Tongue laceration - Revision history

Rossdonaldson1: /* See Also */

2023-03-01T19:21:53Z

Blsimpso at 21:49, 29 June 2021

2021-06-29T21:49:47Z

← Older revision		Revision as of 21:49, 29 June 2021
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	*[[Tongue Diagnoses]]		*[[Tongue Diagnoses]]
	*[[Lacerations]]		*[[Lacerations]]

			==External Links==

			===Videos===
			{{#widget:YouTube\|id=h14KyO8JlZE}}


	==References==		==References==

Rossdonaldson1: /* Management */

2020-02-20T21:52:33Z

Management

← Older revision		Revision as of 21:52, 20 February 2020
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	==Management==		==Management==
			===Adult===
	*Do not need primary repair unless >1 cm in length, widely gaping, involving tip / anterior split tongue, or large hemorrhage		*Do not need primary repair unless >1 cm in length, widely gaping, involving tip / anterior split tongue, or large hemorrhage
	**Use absorbable sutures, chromic gut or vicryl but not fast absorbing		**Use absorbable sutures, chromic gut or vicryl but not fast absorbing

Rossdonaldson1: /* Pediatric patients */

2020-02-20T21:39:26Z

Pediatric patients

← Older revision		Revision as of 21:39, 20 February 2020
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	===Pediatric patients===		===Pediatric patients===
	[[File:TongueLaceration.png\|thumb]]		[[File:TongueLaceration.png\|thumb\|Graphic for determining need for suturing in <u>pediatric</u> patients with tongue laceration.]]
	Who needs suturing (see photo to the right)? <ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> <ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>		Who needs suturing (see photo to the right)? <ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> <ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>
	#Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.		#Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.

Rossdonaldson1: /* Pediatric patients */

2020-02-20T21:38:05Z

Pediatric patients

← Older revision		Revision as of 21:38, 20 February 2020
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	===Pediatric patients===		===Pediatric patients===
	[[File:TongueLaceration.png\|thumb]]		[[File:TongueLaceration.png\|thumb]]
	Who needs suturing~~? See~~ photo to the right ~~or articles 1~~<ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> ~~and 2~~<ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>		Who needs suturing (see photo to the right)? <ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> <ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>
	#Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.		#Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.
	#[[Lidocaine]]		#[[Lidocaine]]

Rossdonaldson1: /* Pediatric patients */

2020-02-20T21:37:21Z

Pediatric patients

← Older revision		Revision as of 21:37, 20 February 2020
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	===Pediatric patients===		===Pediatric patients===
	[[File:TongueLaceration.png\|thumb]]		[[File:TongueLaceration.png\|thumb]]
	**0) Who needs suturing? See photo to the right or articles 1<ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> and 2<ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>		Who needs suturing? See photo to the right or articles 1<ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> and 2<ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>
	**1) Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.		#Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.
	**2) [[Lidocaine]]		#[[Lidocaine]]
	**3) Anxiolysis - [[Midazolam]] 0.3-0.5 mg/kg intranasal (max 10kg) or [[Ketamine]] 3-6 Mg/kg intranasal		#Anxiolysis - [[Midazolam]] 0.3-0.5 mg/kg intranasal (max 10kg) or [[Ketamine]] 3-6 Mg/kg intranasal
	**4) Retraction - Clamp tongue with towel and pull tongue forward. Consider placing O-silk suture midline in tongue for added traction, but be careful to avoid lingual artery when puncturing (go midline and as anterior as possible when puncturing).		#Retraction - Clamp tongue with towel and pull tongue forward. Consider placing O-silk suture midline in tongue for added traction, but be careful to avoid lingual artery when puncturing (go midline and as anterior as possible when puncturing).
	**5) Irrigate and inspect		#Irrigate and inspect
	**6) Suture - many options exist (1 single deep suture through all 3 layers, 1 suture above and 1 below)		#Suture - many options exist (1 single deep suture through all 3 layers, 1 suture above and 1 below)
	**7) Follow-up - Soft diet for 3 days, antiseptic (dilute peroxide) swish and spit, antibiotics not needed unless wound is dirty		#Follow-up - Soft diet for 3 days, antiseptic (dilute peroxide) swish and spit, antibiotics not needed unless wound is dirty

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2020-02-20T21:33:43Z

Management

← Older revision		Revision as of 21:33, 20 February 2020
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	**Use absorbable sutures, chromic gut or vicryl but not fast absorbing		**Use absorbable sutures, chromic gut or vicryl but not fast absorbing
	**Tie 4-5 knots but approximate loosely to allow for swelling		**Tie 4-5 knots but approximate loosely to allow for swelling
	**Anesthesia of the anterior 2/3 of the tongue is obtained through an lingual nerve block or topical anesthesia with 4% lidocaine soaked gauze.		**Anesthesia of the anterior 2/3 of the tongue is obtained through a [[lingual nerve block]] or topical anesthesia with 4% lidocaine soaked gauze.
	**Chlorhexidine mouth wash to prevent infection		**Chlorhexidine mouth wash to prevent infection

