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Laceration: Lid

Laceration

What is it?
A cut through the eyelid tissues. Eyelid lacerations require special care if they extend through the lid margin, displace a great deal of tissue, or involve the medial canthus. In this case, the laceration involves the medial canthus and may have severed the lower canaliculus.

What to do?
Uncomplicated lid lacerations may be left unsutured if they are small and the tissue edges are apposed and not under tension. Otherwise they should be sutured using 6-0 interrupted sutures (nonabsorbable in adults, absorbable in children).

Complicated lid lacerations should be repaired by ophthalmologists.

Lid margin lacerations must be carefully sutured so as not to create an irregular margin or misdirected lashes that would abrade the cornea.

Large lacerations require specialized technique in order to avoid deformity.

Medial canthal lacerations may sever the lower canaliculus, which must be reconnected or the patient may suffer tearing; a severed medial canthal tendon must be sutured to the nasal bone to avoid deformity and tearing.

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