2025 Volume 46 Issue 3 Pages 200-206
We report a case of a patient with intellectual disability and epilepsy who was taking multiple medications and suffered a perforated laceration of the upper lip after a fall. His wounds were successfully healed through collaboration between facility staff and dentists.
The patient was a 30-year-old man who visited the hospital complaining of a fall at a residential facility two nights prior that resulted in a wound that penetrated from his upper lip to the inside of his mouth. The patient had intellectual disability and epilepsy and was taking multiple medications for the treatment of his illnesses that caused dizziness as a side effect. With the cooperation of an oral surgeon, the patient was examined under local anesthesia and diagnosed with a laceration and suppurating wound on the upper lip that had penetrated from the facial skin on the outside of the right upper lip to the mucosa on the inside of the upper lip and had suppurated, reaching the muscle layer. The patient had a habit of inserting his hand into his mouth to remove any foreign objects that bothered him. When a laceration is sutured, it is expected that patients will be concerned about the suture and touch it, and will try to remove it forcefully, causing the suture to become tense. Because the wound had stopped bleeding and the wound was purulent, drainage was expected to be effective, so the decision was made to expect healing without suturing by cleaning the area and prescribing antibiotics to prevent the infection from worsening. A scab formed after one week, the laceration closed, and one month later, the wound had healed, although slight scarring was observed.
Considering the patientʼs characteristics and the extent of the wound, the wound was not sutured, and with the collaboration of facility staff, the wound healed with the help of cleaning the area and administering antibiotics. It was important to provide care in collaboration with the facility staff.
