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View Full Version : Treatment for a cut-open cheek?



HeatherCW
03-17-2008, 09:40 PM
I'm not sure this is the right spot for this, but I can't find a better one!

In my current novel, a character's cheek will be sliced open. I am trying to figure out how such an injury gets treated. Stitches, I presume... but would it be bandaged after, and if so for how long, and how long would the stitches be in place?

My usual Internet searches have led nowhere, and my doctor's not the type I could ask for this sort of information (although I will if all else fails).

Anyone have an idea how this would be treated?

Thanks!
Heather

Jean Marie
03-17-2008, 10:08 PM
http://www.absolutewrite.com/forums/forumdisplay.php?s=&daysprune=&f=66


Story Research, is the forum you're looking for when wondering about this sort of thing. It's found in the drop-down box at the bottom of the page, on the right, as are the rest of the forums, Heather. There are bunches of them on AW!

As to your question, it would depend on the depth of the wound/length of the laceration, as well. Meaning, cause of injury, or mechanism of injury...knife wound, glass, etc. The wound needs to be cleaned, and yes, it would need stitches. Again, the length decides the number of stitches as does the depth. Inner stitches may be required, too. Which also determines the amount of time they're left in.

Probably bandaged.

Welcome to AW :)

WerenCole
03-17-2008, 11:29 PM
Ever seen China Town? J.J. Gittes (Jack Nicholson) goes through most of that movie with his nose cut. Not the same as yours, but similar.

Silver King
03-18-2008, 04:22 AM
Story Research, is the forum you're looking for when wondering about this sort of thing...
As always, JM is on the ball, and we'll move this thread there now.

ColoradoGuy
03-18-2008, 06:30 AM
Stitches in facial wounds are usually left in 5 days or so (shorter than for other spots). If the wound is deep, there would be an inner layer of dissolving stiches (either vicryl or chromic) to bring the wound edges together--it's important not to oppose the wound edges under any sort of tension because that tends to leave a worse scar, and the subcutaneous stitches hold the tension. The skin surface would be closed most likely with prolene (which looks like blue monofilament fishing line) or sometimes nylon (which is black). These days we sometimes use tissue glue for wound edges that come together evenly and if the wound isn't too contaminated. One can also use a combination of dissolving deep stitches and glue on the surface. Scalp wounds are often stapled if inside the hair line. We generally don't put a bandage on afterwards, but often put on a thin film of antibiotic ointment.

GeorgeK
03-18-2008, 06:34 PM
Stitches in facial wounds are usually left in 5 days or so (shorter than for other spots). If the wound is deep, there would be an inner layer of dissolving stiches (either vicryl or chromic) to bring the wound edges together--it's important not to oppose the wound edges under any sort of tension because that tends to leave a worse scar, and the subcutaneous stitches hold the tension. The skin surface would be closed most likely with prolene (which looks like blue monofilament fishing line) or sometimes nylon (which is black). These days we sometimes use tissue glue for wound edges that come together evenly and if the wound isn't too contaminated. One can also use a combination of dissolving deep stitches and glue on the surface. Scalp wounds are often stapled if inside the hair line. We generally don't put a bandage on afterwards, but often put on a thin film of antibiotic ointment.

Nylon is much less irritating. On a cheek it probably wouldn't matter but under the jaw or near a joint or fold of skin, the cut end of the prolene will poke the skin feeling like a needle jab every time you move. Never use prolene on the armpit, inner thigh or scrotum...unless you want to immobilize the patient, but it wouldn't work on crazies. They'd just pull them out.

If for some reason you really want to use prolene, leave a bit of a tail between the end of the knots and the cut end of the suture. The stiffness and ability to poke is inversely proportional to the length of the tail.

ColoradoGuy
03-18-2008, 07:24 PM
George my friend, you really like your nylon! I just tie lots and lots of knots in the prolene. I even put in my post the nylon on the face just for you (and the chromic, too). But yeah, I use nylon away from the face, especially the arms and legs.

giaaddison
03-19-2008, 07:50 PM
this happened to chrissie in holby city last month.

http://www.bbc.co.uk/drama/holbycity/episodes/2008/02/episode20080205.shtml

GeorgeK
03-20-2008, 06:16 PM
George my friend, you really like your nylon! .

lol, yep. I've done enough surgery and had enough done to my wife and myself, that I consider prolene only for vascular and certain viscus repairs and then bury the knots. Also sometimes to suture in certain drains or used in bolsters where you want something that won't dissolve when wet and will be a different color than the surrounding skin and hair. I had by far the lowest infection rate and hardly ever had to transfuse a patient, and those were people that I could tell ahead of time from their X-Rays or labs that they would need to be transfused. My patients also had fewer post op complaints when called independently by the recovery room and went home faster than the national average for same procedures performed.

HeronW
03-23-2008, 03:29 PM
If it's through the cheek to the inside of the mouth, the person may need to be on IV feeding to keep food, drink & bacteria etc from getting into the wound.