Suturing of facial lacerations under general anaesthetic

This leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions. If you have any other questions that the leaflet does not answer or would like further explanation please ask a member of the medical or nursing staff.

The problem

You have a cut on your face which needs to be stitched. The doctor who has examined you has already decided that it is too big to be glued or taped. The treatment that is about to take place involves a general anaesthetic, which means that you will be put to sleep completely.

What does the operation involve?

Once you are asleep the wound will be injected with local anaesthesia. This has two purposes, firstly aids in vasoconstriction (stopping bleeding) and secondly provides local pain relief

After this the wound will be cleaned before it is stitched. The wound is usually closed in layers, ie: some stitches are placed underneath the skin to hold the deeper tissues together before the skin surface is stitched.

The stitches are dissolvable so they do not need to be removed. At the end of the operation a dressing may be put over the wound. In a small number of cases non dissolvable sutures will be used for the skin that will need to be removed usually within 5-10 days depending on the location

What can I expect after the operation?

• It is unlikely to be very sore but regular pain relief in the form of paracetamol and ibuprofen should be sufficient if tolerated. Any discomfort usually peaks in the first few days before dissipating.
• There is a variable amount of swelling and bruising that can occur depending on the site of your cut. It is usually most noticeable with wounds around the eyelids and can last 48 hours. Swelling and bruising can be improved by sleeping propped upright for the first few days after surgery.
• Depending on the size of the cut that is stitched you may leave hospital on the day of surgery or need to stay overnight.
• It might be necessary to give you antibiotics to make sure that the wound heals without any infection. These may be given through a vein in your arm whilst you are in hospital and you may need to complete the tablet version on discharge.
• If any non-dissolvable stitches have been used either we will make a follow up appointment or suggest they be removed locally for example at your local GP surgery.
• In a small number of cases we will arrange local follow up in the majority we suggest follow up with your GP

Do I need to take any time off work?

Depending on the nature of your work it may be necessary for you to take a week or so off and avoid strenuous exercise for this time. It is important to remember that you will not be able to drive or operate machinery for 48 hours after your general anaesthetic.

What are the possible problems?

• Bleeding from the wound is unlikely to be a problem. However should it occur when you get home it can usually be stopped by applying pressure over the site for at least 10 minutes with a clean rolled up handkerchief or swab.
• Infection is usually a rare event after formal cleaning and closing. However, some signs such as discharge, wound breakdown or pus can occur. In these cases we recommend attending your nearest hospital for assessment.
• The wound will appear to change in colour (depending on your skin tone) this is normal and will return to normal after a few weeks. Sometimes there is a little bit of discomfort from the scar when the deeper stitches dissolve a few months after they have been put in.
• A small number of people need revision of the scar if they are unhappy with its final appearance. This is not normally carried out until at least six months after the wound was first stitched due to scar maturation taking many months to finalise.
• Occasionally people can have an excess of scar tissue (hypertrophic scar or keloid). This is very unusual but may require further treatment.

Adapted from:

British Association of Oral and Maxillofacial Surgeons.

British Association of Oral and Maxillofacial Surgeons (opens in a new tab)