Lacerations

Once you have a break in your skin, you will have a scar. There’s not really any way around that. People come to the ER expecting that we will be able to keep them from having a scar, but that’s not the case. Even the most controlled scars, like those from a surgical procedure, will leave you with a scar. Why would getting hit with a baseball bat in the head, causing a big, complex, star-shaped laceration with smashed edges and macerated tissue not result in a scar? It just doesn’t make sense.

Closing lacerations with glue, staples, or sutures brings the edges of the tissue together. The body actually does the healing and the scar remodeling. If you are otherwise healthy, a simple laceration will usually not look much different at the end of the day when it’s completely healed, whether you had it sutured or left it alone. Lacerations will heal by secondary intention, meaning the edges of the wound eventually grow together. This is not true for lacerations that are gaping open, over a joint, or in places where the tissue naturally pulls apart. But for the most part, simple lacerations that aren’t gaping open, even if on the face, will probably heal just fine.

Just because I suture up a laceration doesn’t mean that the healing is done or that the problem is solved. I can’t make time move forward. And time is what wounds need to heal.