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Staples can be applied more rapidly than sutures and have a lower rate of
infection, with less of a foreign-body reaction. They are best for wounds of the
scalp, trunk, and extremities when saving time is important and cosmesis is less
of a concern. Therefore, they are particularly helpful when treating mass
casualties, or when restraining a patient with a suitable wound is challenging.
Staples are left in place for the same length of time as sutures. They are somewhat
more painful to remove and should be removed with a specially designed
instrument to avoid tissue damage. Staples do not allow for meticulous cosmetic
repair as with sutures. Thus, they should not be used for lacerations of the face,
neck, hands, or feet. They should also not be used if the patient requires magnetic
resonance imaging (MRI) or computed tomography (CT).

Painless Alternatives to Sutures
Skin tape causes no suture marks, minimal tissue reaction, and fewer wound
infections than sutures. Tape strips, cut to size, can be used to take up tension at
the wound margins and can be placed between sutures, or can be placed over
absorbable sutures for additional protection. These strips are also useful as the
only means to close simple lacerations that extend just through the dermis. They
may be as useful as tissue adhesives for facial lacerations in children. Multiple
tangential, triangular skin flaps (e.g., those created when an unrestrained
passenger hits the windshield of a car) are closed well with tape strips. Likewise,
old or contaminated wounds, such as dog bites on the extremities, can be loosely
approximated with skin tape.
When tape is used, the wound should be cleansed as any other wound. Care
must be taken to properly realign the dermis and epithelium. If the tape is pulled
too tightly, the margins of the wound may overlap, causing the wound to heal
with a raised ridgelike area where the overlap occurred. The tape is applied
perpendicularly across the wound with some space between to allow the wound to
drain. An adhesive such as benzoin can keep the strips more secure if it is applied
to the adjacent skin (not the wound) and allowed to dry before applying the tape
strips. Importantly, benzoin can cause intense burning sensation if it comes into

contact with the wound and should be applied at least 2 to 3 mm away from the
wound edge but within a reaching distance of the tape. Some recommend leaving
the taped wound uncovered because a bandage may increase moisture and cause
the tape to fall off prematurely.
Tape strips should not be used on wounds subject to tension, such as those over
flexor surfaces of joints. They should not be applied in areas of the body that are
moist, such as the palms or axillae, because they will not adhere. They may be