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Facial lacerations

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Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!

How do you manage simple pediatric facial lacs (eg of forehead)?

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Wound Management

pemsou5_wp • September 27, 2019

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  1. Kelly October 1, 2019 - 1:21 am Reply

    The use of absorbable sutures for facial lacerations is discussed very well here
    As for suture removal, a review of several sources revealed the following recommendations: Roberts & Hedges 5th day (or remove alternate sutures on the 3rd day and the remainder on the 5th day), AliEM 3-5 days, Uptodate 5 days, one Medscape article 5-7 days, Emedicine health 3-5 days. Roberts & Hedges says, “If sutures are removed within 7 days, generally no discernible needle puncture or stitch marks will persist. 87However, at 6 days the wound is held together by a small amount of fibrin and cells, and has minimal strength.” Sutures on the face are removed by 7 days to minimize stitch marks, but we must warn the patient/family that the wound does not have full tensile strength and to avoid re-injury. Consideration can be given to placing steri-strips or dermabond after suture removal.

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