Laceration Repair Best Practices

Lilian White, MD
Posted on August 4, 2025

Lacerations occur most often during weekends in the spring and summer and are most commonly sustained on the upper extremity, face, or trunk. Primary care physicians perform approximately 50% of suture repairs for patients in the United States. An AFP article, A Practical Approach to Laceration Repair, outlines recommendations for laceration repair.

Initially, ensuring hemostasis is key to evaluating a laceration. Then, it is recommended to cleanse lacerations of any debris before whatever method of closure is chosen. However, neither the specific irrigant (tap water vs sterile water vs saline, etc.) nor the cleansing itself appears to affect rates of infection or wound healing significantly. Imaging is recommended if a retained foreign body is suspected.

Lacerations may be repaired using sutures, skin adhesive, or staples or allowed to heal by secondary intention. Topical anesthetics appear to be similarly effective to injected anesthetics for pain control with laceration repair and may be better tolerated by children. A small randomized controlled trial in 2024 compared the use of Steri-Strips, Dermabond, and absorbable sutures in children and found no significant difference in scar appearance, pain, or guardian satisfaction. In two randomized trials, absorbable vs non-absorbable suture material did not appear to have a significant effect on wound healing, cosmetic outcomes, and patient satisfaction in adults or children. Using absorbable sutures can help lower costs by eliminating the need for a follow-up visit to remove sutures. An algorithm in the previously mentioned AFP article is a suggested guide to determine the most appropriate means of laceration closure.

The timing of suture placement may be helpful to promote wound healing while reducing the risk of infection. It is generally recommended to close wounds within 18 to 24 hours of injury, but no strong evidence supports that a more delayed closure significantly increases the risk of infection for clean wounds. Timing of suture or staple removal is based on the location of the laceration; the AFP article on laceration repair also provides a table as a guide for removal timing.

Complications of laceration repair include infection, dehiscence, and the development of chronic wounds. Oral antibiotic prophylaxis is typically not recommended with the exception of contaminated wounds (eg, water, soil, mammalian bite) and open fractures, but this is largely based on expert opinion.

Wound care is critical to prevent infection and promote healing. An occlusive or semi-occlusive dressing is recommended to maintain a moist environment for wound healing, as detailed in an AFP article, Common Questions on Wound Care. Prophylactic topical antibiotics may be considered to prevent wound infection, with some studies demonstrating a benefit compared with topical petroleum.