Suturing laceration
열상 봉합수술
A wound in which part of the tissue is torn is called a laceration.
Laceration can also occur in the skin layer, skin layer and subcutaneous tissue, mucous membrane layer, uterus, vagina, liver, etc.
Here, we will mainly focus on the treatment of laceration sutures in the skin or subcutaneous tissue.
If a laceration occurs in the skin layer and/or subcutaneous tissue, depending on the size and depth of the laceration and the part of the body where the laceration occurred, the laceration should be sutured with a suture (surgical thread) or treated with Delmabond, etc.
Either observation is performed without treatment, or treatment with a disposable band-aid is provided.
In general, it is better to seek medical attention from a surgeon for incisions around the face, lips, hands, external genitalia, mouth, and eyes.
Ideally, the amount of blood flow is relatively small, and it is ideal to undergo suture surgery within at least 6 hours after the wound is inflicted for unclean lacerations infected with bacteria.
Lacerations on relatively clean body parts, less likely to have bacterial infections, and less likely to cause cosmetic problems, can be treated with suture surgery up to 24 hours after the injury.
In general, lacerations caused by human or animal bites may not be treated immediately with suturing.
If the bite laceration is on the face, seek suture surgery if possible.
After 24 to 72 hours of laceration, the laceration wound can be easily infected with bacteria, and the laceration may fester, and if it festered, the wound may be
painful, swollen, and red, and there is a warm touch when touched with the hand.
Even though the laceration does not fester and heals normally about 1-2 days after the laceration, it may be red, slightly swollen, and painful for 2~3mm from the edge of the laceration wound.
After the laceration is sutured with a suture, the number of days that the suture can be extracted differs depending on the body part, the function of the body part, and the degree of laceration.
The longer the stitches (sutures) are left for suture surgery, the more pronounced the scars may develop and the more susceptible to infection.
On the contrary, if the seams are removed too early, the edges of the skin split by lacerations may not stick together well.
The skin edge of the laceration wound that was treated with suture surgery may burst if you apply too much force to the laceration wound, where the stitches were pulled out after the stitches used in the laceration surgery treatment were pulled out.
Even if the laceration is well sutured, some scars may develop after surgical treatment.
However, when lacerations are not treated with sutures, they can become more susceptible to bacterial infection, festering, and more severe bleeding, leading to further scarring. If the laceration is festering, swollen, or very painful, treat it with topical antibiotic ointments or oral antibiotics as directed by your doctor.
Sometimes, prophylactic treatment is given to prevent wound infection with topical antibiotic ointments or oral antibiotics, administered concurrently with suture surgery.
You should be vaccinated against tetanus with a tetanus vaccine as needed. At the doctor’s discretion, lacerations may be treated with a suture band rather than suture repair.
Table 19. The part of the body where the laceration occurred, the size and type of the suture, and the appropriate number of days to remove the stitch after the laceration treatment. The size of the suture on the laceration body part (usually used for superficial laceration)
표 19. 열상이 생긴 신체 부위, 봉합사의 크기와 종류, 열상 봉합술 치료 후 실밥을 뺄 수 있는 적절한 일 수.
열상 신체 부위 |
봉합사의 크기(표재 열상 봉합술에 주로 씀)the size and type of the suture, |
흡수성 봉합사(깊은 절상을 봉합술 치료를 할 때 주로 씀Absorbable suture (usually used for suture treatment with deep cuts) |
절상 봉합술 치료를 한 후 봉합사를 뺄 수 있는 일 수The number of days the suture can be removed after treatment with laceration repair |
두피Scalp |
5~0 또는 4~0 |
4~0 |
5~7일 |
얼굴 Face |
6~0 |
5~0 |
3~5일 |
안검Eyelid |
6~0 또는 6~0 |
– |
3~5일 |
눈썹(미)Eyebrows (US) |
7~0 또는 5~0ㅍ |
5~0 |
3~5일 |
몸통Torso |
5~0 또는 4~0 |
3~0 |
5~7일 |
사지 Limbs |
5~0 또는 4~0 |
4~0 |
7일 |
관절 표면Joint surface |
4~0 |
– |
10~14일 |
손Hands |
5~0 |
5~0 |
7일 |
발바닥Sole 4 |
4~0 또는 3~0 |
4~0 |
7~10일 |
출처 및 참조문헌
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The Johns Hopkins Hospital, The Harriet Lane Handbook, 18th edition, p.96 and 19th ed
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Quick Reference to Pediatric Emergencies, Delmer J. Pascoe, M.D.
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Emergency Pediatrics, A guide to ambulatory care, 5th ed. Roger M. Barkin, Peter Rosen
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Emergency care and transportation of the sick and injured, American Academy of orthopedic surgeons.
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Nelson textbook, 15th~19th-21st edition
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Red book, 27th~29th-31st ed