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Foot & Ankle Lacerations

A laceration occurs when the skin catches on a sharp object, ripping or tearing the skin.  Often, there is pain and bleeding associated with this injury.  If this occurs on the top of the foot, there should be concern for injury to the nerves, vessels, and tendons, as the skin is very thin in this area.  If a laceration occurs on the bottom of the foot, vital structures are normally not damaged because of the extensive protective padding in this area.  Most often, a laceration is deep enough that stitches are needed in order to close the wound.

If a laceration occurs, it should be treated immediately.  First, control the bleeding by applying pressure.  Use a kitchen towel, a shirt, a sock, or anything that soaks up moisture, and firmly apply pressure to the area.  Hold pressure for at least 5-10 minutes without letting go.  This allows the small blood vessels to clot and stop bleeding.  If you are on a blood thinner, expect more bleeding and hold pressure until you reach the emergency department. 

Once the bleeding has reduced or stopped, cleanse the wound thoroughly with soap and water.  This will help flush the wound and get rid of any foreign material that may have been introduced when the skin was punctured.  Materials such as dirt, rust, mold, broken glass, or wood can all cause infection, if left in a wound. 

Next, apply an antibiotic ointment and cover with a dry gauze wrap.  It is best to get to the emergence department as soon as possible, for professional care. Antibiotics will be needed, as well as a tetanus shot, if you have not had one in the last 10 years. Multiple antibiotics may be needed, depending on the nature of the injury. For example, a laceration from a clean kitchen knife will usually need only one basic antibiotic. However, a cut from a rusty nail or a glass bottle  may require additional antibiotic coverage.

Normally, the injury is healed in 10-14 days and stitches may be removed at this time. Continue to protect the injury during this time with an appropriate bandage. If the laceration is on the foot or ankle, a protective boot may be worn as well. If the laceration is extensive and major tendons and nerves are cut, or if the injury becomes severely infected, then surgery is necessary to clean out all the infected tissue and repair any damaged structures that needs to be fixed.

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