Laceration

A laceration is a soft tissue injury that results from blunt force that exceeds the limit of elasticity of the skin and underlying structures. Characteristic features of such a wound are uneven, jagged edges and significant damage (crushing) of the surrounding tissues.

Unlike wounds caused by a sharp object (e.g., cuts), lacerations have a complex shape. They often retain “bridges” of less damaged connective tissue in their depths. Such wounds are usually heavily contaminated and have a high risk of infection and rough scar formation.

Etiology and pathophysiology

Lacerations are caused by falls, blunt force trauma or being struck by moving machinery. The mechanism of injury is not cutting, but tearing and crushing of tissue.

Pathophysiologically, the edges and bottom of a laceration have an extensive zone of injury with compromised blood supply and crushed, nonviable tissue. This creates favorable conditions for the development of microorganisms and slows down the healing process. Bleeding from such wounds is often less intense than from incised wounds due to compression and thrombosis of vessels.

Clinical significance

The main principle of laceration treatment is primary surgical management (PSM). It is mandatory and should be carried out as early as possible. PCI involves wound cleansing, revision, and most importantly, excision of all non-viable, crushed tissue.

After excision of the edges, the laceration actually turns into a cut wound, which creates conditions for its healing by primary tension after suturing. Tetanus prophylaxis is mandatory for all patients with lacerations.

Differential diagnostic aspects

A laceration must be distinguished from a cut wound. A cut wound is characterized by smooth, even edges, minimal damage to surrounding tissues, and usually more profuse bleeding. Incised wounds heal much better and with the formation of a less noticeable scar.