Laceration

WHAT YOU SHOULD KNOW:

• A laceration (las-e-RAY-shun) is a cut in the skin. A laceration can happen anywhere on the body. It may be large or small. It may hurt, feel numb, look swollen, and may bleed. The edges of the cut may be wide open or close together. Lacerations are usually caused by being struck or by hitting something sharp. You may get a laceration if you fall or are in an accident.
  
  
• Lacerations need to be stitched if they are very deep or are bleeding a lot. Stitches may help to keep the wound from getting infected. A stitched wound usually causes less scarring when healed. If you wait too long to be seen by caregivers and the wound is too old, it may not be stitched. Some lacerations may heal better without stitches. The healing time for a laceration depends on where it is on the body. It may take a laceration longer to heal if it is over a joint, such as your knee or elbow.

AFTER YOU LEAVE:

Medicines:

• Keep a list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.
  
  
• Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Over-the-counter pain medicine: You may use over-the-counter (OTC) pain medicines, such as ibuprofen or acetaminophen, for pain or swelling. These medicines may be bought without a caregiver's order. These medicines are safe for most people to use. However, they can cause serious problems when they are not used correctly. People with certain medical conditions, or using certain other medicines are at a higher risk for problems. Using too much, or using these medicines for longer than the label says can also cause problems. Follow directions on the label carefully. If you have questions, talk to your caregiver.
  
  
• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.
  
  
• If a medicine makes you drowsy: Some medicines may make you drowsy (tired) or less able to think clearly. Avoid driving, signing legal papers, operating heavy equipment or other activities that you must be alert to do. Never drink alcohol while you are taking medicines that make you feel drowsy or less alert.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Home care:

• Rest, ice, and elevation: Avoid using or moving the injured area. If possible, raise the wound up on pillows, above the level of your heart. This helps to decrease pain and swelling. Ice may also help to decrease your pain and swelling. It is best to start using ice right after an injury and up to 24 to 48 hours afterwards. Do not use ice directly on the skin, or for longer than 20 minutes at a time. If ice is not covered or is put on one area for too long, it may cause frostbite.
  
  
• Caring for your wound: Always follow your caregiver's instructions for wound care. Wash your hands with soap and warm water before and after caring for your wound. Your caregiver may want you to keep the wound dry for the first 24 to 48 hours. After that, gently clean the wound once or twice a day with cool water. Use soap to clean around the wound, but try not to get any on the wound edges. Do not use alcohol or hydrogen peroxide to clean your wound unless your caregiver tells you to. Ask your caregiver if you should apply antibiotic ointment to the wound after cleaning it. The following are general tips for wound care.
  
  
  • If the wound is on your hand, lip, mouth, or scalp: If your wound is on your hand, do not do dishes or any activity that causes your hand to soak in water. If the wound is on your scalp, ask your caregiver when you can start washing your hair again. If the wound is on your lip or in your mouth, rinse your mouth after eating or drinking. Ask your caregiver if you should rinse your mouth with germ-killing mouthwash. Eat soft foods that are easy to chew. Avoid foods that may sting, such as orange juice or hot, spicy foods.
    
    
  • If you need to keep a dressing in place: Your caregiver may put a dressing (bandage) over the wound before you leave. You may need to keep the dressing on for 24 to 48 hours, or until your follow-up visit. Ask your caregiver if it is OK to change your dressing if it becomes soaked with blood. If you must leave a blood-soaked dressing in place, add clean bandages on top of it. If your wound bleeds more than your caregiver told you to expect, call your caregiver.
    
    
  • If you need to change your bandage yourself: Your caregiver may want you to change your bandage one or more times a day. If the bandage sticks to your wound, use warm water on the bandage and lift it off slowly. Always lift toward the center of your wound, not away from it. Clean the wound and dry the area with a clean towel or gauze before placing a bandage back over it. Then, keep the area as dry and clean as possible.
    
