From the Guidelines
Ear lacerations typically require stitches to ensure proper healing and cosmetic results, and all wounds should be cleaned and repaired within 12 to 24 hours. For minor ear lacerations, 6-0 non-absorbable sutures like nylon or polypropylene are recommended, while deeper or more complex lacerations may require layered closure with 5-0 or 4-0 sutures.
Key Considerations
- Stitches should remain in place for 10-14 days due to the ear's limited blood supply and cartilage involvement, which results in slower healing compared to other body areas.
- Before suturing, the wound should be thoroughly cleaned with saline or antiseptic solution, and local anesthesia (1-2% lidocaine with epinephrine) should be administered, as described in general wound management principles 1.
- After suturing, apply antibiotic ointment like bacitracin or mupirocin and cover with a non-adherent dressing.
- Patients should keep the area dry for 24-48 hours, then clean gently with mild soap and water daily.
- Oral antibiotics like cephalexin 500mg four times daily for 5-7 days may be prescribed if the wound is contaminated or involves cartilage, although the specific choice of antibiotic may depend on various factors including the presence of any underlying infections or the patient's medical history.
Potential Complications
- Watch for signs of infection including increased pain, redness, swelling, or discharge.
- Proper suturing technique is crucial for ear lacerations as poor alignment can result in cosmetic deformities, and any cartilage involvement requires special attention to prevent chondritis, a serious infection of the cartilage, as noted in the context of auricular perichondritis and perichondrial abscess formation 1.
From the Research
Ear Laceration Stitches
- Ear lacerations are a common reason for patients to seek medical attention, and are often acutely managed in the emergency department 2.
- The management of ear lacerations can range from simple closure to more complex reconstructive options, depending on the severity of the injury and whether cartilage is involved 3.
- There is no standardized, definitive management for ear lacerations, but a simple algorithm for classifying injuries can assist in deciding which reconstructive options are most appropriate for a particular case 3.
- The use of antibiotic prophylaxis in ear surgery has been studied, and research suggests that short-course antibiotic prophylaxis (≤24 hours) is as effective as extended-course antibiotic prophylaxis (≥72 hours) in preventing postoperative infections 4.
- However, the use of antibiotic prophylaxis in ear laceration management is not directly addressed in the available evidence, and further research is needed to determine the optimal approach to preventing infection in these cases.
- Topical antibiotic treatments may be considered for acute otitis externa, a common complication of ear lacerations, but the evidence for their use in this context is limited 5.