The care of facial lacerations

The final cosmetic and functional result of closure of a facial wound is many times determined by the promptness and appropriateness of initial care. This includes keeping the wound clean and not adding to the injury. A decision must then be made at the level of primary care to carry out the closure or refer the patient to someone with more expertise. This decision depends on many things including the condition of the wound, the type of wound, and the experience of the primary physician. It is important in the care of the wound that it be properly cleaned and debrided. Fine suture and accurate approximation of the wound edges are also extremely important. Careful follow-up of the wound for potential infection, suture reaction, etc, with removal of sutures as soon as possible, greatly enhances the healing of the wound. These points are discussed in detail with guidelines for making the decisions and providing good wound closure.