What is it?
A laceration is a cut in the skin, a common occurrence in sports. A laceration can occur following contact with a sharp object, such as a piece of equipment or even a tooth, or from a blunt force, such as an elbow during basketball.

Risk Factors
Athletes participating in sports using equipment with sharp edges are at greater risk of lacerations. Contact and collision sport athletes are also at higher risk. Lacerations are commonly seen in ice hockey, figure skating, speed skating, fencing, skiing, and snowboarding.

Symptoms
Symptoms of a laceration are immediate and obvious. Classifications are usually based on the severity of the injury and include associated pain, bleeding, and swelling. Other symptoms may also be present if underlying structures are injured. These may include numbness or weakness if a nerve is damaged, or heavy bleeding if an underlying artery is damaged.

Sports Medicine Evaluation
Evaluation of a laceration includes determining the length, depth, and complexity of the injury. Full evaluation of the wound often requires cleaning the area with fluid to remove any debris and to make sure no foreign bodies are present. The structures underneath the cut should be considered, as well as areas of cosmetic importance (like the face) and any potential problems with healing.

Treatment
Treatment will depend on the severity of the injury. Some small, minor lacerations can be treated by simply covering the injury and allowing it to heal on its own. A mild laceration that is not very deep and whose edges come together easily may be easily closed with adhesive strips or butterfly stitches, or wound adhesive (glue). Larger lacerations will heal better with suture placement by a physician. Sometimes, depending on the location and cause of the injury, antibiotics may be prescribed. A tetanus shot may be given if the player has not received an updated vaccine in the last 5 years.

Injury Prevention
Lacerations are best prevented by maintaining proper equipment and by enforcing safety rules. Despite all attempts at prevention, however, some lacerations are unavoidable. After the injury, proper wound care should be carried out to prevent possible complications of infection and scarring. This includes keeping the wound clean and dry, as well as using antibiotic cream if directed.

Return to Play
Return to play depends on the severity of the injury, as well as the location of the laceration, the treatment required, and the sport in which participation is desired. If the cut is over a joint with a wide range of motion, return to sport may require full healing of the wound, and immobilization may be needed in order to allow this healing. Some lacerations may allow immediate return if the bleeding is stopped and the wound is adequately covered.

AMSSM Member Authors
Kim Harmon, MD and Nicholas R. Phillips, MD

References
Tlougan BE, Mancini AJ, Mandell JA, Cohen DE, Sanchez MR. Skin conditions in figure skaters, ice-hockey players and speed skaters: part I - mechanical dermatoses. Sports Med. 2011 Sep 1;41(9):709-19.