Abstract

Millions of traumatic lacerations are treated in the United States each year. The ED is the most common arena for care of these wounds, due both to its convenience and the expertise of emergency physicians. This review covers the historical and physical exam features in evaluating a laceration and determining the most prudent course of treatment. A comprehensive approach to laceration management will be discussed. Other topics, including methods for anesthetizing and cleansing wounds and wound closure techniques, are also reviewed.

Definitions

• Primary closure is the closure of a wound at the time of ED presentation.
• Delayed primary closure is the closure of a wound 3-4 days after wounding.
• Healing by secondary intention is allowing a wound to heal at its natural rate, through scarring, and without attempted primary closure.