Treatment of Wounds on the Lip or Mouth
For wounds on the lip or mouth, apply white soft paraffin ointment to the lips every 2 hours during the acute phase and clean the mouth daily with warm saline mouthwashes or an oral sponge. 1
Initial Assessment and Cleaning
- Examine the wound thoroughly to assess extent, depth, presence of granulation tissue, fibrin coverage, wound edges, exudates, and/or necrosis 2
- Clean the wound with sterile normal saline (no need for iodine or antibiotic-containing solutions) and remove superficial debris 1
- For deeper wounds, surgical debridement under local anesthesia may be necessary 2
Topical Treatment for Lip Wounds
- Apply white soft paraffin ointment (petroleum jelly) to the lips immediately and then every 2 hours throughout the acute healing phase 1
- For painful wounds, consider an anti-inflammatory oral rinse or spray containing benzydamine hydrochloride every 2-4 hours, particularly before eating 1
- Clean the mouth daily with warm saline mouthwashes or a gentle oral sponge 1
Wound Closure Considerations
- Primary closure of intraoral wounds can be performed up to 24 hours after injury 3
- For through-and-through wounds or wounds on the face, meticulous wound care, copious irrigation, and careful closure are essential 1
- Exact alignment of the vermilion-cutaneous margins is critical for lip defects to ensure both functional and aesthetic outcomes 3, 4
- Consider layered suturing technique for deeper wounds to ensure proper healing 2
Infection Prevention
- Take swabs for bacterial and candidal culture from areas of lesional skin, particularly sloughy or crusted areas 1
- Consider antiseptic oral rinses twice daily to reduce bacterial colonization (options include 1.5% hydrogen peroxide mouthwash or 0.2% chlorhexidine digluconate mouthwash) 1
- If candidal infection is suspected, treat with nystatin oral suspension 100,000 units four times daily for 1 week, or miconazole oral gel after food four times daily for 1 week 1
Pain Management
- For painful wounds, use an appropriate validated pain assessment tool 1
- Consider topical anesthetic preparations such as viscous lidocaine 2%, 15 mL per application, for severe oral discomfort 1
- For systemic pain control, administer adequate analgesia to ensure comfort 1
Special Considerations
- For bite wounds to the lip or mouth, antimicrobial prophylaxis with amoxicillin-clavulanate may be indicated due to the polymicrobial nature of these injuries 1, 2
- Ensure tetanus prophylaxis status is current; if outdated or unknown, administer tetanus toxoid 1
- For severe wounds with significant tissue loss, consider referral to a specialist for reconstruction 2, 4