Antibiotics are not routinely prescribed for head and neck lacerations but should be considered in immunosuppressed patients, in ear or nasal lacerations with exposed cartilage, any open fracture, through and through lip lacerations or any laceration crossing mucosal barriers, and grossly contaminated wounds or bite wounds. While typically ordered by the Emergency Department provider, always ensure tetanus and rabies vaccinations are given when indicated. General principles of facial laceration and avulsion repair include detailed physical exam for additional injuries and damaged critical structures (e.g., facial nerve, salivary ducts, etc.), copious irrigation and cleaning of wounds, minimal tissue debridement or removal in the acute period, and closure as soon as possible after injury (i.e., at least within 24 hours for grossly non-contaminated wounds). The care of head and neck soft tissue wounds including lacerations, avulsions, and abrasions is a crucial skill for the Otolaryngology resident to maximize functional and aesthetic outcomes. Link to instructional video on suture technique.
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