MINORS MANUAL
Lip injuries involve damage to the soft tissues of the lip region, including the skin, mucosa, and, in some cases, underlying muscles. Due to the rich blood supply to the lips, these injuries can bleed profusely but generally heal well if properly managed. They can result from trauma, bites, or accidents.
Diagnosis
Diagnosis is made through physical inspection, evaluating the extent and depth of the wound, whether the inner mucosa or lip border is involved, and if the orbicularis muscle is affected. It is also important to check the alignment of the vermillion border (red lip margin) and rule out associated mandibular or dental fractures.
Differential Diagnosis
Pathology | Key Characteristics |
|---|---|
Simple laceration | Clean cut without deep involvement or vermillion misalignment |
Bite injuries | Irregular margins, higher risk of infection |
Associated alveolar or dental fracture | Gingival bleeding, tooth instability |
Cold sore (herpes labialis) | Painful vesicles, erythema, no acute trauma |
Emergency Management
Haemorrhage control: Apply direct pressure with sterile gauze to stop the bleeding.
Cleaning and decontamination: Irrigate the wound with saline solution to remove foreign bodies and reduce infection risk.
Depth evaluation: Determine whether the wound involves only the mucosa or penetrates to the muscle, which would require layered repair.
Primary closure: For deep wounds or those involving the vermillion border, precise suturing is necessary to restore the lip’s function and aesthetics. Use absorbable sutures for the inner mucosa and non-absorbable sutures for the skin.
Antibiotic prophylaxis: Consider antibiotics for contaminated wounds, especially human or animal bites.
Tetanus: Update tetanus vaccination if necessary.
Definitive Treatment
Definitive treatment includes proper alignment and closure of the wound to prevent visible scars or deformities. In complex cases, a plastic or maxillofacial surgeon may be required to ensure correct muscle and aesthetic tissue repair of the lip.
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