Zip It Up

Question: A 4 year old falls and hits her upper lip on a concrete step. There is significant bleeding that is controlled with pressure. There is a Z-shaped laceration that involves the vermillion border, and examination demonstrates that a cotton swab can be passed through the lip to the teeth. Which layers should be approximated for optimal cosmesis?

a) Mucosa and muscle only to avoid infection

b) Muscle and vermillion only

c) Muscle, mucosa, and skin at and above/below vermillion border

d) Muscle only, allow skin to heal by secondary intention with subsequent scar revision

[Answer will be posted with next week's new question]

Answer to last week's question, “Feeling Full” (January 25, 2020)

B - Non-communicating hydrocephalus.