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Old 12-01-2010, 10:43 PM   #3
Animad
 
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Join Date: Jun 2007
Location: UK

Information on Closing a Wound


What are Steri-strips?
They are the most common trade name for closure strips and there are similar products on the market known as Butterfly stitches (/bandages). Throughout the rest of this article we will refer to closure strips of Steri-Strips for ease though there are many other products are as good as Steri-Strips available on the market.

Steri- strips are thin pieces of specialised sterile tape, which can be used to hold the edges of a wound together in order to promote better healing, reduce the chances of infection and often result in reduced scarring.

Steri-strips do not hold wounds together as strongly as stitches would do, however, they work well for smaller cuts (recommended for wounds less than 4mm deep/ 5mm wide.) Their application is simple and almost painless and if used correctly they can leave less of a scar than stitches may do.

Never close a wound if it is over 24hrs old, shows signs of infection, or hasn't been thoroughly cleaned. See the wound care guide the information on that.

Any cut which is;
wider than 5mm
has bled for greater than 10mins with pressure on it
is down to fat
causes problems with movement in the area
you have areas of numbness/ electric shock feelings which you think may be caused by the wound
is on your face/ genitals/ near a joint or gaping at all and on your lower leg
needs to be assessed by a medical professional & not be steri-stripped by yourself.

The use of Steri-strips is NOT a replacement for good medical advice.


Preparing a cut for using closure
Only apply steri-strips once the wound and surrounding area has been thoroughly cleaned and it has stopped bleeding fully; 2hrs after bleeding has ceased is a good point as the clots are more stable. If it bleeds as you are applying them, stop and once apply pressure to the wound
If anything is embedded in the cut you NEED to get it checked out by a medical professional
Clean your hands and if possible apply latex/ medical gloves when dealing with the wound to reduce the chance of infection
Clean the cut and surrounding area; at least 5cm around the whole cut. Be gentle when you do this ensuring that no extra damage is done. You may use sterile swabs/ gauze to help you clean the wound and surrounding area. Clean the inside of the wound first and then move onto the surrounding area of skin; NEVER use anything that you've used to clean the surrounding skin back onto the cut- you will be transferring bacteria into it. Cleaning the wound may take a few minutes. It is best to use a saline solution, previously boiled lukewarm water, or a shop bought wound wash for cleaning wounds.
o NEVER use products that contain Hydrogen Peroxide or Alcohol. They damage the healthy cells, reducing healing. Saltwater is no longer advised either as it slows healing.
If you have some Tincture of Benzoine you may apply it finely and carefully 25-30mm away from the edge of the wound in a line parallel to its entire length and allow it to dry; this helps the strips to stick.



Directions for application
Work out how many you are likely to need by looking at the size of the cut; They should be placed the whole way down the length of the cut, leaving a gap between each one of 2 to 3 mm to allow any discharge to drain
Cut each Steri-strip to the correct length with clean scissors so that it is big enough for 30mm to be applied to the skin at either edge of the wound
Strips should be placed across a cut, not lengthways ie. the end of each strip should be applied 30mm away from the cut and the Steri-strip running perpendicular to it holding the wound closed.
Start applying them at the centre of the wound
Apply one half of the strip to the skin at one side of the wound and press it firmly into place.
Pull the skin at either edge of the wound together and press the other half of the strip down firmly so that the centre of the cut is held closed.
Complete the closure of the wound using additional strips, placed 2-3 mm from the next. You may need to reapply the first (or any other) strip(s) as it may have come loose when applying the rest.
Once the cut has been closed you can use 2 other steri-strips; 1 for either side of the wound. These should be placed covering the ends of the strips and parallel to the wound, holding them down to your skin for added security to form a '#' sort of shape



If the wound does not stop bleeding once the strips have been applied or the edges do not come together they may not suitable for your wound so further medical attention is advisable.

Care of steri-strips

The wound should be kept clean, dry and covered with a low-adherance dressing pad (e.g.Melolin)held in place with either a bandage or medical tape (or using an adhesive dressing). Ensure that the strips are totally covered by the gauze pad in the centre of the dressing.

If you need to take a shower, use a plastic bag held in place with water-proof tape to protect the area. Some really thin film based water-proof dressings (such as OpSite) may help keep the water out but be careful as some may leak. Generally the thinner they are the less likely it is for them to leak. As soon as you get out of the water check the dressing for any leaks and if it has leaked, remove the dressing, dry the area and apply more Steri-Strips if necessary and a new dressing .
If you go in the bath, try and keep the affected area out of the water.

Loose edges of the strips can be trimmed to prevent them from catching on things.

Monitor the wound for signs of infection. These include but aren’t limited to,
Thick, yellow/green, smelly, pussy discharge
Redness, swelling, pain around the area
Reduced healing
Increase in size of the wound
Red lines spreading from the cut into surrounding skin (Tracking)
Fever or chills
If you wound begins to show signs of infection, you should contact your doctor for advice as you may need anti-biotic treatment. Removing the strips if you feel it is infected is a good idea.


Removal of Steri-Strips
Steri-Strips should be left in place for 5-7 days for cuts a couple of mm wide or up to 10 days for ones up to 5mm wide or on areas of skin that are close to joints or on your lower arm/leg. Anything wider than this needs to be assessed by a doctor/nurse for stitches.
When removing them, be careful not to reopen the wound. It might be useful to soak the strips in some water as you remove them as this will loosen the adhesive holding them in place.

To remove them gently pull one end of the strip up at around a 45o angle to your skin and peal it away.

If the wound is not fully healed then continue applying dressings to it. If it reopens again soon after remove the Steri-Strips, you can Steri-Strip the wound closed again.

Making Butterfly Bandages
This is a practice that is the only advised if the wound needs closing and you haven't got any Steri-Strips available. Using shop bought closure strips is a much better idea than making your own, these will be sterile and also designed for this purpose so won't interfere with wound healing and won’t re-open wounds when removed.
Cut off lengths of Micropore Tape around 6 cm in length using clean scissors
At a third of its length, cut slits in the Micropore Tape, towards the centre on either side of the tape leaving the central third of the tape intact. Now do this at the other side of the length of tape.
This will leave to thick sections at the edge and then the centre which will have a flap on either side.
Fold the flaps into the central area on either side of the central portion of the Tape so it's not sticky
Apply in the same way as Steri-Strips, but have the non-sticky area overlying the wound
If possible, ensure you replace them with Steri-Strips if you have a chance to buy them, being careful and only taking one butterfly strip off and replacing it with one Steri-strip at a time to prevent re-opening.


Pictures of the making and application of 'butterfly stitches' which may make the process clearer for some people;







Last edited by Animad : 03-08-2011 at 05:41 PM.
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