Abstract
Background
Traumatic lacerations to the skin represent a fairly common reason for seeking emergency
department care. Although the incidence of lacerations has decreased over the past
decades, traumatic cutaneous lacerations remain a common reason for patients to seek
emergency department care.
Objective
Innovations in laceration management have the potential to improve patient experience
with this common presentation.
Discussion
Studies have confirmed that delays in wound closure rarely confer increased rates
of infection, although comorbidities such as diabetes, chronic renal failure, obesity,
human immunodeficiency virus, smoking, and cancer should be considered. Antibiotics
should be reserved for high-risk wounds, such as those with comorbidities, gross contamination,
involvement of deeper structures, stellate wounds, and selected bite wounds. Topical
anesthetics, which are painless to apply, have a role in select populations. In most
studies, absorbable sutures perform similarly to nonabsorbable sutures and do not
require revisit for removal. Novel atraumatic closure devices and expanded use of
tissue adhesives for wounds under tension further erode the primacy of regular sutures
in wound closure. Maintaining a moist wound environment with occlusive dressings is
more important than previously thought. Most topical wound agents are of limited benefit.
Conclusions
Recent innovations in wound closure are allowing emergency physicians to shift toward
painless, atraumatic, and rapid closure of lacerations.
Keywords
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Article info
Publication history
Published online: August 25, 2017
Accepted:
May 30,
2017
Received in revised form:
May 7,
2017
Received:
November 4,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
