Skin Laceration Wound Type and Description Management Aims Dressings Other Considerations environment for healing Low adherent Pain management Superficial Skin dressing Laceration General aims include: Note: pre-tibial Moderate Exudate: manage characteristics of wound prevent lacerations often result infection Alginate / in haematoma manage exudate Hydrofibre formation. Haematomas acceptable cosmetic outcome Foam can cause tissue High Exudate: necrosis and may need Description: partial or full thickness wound involving loss assessment in Foam of some or all affected tissue. for evacuation of Depending on mechanism of injury, refer to A&E e.g. crush Secure with light haematoma formation injuries need to be observed for signs of compartment retention bandage, syndrome; where an impact causes bleeding within a closed bandage toe to anatomical space causing swelling with subsequent If lower limb laceration compromise of circulation and tissue function, which can knee (if lower leg does not heal within 6 lead to irreversible nerve damage or tissue necrosis within wound) weeks perform leg ulcer hours of injury. Skin Laceration assessment Particularly common in the compartment of lower leg and forearm. Signs include: pain, swelling, numbness, loss of Dressings will peripheral pulse, contracture. Description: breach or split in depend on skin Also refer to A&E if: After care advice: the skin caused by blunt fragility. Indications of bone involvement instrument or force (e.g. result Elevate legs, rest, Superficial Indications of full thickness laceration exposing deeper of fall) steristrip management lacerations to lying structures (keep dry, leave in situ Lower limb looks discoloured and capillary refill is reduced face / scalp Initial aims include: until wound review) Indication of change in sensation to lower limb may be debridement of any foreign material inappropriate loosely align skin edges with Treatment Choice: to apply wound closure strips leaving gaps dressings to allow exudate drainage, Low Exudate: Tissue adhesive Wound closure strips promote healing; provide optimal
Skin Laceration Wound Type and Description Management Aims Dressings Other Considerations Superficial Skin Laceration Skin Laceration Description: breach or split in the skin caused by blunt instrument or force (e.g. result of fall) Initial aims include: debridement of any foreign material loosely align skin edges with wound closure strips leaving gaps to allow exudate drainage, promote healing; provide optimal environment for healing General aims include: manage characteristics of wound prevent infection manage exudate acceptable cosmetic outcome Description: partial or full thickness wound involving loss of some or all affected tissue. Depending on mechanism of injury, refer to A&E e.g. crush injuries need to be observed for signs of compartment syndrome; where an impact causes bleeding within a closed anatomical space causing swelling with subsequent compromise of circulation and tissue function, which can lead to irreversible nerve damage or tissue necrosis within hours of injury. Particularly common in the compartment of lower leg and forearm. Signs include: pain, swelling, numbness, loss of peripheral pulse, contracture. Also refer to A&E if: Indications of bone involvement Indications of full thickness laceration exposing deeper lying structures Lower limb looks discoloured and capillary refill is reduced Indication of change in sensation to lower limb Treatment Choice: Low Exudate: Tissue adhesive Wound closure strips Low adherent dressing Moderate Exudate: Alginate / Hydrofibre Foam High Exudate: Foam Secure with light retention bandage, bandage toe to knee (if lower leg wound) Dressings will depend on skin fragility. Superficial lacerations to face / scalp may be inappropriate to apply dressings Pain management Note: pre-tibial lacerations often result in haematoma formation. Haematomas can cause tissue necrosis and may need assessment in for evacuation of haematoma formation If lower limb laceration does not heal within 6 weeks perform leg ulcer assessment After care advice: Elevate legs, rest, steristrip management (keep dry, leave in situ until wound review)