A laceration is a wound that is usually irregular in shape and has jagged margins
A laceration is a wound that is usually irregular in shape and has jagged margins

A laceration is a wound that is usually irregular in shape and has jagged margins, which is produced by tearing of the soft body tissues. A laceration often tends to be contaminated with debris and bacteria by the object that caused the laceration. A cut is a wound that breaks the skin due to the trauma from a sharp object. Lacerations are deeper and more irregular in shape that causes more bruising and bleeding.

The tongue is a muscular organ in the oral cavity and is essential for several important functions, such as taste, movement of food, swallowing, and speech production.

Most tongue lacerations do not require sutures (stitches), and they usually heal in a few days without much intervention because the tongue has a rich blood supply. Simple lacerations, especially if it is centrally located on the tongue, usually heal well with minimal risk of infection. Some injuries of the tongue may require immediate medical attention and surgical treatment. Major injuries of the tongue can cause severe bleeding and swelling, affecting speech, swallowing, and breathing.

When do tongue lacerations need stitching?

Following injuries of the tongue require surgical repair:

  • Bisecting wounds
  • Persistent bleeding of the wound
  • Large flaps
  • Wounds to the tip of the tongue 
  • Wounds with a large gap
  • Wounds larger than 1-2 cm
  • U-shaped lacerations
  • Avulsion or amputation of the tongue 

What causes tongue lacerations?

Some common causes of tongue lacerations are as follows:

  • A fall
  • Tongue bites while chewing or during a seizure episode
  • Blunt or penetrating injuries
  • Piercings
  • Intoxication
  • Self-mutilation
  • Anesthesia
  • Surgery of the oral cavity
  • An explosion of electronic cigarettes
  • Chemicals
  • Physical abuse

How is the tongue surgically repaired?

Major injuries of the tongue may require emergency medical care and surgical intervention. Major injuries of the tongue can cause severe bleeding and swelling, affecting speech, swallowing, and breathing.

During surgery:

The patient is first given sedation and numbing medicine, after which the surgeon carefully inspects the wound.

The surgeon would also check for other oral cavity injuries, chipped, or missing teeth. Tooth fragments may be lodged inside the wound. If not removed, it can lead to infection. The surgeon will consider obtaining radiographic imaging to locate missing tooth fragments. The wound may be contaminated with bacteria and debris and hence would be thoroughly cleaned by the surgeon. The tongue is stabilized. The lacerations are usually closed in one, two, or three layers. Suturing the muscular layer of the tongue can control bleeding sufficiently, and the function of the tongue is restored. The superficial mucosal layers of the tongue usually heal rapidly.

After surgery:

Painkillers, anti-inflammatory medications, and antibiotics are usually administered.

The patient is advised cold, icy foods in the first one to two days, such as ice cream, cold milkshakes, cold water, or sucking on ice cubes.

The patient should eat a soft diet for two to three days until the pain and swelling reduce.

The patient would be advised to gargle with hydrogen peroxide or chlorohexidine diluted with water.

Healing occurs very rapidly, usually within a week.

What are the complications following surgical tongue repair?

Complications can include the following:

  • Infection
  • Bleeding 
  • Swelling 
  • Disfigurement 
  • Difficulty in speech
  • Difficulty in chewing and swallowing 
  • Blockage of the airway

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Medically Reviewed on 10/19/2020
References
https://emedicine.medscape.com/article/83275-overview#a2

https://www.uptodate.com/contents/evaluation-and-repair-of-tongue-lacerations

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