Wound Care for Ear Lacerations

Initial Assessment and Cleaning

Thoroughly irrigate the wound with a large volume of warm or room temperature potable water or sterile normal saline until all foreign matter and debris are removed, as recommended by the American Heart Association 1, 3
Cold water is equally effective but less comfortable for the patient, according to the American Heart Association 1
No need for iodine or antibiotic-containing solutions for initial cleaning, as stated by the Infectious Diseases Society of America 2
Remove only superficial debris; deeper debridement is usually unnecessary and may impair skin closure, as recommended by the Infectious Diseases Society of America 2

All ear lacerations should be cleaned and repaired within 12-24 hours of injury for optimal outcomes, according to the American Academy of Pediatrics 4, 5
Simple ear lacerations can be sutured under local anesthesia, as recommended by the American Academy of Pediatrics 4, 5
If the laceration involves the auricular cartilage, be vigilant for signs of perichondritis, such as painful swelling, warmth, redness that spares the earlobe, as advised by the American Academy of Pediatrics 4, 5

Cover the wound with a clean occlusive dressing to keep the wound moist and prevent drying, as recommended by the American Heart Association 1
Consider applying antibiotic ointment or cream if it's a superficial injury and the patient has no known allergies to antibiotics, according to the American Heart Association 1
Instruct the patient to keep the wound clean and dry, as advised by the Infectious Diseases Society of America 2
Advise elevation of the injured ear during the first few days after injury to accelerate healing, especially if swelling is present, as recommended by the Infectious Diseases Society of America 2

Follow up within 24 hours either by phone or during an office visit, as recommended by the Infectious Diseases Society of America 2
Monitor for signs of infection: increasing pain, redness, swelling, warmth, or purulent discharge, as advised by the American Academy of Pediatrics 4, 5
If infection develops, particularly auricular perichondritis, prompt treatment with fluoroquinolone antibiotics is indicated, as recommended by the American Academy of Pediatrics 4, 5
If an abscess develops, surgical incision and drainage may be necessary, according to the American Academy of Pediatrics 4

Ensure tetanus prophylaxis status is current, as recommended by the Infectious Diseases Society of America 2
If outdated or unknown, administer tetanus toxoid, as advised by the Infectious Diseases Society of America 2

Infection, particularly auricular perichondritis, is a potential complication, as noted by the American Academy of Pediatrics 4
Abscess formation is a potential complication, according to the American Academy of Pediatrics 4
Cosmetic deformity is a potential complication, as noted by the American Academy of Pediatrics 5
Keloid formation is a potential complication, as advised by the American Academy of Pediatrics 4, 5