Lip laceration

Management

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

1. Intraoral mucosal laceration (isolated)
   • Only need to close if >1cm
   • Use absorbable 5-0 suture
   • Avoid catching underlying muscle during suturing
2. 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
3. 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

• Tintinalli
• Rosens Chapter 42 - Facial Trauma