    
  • Keeping your wound uncovered: Many lacerations can be kept uncovered, or "open to air". This allows the wound to stay dry and heal faster. If your caregiver did not tell you to keep a dressing or bandage on your wound, you may leave it uncovered. Use a bandage or dressing over the wound if it is bleeding or has drainage (fluid coming from it). You should also cover the wound if it is in an area where it may get dirty, or where clothes may rub on it.
    
    
  • If your wound was closed with wound tape: Your caregiver may use wound tape or special adhesive strips to hold your wound closed. Examples include butterfly tape or Steri-Strips™. Keep the area clean and dry. The strips will fall off on their own after several days. Sometimes only half of the strip falls off, and you will need to remove the rest of it. If you have to remove a strip, gently pull the edge towards the center of the wound. If only a small part of the tape strip starts to come off, trim the loose part off with blunt-edge scissors. Take care not to cut your skin with the scissors.
    
    
  • If your wound was closed with a tissue adhesive: Caregivers may use a special tissue adhesive to close your wound. This adhesive is a special kind of "glue" that is made to be safely used on skin. Do not use any ointments or lotions on the area. You may shower, but do not swim or soak in a bathtub. Gently pat-dry the area after showering. Do not pick at or scrub the adhesive area. If the adhesive comes off too soon, call your caregiver. Never use your own adhesive to try and re-glue the wound back together.
    
    
  • If your caregiver wants to wait before closing your wound: Sometimes a wound has to be left open for a few days before it is sutured (sewn) shut by your caregiver. This is called delayed closure. Ask your caregiver for more information about wound care for an open wound, or a wound that is packed with gauze.
    
    
  • If you have sutures (stitches) or staples:
    
    
    • Most wounds may be kept covered with a non-stick, sterile dressing for the first 24 to 48 hours after treatment. After that, you should gently clean the area as described above. Then, keep the area as dry and clean as possible. Your caregiver may want you to apply antibiotic ointment to the sutures or staples. Ask your caregiver if you should re-cover the area with a clean dressing, or leave it open to air.
      
      
    • Ask your caregiver when you should have your sutures or staples removed. They may need to stay in for five days to three weeks or longer, depending on where the wound is. Sutures on your face may need to be removed sooner. A caregiver will need to check your wound before the sutures or staples are removed. Some sutures will be absorbed by your body and do not need to be removed.
  
  
• Decrease your chance of scarring: A scar is the mark that stays on your skin after a wound heals. Using antibiotic or other ointment on your wound may decrease the amount of scarring that you have. Ask your caregiver what ointment to buy, and how often to use it. The skin of your wound area may turn a different color if it is exposed to direct sunlight. After your wound is healed, use sunscreen over the area when you are out in the sun. You should do this for at least six months to one year after your injury. Some wounds scar less if they are covered while they heal. Ask your caregiver if your wound should be covered with a clean bandage, or left open to air.

CONTACT A CAREGIVER IF:

• You have a shaking, chills, fever, or any other signs of infection. Signs of infection may include increasing redness, swelling, or warmth around the wound. Other signs that your wound may be infected include a bad smell, red streaks, or pus coming from the wound. Pus is fluid that is milky (not clear), and may be white, yellow, green, or brown.
  
  
• You have pain in the injured area that does not go away or is getting worse.
  
  
• Your wound does not heal.
  
  
• You have skin tearing around your stitches or staples, or if your wound gapes open.
  
  
• The skin around your wound feels numb.
  
  
• You have numbness or swelling below the wound.
  
  
• You cannot move the joint below the wound.
  
  
• You think you may have problems from your tetanus shot. After a tetanus shot, the shot site may get sore, swollen, red, and warm to touch. This is a normal response to the medicine in the shot. Call your caregiver if these signs last for more than a few days. Call your caregiver if you have severe (very bad) pain in the area where you had your shot.

SEEK CARE IMMEDIATELY IF:

• Your symptoms (redness, pain, fever) get worse very quickly.
  
  
• You have heavy bleeding or bleeding that does not stop after 10 minutes of holding firm, direct pressure over the wound.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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