Mouth Wounds and Treatments in Adults and Children (cont.)
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Mouth Wound Treatment
Initially, the person should be checked for associated injuries such as problems breathing or swallowing, facial fractures, loose or missing teeth, and/or more serious tissue loss. Patients should receive a tetanus vaccine if their tetanus shot is not up-to-date. Serious facial wounds should be treated at a trauma center by a surgeon.
Very often, treatments include observation for many wounds (usually under about 1 cm in length and less than about ¾ cm in-depth) and do not involve the vermilion border (the cosmetic line that marks the border of the lips on the face). However, lacerations that bleed for more than 15 minutes after holding pressure may require stitches. Tissue flaps, cuts through the vermilion border, and deep lacerations that involve the musculature usually require stitches as do those lacerations that penetrate all away through the skin, and those with jagged, irregular edges and deeper than about 3/4 centimeter in depth. In addition, the skin at the right and left corners of the mouth may have a tendency to bleed freely and also may require a stitch to prevent bleeding and further damage.
Mouth Wounds and Stitches in Adults and Children
Wounds that require stitching can be numbed (anesthetized) with lidocaine/epinephrine and then cleaned with saline solution. The doctor will choose from different types of stitches (absorbable or non-absorbable) to repair a mouth wound. Deep wounds involving musculature should have the musculature sutured first with absorbable sutures and then the overlying mucosal surface sutured with absorbable sutures. All mouth wounds that penetrate all the way through to the skin should be sutured with absorbable sutures. Patients with deep lacerations and/or patients with sutured wounds may be given penicillin or erythromycin to prevent deep tissue infections.
Children may become uncooperative when mouth wounds need to be sutured. Consequently, for many children and a few adults, conscious sedation may be required. In addition, traction may need to be placed on certain areas (for example, the tongue) and many individuals may find this to be very uncomfortable without conscious sedation.
If there are any major concerns about appearances or functionality (for example, scars, tongue movement), immediate consultation with a maxillofacial or plastic surgeon may be offered to the patient. All patients should be informed that lacerations, sutured or unsutured, may have some scar formation as they heal.
Medically Reviewed by a Doctor on 4/8/2016
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