Closing up Cuts at the Cobia Clinic
- mitchellcobia
- Jan 6
- 3 min read
There are several goals when considering how to close up a cut. First, we want to restore the function of the skin. Second, infection prevention- a nasty infection can turn a bad accident into a terrible tragedy- good cleaning and closing up the wound can help prevent this. Last, aesthetics. Some scars aren't welcome- some techniques are better at concealing the wound than others.
****************Fair warning: this post contains some images of wounds that can be unsettling! May not be suitable for the dinner table, children and the faint of heart.***********************************************************************************
Traditional Sutures:
Description: Sutures, or stitches, are probably the most traditional method for closing wounds. A tried-and-true classic. Very versatile, adaptable to most situations.
Pros:
Control: Offers surgeons precise control over wound edges. Allowing for a more precise wound juncture.
Strength: They are strong. This depends on the material used but they are among the strongest methods of closure, making it great for use over skin that moves such as over a joint.
Cons:
Invasive: Requires piercing the skin, and no one likes getting poked. Numbing prior is important, but no matter what it is not a pain free option.
Risk of Infection: This is minimal, compared to the already existing cut. But more holes in the skin is not good. Good irrigation and cleaning of the area prior helps minimize this risk.
Removal: Most sutures used in this setting need to be removed, which can be inconvenient and uncomfortable- but not usually terribly painful.
When to Use: Best for deep wounds, areas under tension, or where cosmetic outcome is crucial.
Adhesive Strips: (Butterfly Closures, Steri-Strips):
Description: These are thin adhesive strips applied across a wound to hold the edges together, mimicking stitches.
Pros:
Cons:
Limited Strength: Simply won't work if the skin is highly mobile.
Durability: Can get wet or peel off, reducing effectiveness.
When to Use: Ideal for small, at home use, for superficial lacerations where you're not too concerned about aesthetic outcomes.
Tissue Adhesives (Dermabond):
Description: Cyanoacrylate adhesives (like Dermabond) are used to glue edges of the skin together.
Pros:
Pretty Near Pain Free: No needle pokes. Used often in kids.
Waterproof: Once set, it creates a barrier against infection.
Cons:
Durability: Does not have the durability of regular stitches, so areas that move or wet are a problem with tissue glue.
Heat Sensitivity: Some adhesives can react to heat, potentially causing burns. Not common, I have never seen it, but possible.
When to Use: Suitable for clean, straight-edged lacerations, especially in areas with low tension.
Staples:
Description: basically, what it sounds like, it's a big staple gun.
Pros:
Speed: Faster application in long lacerations or scalp wounds. Frequently used to seal up long surgical incisions.
Strength: Strong hold, ideal for areas under tension or with thick skin.
Cons:
Aesthetics :Tends to leave more of a scar than traditional sutures.
Invasive: These require more holes in the skin. So, they are about as painful as traditional sutures. Lidocaine is necessary.
Removal: Requires a staple remover, which can be intimidating for some. But not usually painful.
When to Use: Commonly used for scalp lacerations or after cesarean sections due to quick application and strong closure.
This was your quick course of stitches 101. I hope you now understand a little bit more about what is out there and how we use it to treat different types of cuts. If you have a cut, come see me at the Cobia Clinic. We we'd love to take care of you. 801-407-9595
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