Example of a through-and-through lip laceration. Image from Closing the Gap
A laceration that extends from the epidermis externally through to the intra-oral mucosa internally. Commonly caused by trauma with teeth piercing the oral mucosa and therefore commonly occur around the lips and mouth.
A Nerve Block can help avoid distortion of tissue related to local infiltration of anesthetic.
After thorough irrigation and local anesthesia, create an “under-layer” suture of the dermis and subcutaneous tissue. Using size 4-0 absorbable material, drive the suture through the dermal layer on either side of the wound just below the epidermis and the intra-oral mucosa.
The second layer is the epidermal closure, which is the most cosmetically important portion of this closure. This layer can be closed with simple interrupted 6-0 non-absorbable sutures.
The final layer is closure of the mucosal side, which can be repaired with simple interrupted size 4-0 absorbable suture.