Lacerations of elderly patients or chronic corticosteroid users can be a challenge because they often have very thin skin. Sutures can tear through the fragile skin. Tissue adhesives may not adequately close the typically irregularly-edged laceration.
How do you repair these lacerations?
Do you just slap a band-aid on it?
Trick of the Trade
Use a steristrip-suture combination approach.
Apply steristrips to reapproximate the wound edges. Reinforce the steristrips with suture material, as demonstrated in the article’s figure. The steristrips provide an artificial layer of “skin”, which sutures can use to reapproximate the wound edges.
My commentary
While I haven’t used the approach described in this article, I have, however, used steristrips positioned in parallel with the wound edge (rather than perpendicularly). Borrowing from the article’s figure, I drew in the longitudinally-positioned steristrips to show how I’ve done it in the past. It works great. I don’t use the perpendicular steristrips. I find that longitudinal steristrips provide even tensile strength along the wound edges.
Reference
Davis M, Nakhdjevani A, Lidder S. Suture/Steri-strip combination for the management of lacerations in thin-skinned individuals. J Emerg Med, 2011. 40(3), 322-3. PMID: 20880653.
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