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Use of existing lacerations

Horizontal lower lid laceration

Principles

General considerations
Facial fractures are often associated with lacerations. These existing soft-tissue injuries can be used to access directly the facial bones for management of the fractures.
The surgeon may elect to extend the laceration to attain enough access to the fractured area, placing additional incisions starting from the wound margins along the relaxed skin tension lines (RSTL).
Bacterial contamination is not a contraindication for the use of existing lacerations for surgical approach.

Access to infraorbital rim and orbital floor through a horizontal lower lid laceration is shown.