Obtain good anesthesia as above
Irrigate the wound under pressure with copious sterile saline and explore for foreign bodies
Explore the wound to appreciate approximation of anatomic landmarks and search for cartilage involvement
Small superficial wounds without cartilage involvement can be approximated with simple interrupted sutures through the skin at 2-3mm intervals
Ensure that the skin can appropriately cover the remaining cartilage when closed
If needed, up to a 5mm wedge of cartilage may be removed through the helix without significant detriment to aesthetics or function. Anything larger will require staged surgical repair or flaps.
Use deep sutures with buried knots to approximate the cartilage.
Sutures should be thrown through the perichondrium as the cartilage itself is prone to tearing
Consider horizontal mattress sutures to hold tension with reduced risk of tearing
Next close the overlying skin with simple interrupted sutures as above
If needed, up to a 5mm wedge of cartilage may be removed through the helix without significant detriment to aesthetics or function. Anything larger will require staged surgical repair or flaps.
Sutures should be thrown through the perichondrium as the cartilage itself is prone to tearing
Consider horizontal mattress sutures to hold tension with reduced risk of tearing
Ear laceration
Tongue laceration
Nasal fracture
Nasal septal hematoma
Nailbed laceration
Lip laceration
Eyelid laceration
Conjunctival laceration