Managing the appearance of a wound

A laceration is a wound anywhere on the body caused by a sharp or dull object.  Depending on the sharpness of the object the edges may be jagged, dirty, or bleeding.  Lacerations most often affect the skin but any tissue may be lacerated, including subcutaneous fat, tendon, nerves, blood vessels, muscle, or bone.

Plastic surgeons form part of the team of primary care physicians, emergency room physicians, and surgeons who repair lacerations.  The main goals are to stop bleeding, prevent infection, preserve function, and restore appearance. 

Dr. Walker is trained in the techniques and suture materials available to minimize scarring and using these can improve the appearance of many scars by simply handling the laceration correctly.

Laceration surgery falls into four categories

  1. Direct closure or stitches are primarily used on wounds that are not very deep.  The ultimate goal is to permanently close the wound and minimize scarring .
  2. Skin grafts are used on wounds that are too wide to be closed directly.  The surgeon removes healthy skin from another area on the patient's body and covers the open wound with it.
  3. Tissue expansion is a technique used in cases where a significant amount of skin has been lost, creating an area too large to be covered with a small amount of skin grafted from the patient's body.  This requires the surgeon to acquire new tissue to cover the area.  This is achieved by inserting a balloon under a healthy area of skin, slowly inflating it with salt water until the skin stretches to the required size.  Eventually the wound can be repaired using the extra skin formed by the expansion process.
  4. Flap surgery involves the removal of living tissue, including its blood supply, from one area of the body and transplanting it to the area that needs it.