Answer
Emphasis on accurately approximating the vermilion border is advised for the best cosmetic outcome.
The location of intraoral lacerations can make repair difficult without assistance for retraction. One option is to have the patient retract his or her own lip.
Strongly consider the use of regional nerve blocks.
If a patient with a lip or oral laceration also has a newly chipped tooth, search diligently for tooth fragments in the oral mucosa [11] ; if not removed, such fragments may cause wound infections. Retained tooth fragments can be visualized on radiographs of the soft tissue. [12, 21]
Lip wounds are more prone to infections than other wounds due to the saliva and contamination from dental bacterial plaque. [13, 19]
Consider the possibility of underlying facial fractures or dental injuries in trauma patients with lip lacerations; order imaging as necessary. [22]
Remember to update a patient's tetanus vaccination when necessary.
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Equipment for the anesthesia, irrigation, and closure of a lip laceration.
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Lip laceration involving the lower vermilion border.
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Identification of intraoral skin laceration.
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Lip laceration involving the upper vermilion border.
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Deep intraoral lip laceration that needs repair.
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Technique for extraoral infraorbital nerve block.
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Intraoral approach for infraorbital nerve block.
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Placement of the first suture through the vermilion border.
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Assessing for mobile or broken teeth.
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Further inspection of the anesthetized wound reveals a through-and-through laceration.
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Extraoral approach to close the deep layer.
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Wound approximation after 2 deep sutures are placed.
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First suture aligning the vermilion border.
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Placement of intraoral skin suture with buried knot.
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Closure of an intraoral skin laceration.
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Closure of an intraoral laceration.
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Intraoral approach to close the deep layer.
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Wound approximation after placement of deep muscular sutures.
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Placement of the first suture through the vermilion border.
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Placement of the first suture through the vermilion border.
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Complete closure of the facial skin.
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Complete closure of the facial skin.
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Illustration of the upper and lower vermilion border.
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Areas of regional nerve blocks for the lips.
