Dear NP

Dear NP,

How long do I have to get a laceration repaired?

Dear Reader,

Repair of a laceration depends on several factors, which is likely why you get different answers to your question. Let’s start by discussing what a laceration is.

A laceration is a cut or wound caused by tearing the body’s soft tissue. The wound might be irregular or jagged.

Lacerations carry a risk of contamination with bacteria or debris from whatever caused the cut. Lacerations can be deep or shallow, long or short and wide or narrow.

Repair of a laceration can be done in several ways. Minor lacerations that are shallow, small, clean and not actively bleeding might only need to be cleaned and have an antibiotic ointment and bandage applied. These will heal on their own.

Deeper wounds or lacerations with bleeding and jagged edges may require repair with sutures or stitches. But sometimes, a laceration can be repaired using surgical tape, steri-strips, staples, or even medical-grade wound glue (sometimes called liquid stitches).

General medical guidelines for repair times state that clean, uninfected lacerations can be repaired for up to 18 hours after the injury. Still, some healthcare providers will continue to repair a wound for up to 24 hours after an injury and even up to 72 hours if the wound is on the face and at low risk of infection.

The older a laceration is, the higher the risk of infection and the less likely it can be repaired. It’s best to go for an evaluation of a laceration as soon as possible after the injury to ensure it can be repaired, prevent infection and get the best cosmetic outcome from the repair.

Sometimes, your healthcare provider might recommend against laceration repair with sutures. Some lacerations are at high risk for infection, and repairing them with stitches seals in bacteria, causing an increased risk of infection.

Lacerations through already infected skin, deep puncture wounds or wounds with a lot of contamination with dirt or debris that can’t be adequately cleaned out are at high risk for infection.

Bites from animals or humans present situations where the risk of infection must be weighed against the cosmetic outcome. Bites are often not able to be repaired with sutures.

Lacerations that are not repaired will heal over time by secondary intention. These wounds may need antibiotic ointments and dressing changes to allow them to heal.

However, if you get a laceration, there are reasons other than repair to seek the care of a healthcare provider. Cleaning the laceration properly is critical to preventing infection and ensuring the wound heals with minimal scarring.

Deep wounds might need to be irrigated to remove all dirt from them. Often the wound will be soaked in a special antiseptic cleaning solution.

You might need a tetanus vaccine if it’s been more than five years since your last vaccination. For wounds that are highly contaminated or at high risk of infection, your healthcare provider may prescribe an antibiotic for you to take. Bite wounds often need treatment with an antibiotic to prevent infection.

Once your laceration has been repaired, you’ll want to follow your healthcare provider’s instructions for care at home. This might involve using antibiotic ointment and dressings and keeping the laceration clean and dry.

If you needed sutures, they might need to be removed. Some sutures dissolve on their own, but most will need to be taken out once the wound is healed. Your healthcare provider will tell you when to return for the removal of your sutures.

Dr. Wesley Davis is an Emergency Nurse Practitioner at Crook County Medical Services District and Coordinator of the Family and Emergency Nurse Practitioner program at the University of South Alabama. He encourages readers to send their questions to [email protected]