Rossdonaldson1 at 21:32, 20 February 2020

2020-02-20T21:32:57Z

← Older revision		Revision as of 21:32, 20 February 2020
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	**Anesthesia of the anterior 2/3 of the tongue is obtained through an lingual nerve block or topical anesthesia with 4% lidocaine soaked gauze.		**Anesthesia of the anterior 2/3 of the tongue is obtained through an lingual nerve block or topical anesthesia with 4% lidocaine soaked gauze.
	**Chlorhexidine mouth wash to prevent infection		**Chlorhexidine mouth wash to prevent infection
	*In pediatric patients
			===Pediatric patients===
	[[File:TongueLaceration.png\|thumb]]		[[File:TongueLaceration.png\|thumb]]
	**0) Who needs suturing? See photo to the right or articles 1<ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> and 2<ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>		**0) Who needs suturing? See photo to the right or articles 1<ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> and 2<ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>
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	**6) Suture - many options exist (1 single deep suture through all 3 layers, 1 suture above and 1 below)		**6) Suture - many options exist (1 single deep suture through all 3 layers, 1 suture above and 1 below)
	**7) Follow-up - Soft diet for 3 days, antiseptic (dilute peroxide) swish and spit, antibiotics not needed unless wound is dirty		**7) Follow-up - Soft diet for 3 days, antiseptic (dilute peroxide) swish and spit, antibiotics not needed unless wound is dirty

			==Disposition==
			*Typically outpatient

	==See Also==		==See Also==

Hoxbox: /* Management */

2020-02-14T16:27:22Z

Management

← Older revision		Revision as of 16:27, 14 February 2020
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	**Chlorhexidine mouth wash to prevent infection		**Chlorhexidine mouth wash to prevent infection
	*In pediatric patients		*In pediatric patients
			[[File:TongueLaceration.png\|thumb]]
			**0) Who needs suturing? See photo to the right or articles 1<ref>Seller Et al. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018;148:w14683 https://smw.ch/article/doi/smw.2018.14683</ref> and 2<ref>Sibley, A., Atkinson, P., & Lobay, K. (2020). Just the facts: Pediatric Dental and Oral Injuries. CJEM, 22(1), 23-26. doi:10.1017/cem.2019.440 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/just-the-facts-pediatric-dental-and-oral-injuries/D795F04C6B4CA2AA6C894B5BE1A835F0</ref>
	**1) Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.		**1) Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.
	**2) [[Lidocaine]]		**2) [[Lidocaine]]

ClaireLewis at 22:49, 30 September 2019

2019-09-30T22:49:14Z

← Older revision		Revision as of 22:49, 30 September 2019
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	==Background==		==Background==
	*Secondary to tongue biting		*Secondary to tongue biting
	*Serious injuries can cause hemorrhage and potential airway compromise		*Serious injuries can cause [[hemorrhage]] and potential airway compromise

	==Clinical Features==		==Clinical Features==
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	*In pediatric patients		*In pediatric patients
	**1) Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.		**1) Consult Head & Neck service if any large amputation of tongue. Otherwise, proceed below.
	**2) Lidocaine		**2) [[Lidocaine]]
	**3) Anxiolysis - Midazolam 0.3-0.5 mg/kg intranasal (max 10kg) or Ketamine 3-6 Mg/kg intranasal		**3) Anxiolysis - [[Midazolam]] 0.3-0.5 mg/kg intranasal (max 10kg) or [[Ketamine]] 3-6 Mg/kg intranasal
	**4) Retraction - Clamp tongue with towel and pull tongue forward. Consider placing O-silk suture midline in tongue for added traction, but be careful to avoid lingual artery when puncturing (go midline and as anterior as possible when puncturing).		**4) Retraction - Clamp tongue with towel and pull tongue forward. Consider placing O-silk suture midline in tongue for added traction, but be careful to avoid lingual artery when puncturing (go midline and as anterior as possible when puncturing).
	**5) Irrigate and inspect		**5) Irrigate and inspect

← Older revision		Revision as of 19:21, 1 March 2023
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	*[[Tongue Diagnoses]]		*[[Tongue Diagnoses]]
	*[[Lacerations]]		*[[Lacerations]]

			{{Special lacerations see also}}

	==External Links==		==External Links==