Traditional approach to laceration repair dictates closure of laceration as soon as possible after an injury. Usually this involves closing the wound with stitches, staples, or skin glue within the first 24 hours.
This timeline can make it difficult for the treating provider to distinguish between viable and irreversibly damaged tissue. This is particularly true with lacerations caused by blunt trauma. This could involve hitting the pavement, edge of a table, or other non-cutting objects. The trouble with those lacerations is that the splitting of skin is associated with crush injury of the edges. The crushed edges heal with greater scarring.
To achieve the best results with repair of those types of lacerations requires surgically removing crushed edges. Most urgent care and emergency room healthcare providers simply repair the laceration without trimming of the edges. Trimming or excising of edges is time consuming and can be technically challenging. The eventual widened scar can be revised at a later date.
An alternative approach is to delay laceration repair for a few days to allow the crushed edges of laceration to “declare” themselves – making them obvious to see. At that point, the damaged tissue is trimmed off, and the laceration is repaired bringing healthy edges together. The results are usually better.
In some cases, when the repaired lacerations are referred to the SCARS Center a few days after repair, our physicians and PA’s recommend excising the damaged edges of the repaired laceration and closing it again. This can be done a few days after the initial repair or a few weeks later. This improves the final appearance of the scar after healing.
The moral of the story is that laceration repairs can be delayed or re-sutured days later. That approach achieves better healing and appearance.