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Lacerations Can Be Nasty!

A laceration is defined as a jagged tear in the skin.  This occurs by catching the skin on a sharp object and ripping or tearing the skin.  Often there is pain and bleeding associated with this injury.  If this occurs on the top of the foot, there should be concern for injury to nerves, arteries and tendons as there is very little protective padding below the skin in this area.  If a laceration occurs on the bottom of the foot, vital structures are normally not damaged because of the extensive protective padding in this area.  Most often, a laceration is deep enough that stitches are needed to close the wound. 

If a laceration occurs it should be treated immediately.  First, control the bleeding by applying pressure.  Use a kitchen towel, a shirt, a sock or anything that soaks up moisture and apply firm pressure to the area.  Hold pressure at least 5-10 minutes without letting go.  This allows the small blood vessels to clot and stop bleeding.  If you are on a blood thinner, expect more bleeding and hold pressure until you reach the emergency department. 

Once the bleeding has reduced or stopped, then cleanse the wound thoroughly with soap and water.  This will help flush the wound and get rid of any foreign material that may have been introduced when the skin was punctured.  Things like dirt, rust, mold, broken glass or wood are all things if left in a wound can cause infection. 

Next apply an antibiotic ointment and cover with a dry gauze wrap.  Your best bet is to get to the emergence department as soon as possible for professional care.  There may be times when a simple cut in the skin could actually be much worse.  You will also need a tetanus shot if you have not had one in the last 10 years and antibiotics.  Depending you where you injured yourself, you may need to take multiple antibiotics.  For example, a laceration from a clean kitchen knife will normally only need one basic antibiotic.  But a cut from a rusty nail at the horse pens or a glass bottle at the lake require antibiotics that cover more than just one bacteria. 

Normally, the injury is healed in 10-14 days and stitches may be removed at this time.  You should be protecting the injury during the time with an appropriate bandage and if the laceration is on the foot or ankle, a protective boot may worn as well. 

If the laceration is extensive and major tendons and nerves are cut, or if the injury becomes severely infected, then surgery in the operating room is necessary to clean out all the infected tissue and repair any damaged structures that can be fixed.