Scalp lacerations caused by sharp objects typically present with neat wound margins and are often limited to the scalp, though they may extend as deep as the periosteum. In most cases, the skull remains intact. However, in some instances, sharp objects may penetrate into the cranial cavity, traversing the skull and dura mater, resulting in open brain injuries. In contrast, scalp lacerations caused by blunt objects are often irregular in shape, with contusion marks at the wound edges. These injuries may be accompanied by skull fractures or brain injuries at the point of impact.
A scalp laceration is an open injury to the scalp and should be addressed as soon as possible with debridement and suturing. Even if the injury has been present for 24 hours, as long as there are no signs of obvious infection, thorough debridement followed by primary closure is still feasible. During the procedure, hair, sand, and other foreign objects within the wound should be thoroughly removed. Severely necrotic or contaminated scalp tissue should be excised, but excessive removal should be avoided to prevent tension during suturing. Any skull fractures or bone fragments should be carefully observed during debridement. If cerebrospinal fluid or brain tissue is noted to be leaking, the injury should be managed as an open brain injury. Postoperatively, antibiotic therapy should be administered.