Laceration

GENERAL DESCRIPTION

Lacerations occur when the skin is cut or torn open and apart.  Depending on what caused the laceration the result can be a wound that has clean edges and is well defined and only superficial in nature, or the wound can have jagged edges and be dirty and be affecting several layers of the skin and into the muscle tissues.

SOURCE & CAUSE(S)

TYPES OF LACERATIONS

Simple and Clean – these lacerations are most commonly caused when the skin is cut or broken open in a fashion that leave the wound with nice straight clean edges.  There are numerous ways this can occur, but in most cases a sharp object is involved.  In some cases the laceration can involve just the first few layers of skin, or the laceration can be more severe and involve the skin layers and some muscle layers.

Complex and Dirty – These lacerations are caused when the layers of the skin are torn open in a fashion the leaves the wound with jagged and/or uneven edges.  Sometimes pieces of the skin are torn off altogether.  The area involved in this type of laceration is usually left dirty with fur and debris which are precursors to causing an infection.

SIGNS & SYMPTOMS

• Area of skin is broken or cut open and bleeding
  
  
• Area of cut can appear clean well defined or jagged and dirty
  
  
• Obvious pain around wounded area
  
  
• Bleeding at site of laceration

DIAGNOSIS & TESTS

Diagnosis begins with a complete history and a physical exam.  Your veterinarian will be able to diagnose most wounds by sight on a physical exam. If the laceration is severe, your veterinarian may wish to perform the following:

• Radiographs (X-rays) - your veterinarian may want to rule out any internal    bleeding or fractures that may have occurred during the injury process.  They will also want to evaluate the depth of the wound, and rule out the possibility of foreign objects left in the wound.
  
  
• Ultrasound- Again this is a diagnostic tool used to rule out any internal injuries as a result of the injury process.

TREATMENT & MANAGEMENT

The first two objectives in wound treatment are:

• Stopping the bleeding
  
  
• Preventing infection
  
  
  

There are a few guidelines that are generally followed in wound treatment:

1. Preparation of the skin for wound treatment
2. Cleaning and debridement of the wound
3. Irrigation of the wound if needed before closure or bandage
4. Wound Closure
5. Bandaging
   
   

*These steps are taken after the patient has been stabilized if shock has set in, or after the patient has been sedated to provide pain management during the treatment process.

Your veterinarian or veterinarian technician will most likely do the following

Simple Clean Lacerations

1. Most lacerations will be treated under some degree of sedation.  If the laceration is simple and clean, then the area is clipped and cleaned surgically for closure. 
   
   
2. The laceration will most likely be closed using surgical glue, sutures or staples. 
   
   
3. Oral antibiotics and oral pain medication will most likely be prescribed to assist in the healing process.
   
   

Complex Dirty Lacerations

1. These wounds will require general anesthesia and surgery to repair. 
   
   
2. Under sedation and after the area is surgically prepared the edges of the laceration will be trimmed and any dead tissue will be removed. 
   
   
3. The wound will be irrigated with antimicrobial solution and the veterinarian will determine whether to close the wound for healing or leave it open for healing. 
   
   
4. Not all lacerations can be sutured or stapled.   Some will have to heal from the inside out.  Wounds that are left open during the healing process generally require repeated bandaging or a drain is put in place to allow a pathway for infection to drain out of the tissues. 
   
   
5. Management of bandage changes and drains can be done at home if the owner is trained properly, or they can be managed at the hospital on repeat visits to the technician in charge of your case. 
   
   
6. Oral antibiotics and oral pain medication will most likely be prescribed to assist in the healing process.
   

PREVENTION & HELPFUL TIPS

First-Aid Tips:

Wounds are painful, be CAUTIOUS when treating your pet with a wound.  It is advisable to use a muzzle and get someone to help restrain your pet so you don’t get bit!

Remember, the first two objectives in wound treatment are:

• Stop the bleeding
  
  
  1. Apply pressure directly to the wound.  Use something that is absorbent and clean. Gauze pads, wash cloths, towels, sanitary napkins work great.
     
     
  2. Apply pressure for 5-10 minutes then secure in place with an ace bandage or a sock will hold for a short amount of time.
     
     
  3. Check the area around the bandage for swelling, if swelling appears, you need to loosen the bandage or remove it all together.
     
     
  4. Transport your pet to the closest animal hospital for treatment.
     
     

• Preventing infection
  
  
1. Removing the dead tissue and foreign material in and around the wound is known as debriding. This reduces bacterial contamination. This should be done by your veterinarian.
   
   
2. Irrigation with a constant stream of water will help wash away contaminants. This is usually done by your veterinarian.
   
   
3. Deep wounds where the risk of infection is high may be left open to drain. Others may be closed using stitches, staples, or surgical glue.
   
   
4. Keeping your pet from scratching or excessively licking the wound will help prevent infection.
   
   
5. Your veterinarian may put your pet on preventative antibiotics before the signs of infection show.
   

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