Lacerations

Introduction – epidemiology

Prevalence – While there are no epidemiologic studies looking exclusively at ground crop work among migrant and seasonal workers, some regions, such as California have such a predominance of ground crops that they provide the best available measure of the most common hazards. In a large California injury study in 2003, lacerations were found to be the second most common injury, affecting 12% of respondents.

Mechanisms of injury – There is no single type of laceration incident that can be described. The McCurdy et al. study suggests that machinery and hand harvest work with knives are leading sources of laceration injury among ground crop workers. Because there is such a wide variety of tasks that can result in laceration, clinicians should ask the patient to describe the task and tools involved.

Special issues to consider in treating farmworker lacerations – Farmworkers with lacerations may wait longer than other patients before seeking treatment for lacerations, and are likely to return to work in a very dirty environment. Therefore, there should be a high level of concern for infection. In addition, farmworkers who are seen near the end of the season may not be able to return for follow-up visits (removing stitches or assessing healing). A return to work plan that recognizes that the patient is not likely to take time off to heal is likely to be followed more completely.

References:

Treatment:

Essentials of Skin Laceration Repair (Forsch, RT, Am Fam Physician. 2008 Oct 15;78(8):945-951.)

Patient Education:

Hand-out on Taking Care of Healing Cuts