Choice of closure method for minor wounds

Method	Wound selection*	Wound with actively oozing blood	Use for wounds in hair or near moist regions of the body (eg, axilla, perineum)	Use if wound under tension (eg, hands, feet, or over joints)	Use in patients with conditions associated with poor healing^¶	Pain of repair	Speed of closure	Difficulty of technique
Sutures	Any laceration through the dermis, especially wounds that require careful wound approximation (eg, vermillion border)	Yes	Yes	Yes	Yes	+++	Slower	+++
Staples	Scalp wounds, wounds in noncosmetic areas, especially long, linear wounds	Yes	Yes	Yes	Yes	+++	Fast	++
Tissue adhesives	Linear wounds under low tension, skin tears and flaps in patients with fragile skin (eg, older adults)	No	No^Δ	No^◊	Yes	None/+	Fast	+
Wound-closure tapes	Linear, low-tension lacerations, skin tears and flaps in patients with fragile skin (eg, older adults)	No	No	No	Yes	None/+	Fast	+

* Wounds eligible for closure must be appropriately irrigated, debrided of all devitalized tissue and foreign bodies, and have no signs of infection. Refer to UpToDate topics on minor wound preparation.
¶ For example, diabetes mellitus, peripheral vascular disease, chronic steroid use, or history of keloids. The clinician should use judgment regarding whether wound closure is preferred to healing by secondary intention in such patients. Factors to take into account include the size of the wound, age of the wound, degree of wound contamination, and the severity of the underlying disorder.
Δ Tissue adhesives may be used on hairy areas such as the scalp, if the hair is first trimmed.
◊ Tissue adhesives can be used on hands, feet, or over joints, if the involved area is immobilized with a splint or cast.

Graphic 90472 Version 7.0

خرید پکیج

Choice of closure method for minor wounds