Lip laceration: Difference between revisions
| Line 20: | Line 20: | ||
===Through-and-through laceration=== | ===Through-and-through laceration=== | ||
Close in layers: | |||
#Close mucosal layer w/ absorbable 5-0 suture | |||
#Irrigate from outside | |||
#Close orbicularis oris muscle w/ 4-0 or 5-0 absorbable suture | |||
#Close skin w/ 6-0 nonabsorbable suture | |||
===Vermilion border laceration=== | ===Vermilion border laceration=== | ||
Revision as of 21:27, 19 June 2015
Background
Clinical Features
Differential Diagnosis
Diagnosis
Management
- Consider Nerve Block: Infraorbital for upper lip, Nerve Block: Mental for lower lip
- Antibiotics not required
- 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
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:
- Close mucosal layer w/ absorbable 5-0 suture
- Irrigate from outside
- Close orbicularis oris muscle w/ 4-0 or 5-0 absorbable suture
- 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
Disposition
See Also
External Links
References
- Rosens Chapter 42 - Facial Trauma