Tongue lacerations do not generally require suturing, but there are some exceptions. What are those and what kind of anesthesia is appropriate? This patient simply bit his tongue in a fall.

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The decision to suture a tongue laceration depends on the size of the laceration or the gaping nature of the wound. Performing tongue assessment is best when the tongue is at rest inside the mouth as this is the most common position, as opposed to protruding outside the mouth. Complex lacerations are those that involve large flaps, active bleeding or through-and-through injuries of the tongue and are more likely to require repair. Lacerations or avulsions that are small can potentially be left to heal without intervention due to the tongue’s ability to bulk up via hypertrophy. The ability to hypertrophy can often fill in the gaps of the wound so that no deficit is identifiable. Anesthetic (topical, local, block): Lidocaine with or without epinephrine, LET, bupivacaine with or without epinephrine

Indication of stitch in case tongue injur or laceration A. Laceration in more than 2 cm B. If profuse bleeding for proper haemostasis C if the laceration both is through and through or margin laceration D. Complex laceration where there is cogulopathy Preferably stitched to be under general anaesthesia because it is difficult to fix the tongue for stitching

Thanks Dr Shital Yadav
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Tongue is a very vascular structure. So partial thickness laceration do not require any suturing. But a full thickness laceration may require one to keep tongue in position. Usually vycril 3-0 or 2-0 is used. Outcome is excellent if wound is not infected. For suturing of oral tongue only local anaesthesia is required. But if tongue base is involved a GA may be required in some cases

Xylocaine 4 percent local xylocaine 1 percent or xylocaine with epinephrine if bleeding local effect is good generally tongue recover faster with antibiotic

Tongue laceration can be Sutured under local anesthesia Tongue laceration with wide separation of edges need to be Sutured

Tongue laceration such as in picture require sutures under local By catgut will be better or you can opt for mersilk

Thanx dr Dinesh Gupta
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SUGGESTIVE OF.. CONDITIONS.... 1. WHERE. THE. WOUNDS. OR. LACERATION.....BISECT. THE. TONGUE 2. GAPING. WOUNDS 3. LACERATIONS. MORE. THAN.... ....AT. LEAST. ..1 CM....... 4. DEEP. WOUNDS./.LACERATIONS ....ON .....BOTH. DORSAL. AND. VENTRAL SURFACES. Of. TONGUE ..5. CHANCES. OF. SECONDARY INFECTIONS ANAESTHESIA..... ......THE. ATTENDING. DOCTOR. DECIDES.....THE. MODE. OF. ANAESTHESIA.......SUCH. AS..... ....LOCAL... ..... REGIONAL.. ... SEDATION... IN. THE. ABOVE. PRESENT. CASE... ...if. THE. PATIENT. IS. ADULT..... OPTIONS. FOR..... L. ANAESTHESIA... ....ARE.... ..... INFILTRATIONS. AND .. UNILATERAL. BLOCK FOR. SUTURING. WITH. CATGUT .. ... ABSORBABLE....CHROMIC.. 3 . 0. Or. 4 . 0. ..... SUTURES......NEEDED

Xyelocaine jelly to be applied & 5 0 plain catgut for sutures

Deep lacerations need sutures. Central long cut as well. Generally a local block is given. Sometimes in minor cases xylocaine sprays can be used.

Catgut Suture a tongue laceration 2cn Vascular steucture Lical Anesthesia Liquid diet Antibiotics

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