Clinical Case - Tongue Laceration Management

[jondudent]

This question came up in my exam (conservative dentistry) and I was curious to see how medschool students would attempt answering it.

Q: 16yr old boy presents at the oral health centre with a severely cut tongue. Caregiver indicates the trauma is due to the boy biting down on his own tongue during a rugby match. His school indemnity form indicates his medical history is clear.

Discuss the initial management of this patient (5mks)

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[Krazykritter]

Interesting question, but I'm afraid that the question doesn't have quite enough information to answer.

Is the wound actively bleeding? What type of laceration are we talking about here? If it is a bisecting injury, it should be repaired. Is there a flap?

I'm not planning on writing a full essay here & finishing your work for you, but the literature I've seen recommends closing a full-thickness wounds in 1-3 layers. Having closed many different types of wounds but never any severe oral wounds, I would probably plan on 3 layers using an absorbable suture.

BTW, I would probably consult ENT or one of the OMFS people if severe since my hospital doesn't have any staff dentists & if I didn't feel comfortable with what I saw.