Dr. Stefan Szczerba, plastic surgeon at Advocate Sherman Hospital in Elgin, Ill. “Most standard lacerations can be managed without a plastic surgeon. Follow up the next day can be offered if there is concern about the outcome from a laceration managed by the ER. Alternatively, if you insist a plastic surgeon treat your injury, you can electively see the plastic surgeon for repair of your laceration in the office within 24 hours without affecting the outcome.” Dr. Szczerba goes on to explain that if the injury is a complex wound or laceration, and the emergency room does not feel comfortable managing the closure the patient requires, a plastic surgeon who is on call for the ER is called and can treat the patient in the ER, or if necessary, in the operating room (OR). “We wear special magnifying surgical eyewear that enlarges the area we are looking at so we can see more accurately what needs to be done,” commented Dr. Szczerba. “I try to align the skin landmarks and then place enough sutures to ensure there is minimal gaps or exposed pink tissue at the end of the repair. When the skin is well approximated with minimal gaps, the body produces minimal scarring to heal the wound.” Dr. Szczerba shared that Carrie Underwood having 40-50 stitches does not always correlate to the severity of the injury. It is best practice to have as many stitches as needed to approximate the skin with minimal gaps. “Better to put more in than too few” is a common phrase used by plastic surgeons, says Dr. Szczerba. After the repair of a laceration, there are a few things plastic surgeons do to influence the best health outcome for the patient:
- Laser treatments to minimize the appearance of a scar
- Photo Facial or Intense Pulse Lights (IPL) for bruising and color improvement of the scar
- Good, quality wound care cream that has sunscreen and silicone in the cream. It is typically applied 1-2 x a day for a few months.
- General Post-care recommendation is the following: Keep the area moist, clean and out of the sun.