Trick of the Trade: Steristrip-suture combo for thin skin lacerations
When geriatric patients or those who chronically utilize corticosteroids develop lacerations it can be difficult for healthcare providers to determine the most efficient method of treatment. Oftentimes, these patients have very thin skin which can make it relatively simple for sutures to tear through the skin. In order to avoid this undesirable outcome, healthcare professionals should be knowledgeable of various methods of treatment that can be utilized for lacerations on these types of patients.
Overview of Steristrips
Though traditional sutures have ruled the surgical field for decades, other forms of surgical closure were recently discovered and have gained popularity on a national basis. These new found non-woven, adhesive strips, or steristrips, are commonly utilized in healthcare facilities to close small incisions and wounds. By holding the edges of an incision together, surgeons often use steristrips in place of sutures based on their distinct advantages over sutures.
Delicate areas that are contoured or located in regions where traditional sutures would be difficult to maintain can benefit from the use of steristrips and may improve patient recovery, as well as patient satisfaction. These devices have been known to reduce the risk of infection, as they fall off on their own as the wound heals. This may reduce the inconvenience of scarring and stress that is relevant to healing with traditional sutures.
Potential Methods of Laceration Repair
Since tissue adhesives do not usually provide adequate closure for lacerations that feature irregular edges. As a result, a steristrip combination approach may provide optimal results. In this case, applying steristrips to reapproximate wound edges and reinforcing these strips with sutures may provide an artificial layer of skin. In this manner, sutures can be used to reapproximate the wound edges.
Preferred Steristrip/Suture Utilization
Though use less regularly, steristrips may also be positioned in a parallel fashion (rather than perpendicularly) to the wound edge. In essence, longitudinal steristrip application provides tensile strength, even along wound edges. Through this form of closure, the strip prevents the suture from tearing through the thin skin. Simultaneously, the suture eliminates tension produced from the strip, reducing the change of tearing.
Wound Care
As with any other type of closure, constant maintenance of wounds and lacerations is crucial to recovery. The routine use of antibiotic ointment and mild soap is recommended by most surgeons. However, these strips generally fall off on their own once the wound has closed enough to release tension and loosen the adhesive. However, it is important to patients to leave the laceration alone in order to promote healing.
Closing Thoughts
Therefore, this quick and simple technique is optimal for alleviating complications that are prevalent with other methods, reducing the possibility of farther morbidity. It provides emergency physicians with a logical way to deal with skin contracture and inflamed wounds that prevent easy closure.
