Scalp laceration (scalp cut)

Head | General Practice | Scalp laceration (scalp cut) (Disease)


Description

A scalp laceration is a cut through the surface of the scalp. Some scalp lacerations involve all the skin layers over the skull. Symptoms of a head injury with laceration include headache, scalp swelling, bleeding, scalp tenderness, dizziness, nausea, sleepiness, and fatigue.

Symptoms of a serious head injury include repeated vomiting, severe headache, amnesia, confusion, lethargy, loss of consciousness, slurred speech, seizures, and difficulty walking. Worsening redness, swelling, and tenderness around a laceration are signs of a skin infection, called cellulitis. Scalp lacerations are a common injury.

Causes and Risk factors

Common causes of head injuries include falls, automobile accidents, sports injuries, occupational injuries, and assaults. Soft tissue scalp injuries include lacerations, abrasions, and puncture wounds.

Diagnosis and Treatment

Clinical evaluation should identify associated serious head injury, laceration of the galea, or bony defect of the skull. After hemostasis is achieved and the wound is irrigated, scalp lacerations are typically closed with surgical staples under local anesthesia. Sutures may be preferred over staples for large, gaping wounds and to provide hemostasis for wounds with brisk bleeding.

As in all trauma patients, the initial clinical assessment should provide rapid identification of potentially fatal conditions. Evaluation should rapidly identify airway compromise (while maintaining cervical spine immobilization), impaired breathing, hemorrhagic shock, and altered level of consciousness upon patient arrival at the emergency department. Such systematic evaluation helps ensure detection of potentially life-threatening injuries.

Treatment for a head injury with laceration includes cold compresses, rest, medications for nausea, and nonsteroidal anti-inflammatory medications for pain. An open or bleeding scalp laceration may need to be repaired with sutures. Treatment for a serious head injury may require corticosteroids, anticonvulsants, and surgery. Additional treatment for lacerations may include a tetanus vaccine, antibiotics, and pain medications.

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