Assessment and management of intra-oral lacerations
- Judd E Hollander, MD
Judd E Hollander, MD
- Professor and Vice Chair Department of Emergency Medicine
- Thomas Jefferson University
- Lauren N Weinberger Conlon, MD
Lauren N Weinberger Conlon, MD
- Assistant Professor Department of Emergency Medicine
- University of Pennsylvania
- Section Editors
- Anne M Stack, MD
Anne M Stack, MD
- Section Editor — Pediatric Procedures
- Associate Professor, Department of Pediatrics
- Harvard Medical School
- Allan B Wolfson, MD
Allan B Wolfson, MD
- Section Editor — Adult Procedures
- Professor of Emergency Medicine
- University of Pittsburgh
Intra-oral lacerations represent a small percentage of lacerations, but the repair of them has some important differences relative to lacerations of the skin. Once serious airway compromise is excluded, careful assessment of concurrent oral injuries is necessary. Oral lacerations commonly occur from the impact of teeth on oral mucosa secondary to motor vehicle accidents, contact sports, industrial accidents, and personal violence; fortunately, lacerations that do not gape open often heal well without intervention. Larger, gaping oral lacerations benefit from wound closure to reduce infection and bleeding complications. Most lacerations can be repaired by the emergency clinician; however, there are rare circumstances where specialist referral may be necessary.
Minor wound management, methods of suture placement, repair of adjacent anatomic sites, and evaluation of dental or oropharyngeal trauma are discussed in detail separately:
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- Physical examination
- Ancillary studies
- INDICATIONS FOR SUBSPECIALTY CONSULTATION OR REFERRAL
- WOUND REPAIR
- Indications for primary closure
- Contraindications and precautions
- Anesthesia and analgesia
- - Local or regional anesthesia
- - Procedural sedation
- Wound preparation
- - Suture selection
- OTHER CONSIDERATIONS
- Tetanus prophylaxis
- Prophylactic antibiotics
- Bite wounds
- SUMMARY AND RECOMMENDATIONS