- by Dr. Santosh. K
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- Aug 19 2017
What is Lip Laceration or Tearing?
A laceration is a wound that takes place when tissue, skin and/or muscle is cut open or torn. Lacerations may be shallow or deep, short or long or, and narrow or wide. Most lacerations are the outcome of the skin slamming an object, or an object striking the skin with force. Laceration repair is the work of cleaning, arranging and sealing the wound.
Small lacerations that are small, shallow, not bleeding, and clean may not need medical regard. Antibiotic cream and a bandage may be all that is required. However, most lacerations do require restoration.
The lips are a highly noticeable facial anatomy used in speech expression, consumption of food and sensation of touch. Because of their important location on the face, tearing of the lips can be cosmetically impairing.
Lip lacerations are usually seen in emergency departments and are one of the most common oral-maxillofacial wounds. Careful reconstruction is necessary to minimize infection while ensuring the best cosmetic results and patient satisfaction. The essential in repair relies largely on place and type of injury.
Signs for intraoral closure are as follows:
Mucosal laceration that causes a flap that hampers chewing
Mucosal laceration that is big enough to confine food particles
Lesions longer than 2 cm
Certain lesions, such as the following, are best closed in discussion with a plastic surgeon:
Large openings that overhang
Large amounts of the vermilion border absent
Involvement of the commissure
Loss of more than twenty five percent of the lip
Lips are well supplied and very sensitive to pain. They can be strenuous to anesthetize locally. In addition, local penetration of anesthesia into external lip lesions often causes swelling and deformation of original landmarks.
Executing regional nerve blocks when possible can lead to ideal anesthetic and cosmetic outcome.
Pre-anesthetizing the mucosal region with a topical anesthetic three minutes before to penetration of injection is advised.
For intraoral lesions, nerve blocks may not always be as successful. In these instances, consider further local anesthesia.
In small or uncooperative kids, procedural sedation is highly advised because of the significance of a motionless field.
Once the patient is anesthetized, the wound is carefully examined.
Gentle probing may be needed to see through-and-through the wounds.
Check for co-existing cracked, missing, or moving teeth. Tooth particles may be present inside the wound and may serve as a nest of infection if not removed.
Intraoral wounds are susceptible to considerable contamination; therefore, detailed irrigation is essential.
Through-and-through lip lesions are closed in successive layers.
Make sure that tetanus status is recent.
Antibiotic cream, lotion or petroleum jelly may be applied daily over the surface of the skin of the wound. This should be circumvented with absorbable sutures, however, as it may improperly shoot absorption.
Nonsteroidal anti-inflammatory drugs or cold packs may aid with pain management.
If the wound involves the oral mucosa, consider recommending a bland diet to avoid irritating the wound.
For intraoral lesions, especially if not closed, dismissing the patient with a saline and syringe is considered. It may be helpful for them to gently irrigate the lesions after eating to keep them clean of remains.
The non-absorbable sutures are removed that are noticeable on the external tissue in four-five days to avoid scarring.
The patients should be advised not to allow themselves to distort the sutures with their tongue.
The use of prophylactic antibiotics in lip lacerations is disputable but advised in certain situations. Medications used for protection vary depending on clinician priority and vary from oral cephalexin to chlorhexidine rinse.
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