Trick of the Trade: Tie-over dressing for scalp lacerations

Scalp lacerations are apparently a hot topic these days. This is the third post now on how to apply a bandage to a scalp laceration.

• Beanie hat using tubular gauze
• Hair braid dressing

Trick of the Trade

Tie-over dressing technique

• After suturing a laceration in place, leave the suture tails 6-8 cm long.
• Roll up a piece of gauze.
• Place the gauze roll on top of the sutured laceration.
• Secure the gauze using the long tails of the sutures.
• After 1-2 days, the patient should cut the tied-over knots to remove the gauze. This allows the wound to be inspected and cleaned.

For step-by-step photos, check out Dr. Gemma Morabito et al’s Medicinadurgenza website post.

I have a question though

I suture scalp lacerations only if the patient is balding or bald in the area. How would I bandage if you use staples instead of sutures for the scalp? I imagine my options:

• Beanie hat approach
• Hair braid dressing
• Place 2-3 sutures to help close the laceration (interspersed amongst the staples) just to do a tie-over dressing
• Don’t bandage. Just cover up the staples with the overlying hair.

Thanks to Dr. Gemma Morabito (Rome, Italy) and Vincenzo Peloponneso (nurse in Cuneo, Italy) for the idea and images!

Reference
Ginzburg A, Mutalik S. Another method of tie-over dressing for surgical wounds of hair-bearing areas. Dermatol Surg. 1999 Nov; 25(11):893. .

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