A facial laceration involves having a cut or tear in the skin caused by being struck by a blunt or penetrating object, a serious fall, an altercation with another person, a motor vehicle accident or a sporting event. Facial lacerations are particularly important in that they can involve nerves and blood vessels that can endanger the integrity of the skin and soft tissue.
What are Facial Lacerations?
Facial lacerations can involve minor cuts to the skin only that are linear in nature. These are easily repaired with Steri-strips, which are small strips of cloth tape and string that seal the wound for about 4 days, at which time they can be removed.
Facial lacerations can also be jagged in nature and require complex plastic surgery repair to close the wound. A particularly difficult laceration is the burst-type of laceration that involves being struck by a blunt or marginally sharp object. The laceration goes off in all directions from a central point. This can also require a complex repair.
Common places for a laceration in children are the forehead, lip and chin. These usually heal within a few days. Adult lacerations can be anywhere and can include areas around the eye, the cheeks and the chin. Lacerations in adults and children can involve just the skin or can involve the deeper fatty tissue, tendons, muscles, nerves and blood vessels. On average, facial lacerations tend to bleed more than lacerations in other body areas.
Of particular note in facial lacerations is the need for a repair that gives the best possible outcome. People need to have a repair that hides, to the best possibility, the scar. This is why many facial lacerations should be repaired by a board certified plastic surgeon who can make the scar as hidden as possible after it heals. In some cases, this requires more than one restorative surgical procedure.
Types of Facial Lacerations
Lacerations to the face can be simple or complex. Simple lacerations usually are linear and involve just the skin and perhaps a small amount of soft tissue. These can be treated with Steri-strips or primary suturing. There is rarely an infection or need for complicated repair because the blood supply to the face is so good that the wound heals easily.
There can be V-shaped flap lacerations of the face that involve skin and soft tissue lifting up in a V-shape. These are generally repaired primarily after cleaning out the underside of the flap. Unfortunately, there is a greater chance of scarring with these types of lacerations because scar tissue builds up beneath the V, leaving a built up scar.
The laceration can be jagged, being of no particular shape. Because the facial tissue has a lot of laxity, the surgeon can cut out the jagged portion, leaving a linear laceration and a defect. The defect is easily closed with absorbable or Ethilon sutures.
The laceration can have a defect, with a portion of the skin missing. This can leave behind jagged or smooth edges. Because the skin stretches nicely, the wound edges can be cleaned up and it can be treated primarily with good results.
A burst laceration is not uncommon and is difficult to manage. It happens when something relatively pointy but still dull bursts the skin open, leaving multiple small lacerations spreading out in all directions from the center point of the wound. These often need creative stitching by a maxillofacial surgeon in order to leave the person without an unsightly scar.
Complex lacerations involve muscle, tendon, ligaments, nerves and blood vessels. These must be religiously cleaned out and repaired with absorbable and non-absorbable sutures. Special attention must be made to damage to facial nerves.
Several major nerves run superficially in the face and must be approximated in the hope that the nerve regenerates itself.
What causes Facial Lacerations?
There are many causes of facial lacerations. Children are at a special risk for facial lacerations from falls and from running into things. Fortunately, most of their lacerations are minor and easy to manage.
Other causes of facial lacerations are sports injuries, such as being struck by a bat, a hockey puck or another player. Motor vehicle accidents can easily yield facial lacerations. Occupational injuries can cause these types of lacerations and people involved in altercations can get lacerations from being punched. Falls from even short objects onto the face can result in a fracture.
All lacerations should be considered contaminated and washed thoroughly with copious amounts of water and antiseptic soap, removing all obvious debris, before repairing the wound using ordinary suturing or complicated plastic surgery technique.
Symptoms of Facial Lacerations
Because there are a lot of nerves in the face, facial lacerations tend to be more painful than lacerations in other parts of the body. A clean cut tends not to swell; however, a cut that is associated with blunt trauma or heavy bleeding can swell and be bruised. If no nerve is involved, there will be little to no numbness of the face. If the trigeminal nerve is involved or another large nerve, there can be numbness in the area of distribution of the nerve.If you or a loved one has suffered a facial laceration as a result of someone else's negligence and would like to discuss your legal options with an experienced Sacramento Personal Injury Attorney, contact us online or call us at 916-921-6400 or toll-free at 800-404-5400 to set up a FREE consultation