How do you repair these lacerations?
Do you just slap a band-aid on it?
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.
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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I had this question last night. Sounds like an effective (and fun, as we are all carpenters at heart) solution. Will try and report back. Only problem is, where can I find patients with lacs. Oh wait... :)
ReplyDeleteWould love a photo (consented by patient, of course) if you get a chance to do this. I don't use this trick too often since dermabond alone typically can fix the laceration. But when the skin is thin and a bit macerated, the steristrip-suture hybrid approach work well.
ReplyDeleteSee these references for more pictures of similar technique.
ReplyDelete1. Valente, Muetterties: Wound Care Issues. In Meldon, Ma, Woolard (eds.)Geriatric Emergency Medicine. 2004
2. Silk J: Injury Int J Care Injured 2001
JV
@JV: Wow, thanks for the references. Sounds like this trick is really a reminder that we often are reinventing the wheel. Published in 2001 and 2004, huh? Thanks!
ReplyDelete