Lip laceration

Management

• Consider Nerve Block: Infraorbital for upper lip, Nerve Block: Mental for lower lip
• Antibiotics not required

Intraoral mucosal laceration (isolated)

• Only need to close if >1cm
• Use absorbable 5-0 suture
• Avoid catching underlying muscle during suturing

Through-and-through laceration

• Close in layers:
  1. Close mucosal layer w/ absorbable 5-0 suture
  2. Irrigate from outside
  3. Close orbicularis oris muscle w/ 4-0 or 5-0 absorbable suture
  4. Close skin w/ 6-0 nonabsorbable suture

Vermilion border laceration

• Place 1st stitch w/ 6-0 nonabsorbable suture to align edges of vermilion border
• Then repair rest of lip in usual manner

Special Considerations

• Vermillion border and philtrum architecture must be maintained for cosmesis
• Infiltration of local anesthetic can distort soft tissue
  • Consider marking vermillion border prior to infiltration of anesthetic to facilitate repair

References

• Rosens Chapter 42 - Facial Trauma