8. Lip Laceration Scott C. Sherman FIGURE 1. Laceration through the vermillion border of the lip. Save Image Enlarge Image FIGURE 2. This laceration extended through to the oral mucosa. Save Image Enlarge Image Clinical Presentation May be due to blunt or sharp trauma; frequently due to a fist Special attention should be made to determine whether the laceration involves the vermillion border or extends through the skin to the oral mucosa. Diagnosis Diagnosis is based on a thorough physical examination. Radiographs are only necessary if there is concern for a mandible fracture or that a tooth avulsed and entered into the soft tissues. Management Anesthetize the lip using a mental or infraorbital nerve block. This avoids tissue distortion that occurs with local anesthetic into the wound. Irrigate with saline. Start the repair by approximating the vermillion border with a single 6-0 nonabsorbable suture. Next, close the muscle layer using 5-0 absorbable suture. Then, close the mucosal layer with 5-0 absorbable suture. Finally, close the skin with interrupted 6-0 nonabsorbable suture. Prophylactic antibiotics are controversial.

8. Lip Laceration

Scott C. Sherman

FIGURE 1. Laceration through the vermillion border of the lip.

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FIGURE 2. This laceration extended through to the oral mucosa.

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• Enlarge Image

Clinical Presentation

• May be due to blunt or sharp trauma; frequently due to a fist
• Special attention should be made to determine whether the laceration involves the vermillion border or extends through the skin to the oral mucosa.

Diagnosis

• Diagnosis is based on a thorough physical examination.
• Radiographs are only necessary if there is concern for a mandible fracture or that a tooth avulsed and entered into the soft tissues.

Management

• Anesthetize the lip using a mental or infraorbital nerve block. This avoids tissue distortion that occurs with local anesthetic into the wound.
• Irrigate with saline.
• Start the repair by approximating the vermillion border with a single 6-0 nonabsorbable suture. Next, close the muscle layer using 5-0 absorbable suture. Then, close the mucosal layer with 5-0 absorbable suture. Finally, close the skin with interrupted 6-0 nonabsorbable suture.
• Prophylactic antibiotics are controversial.