern 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.

• The mechanism also 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?

• 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