Pediatric emergency medicine trisk 3390 3390

TABLE 110.3
COMMON TECHNIQUES OF WOUND CLOSURE
Technique

Advantages

Disadvantages

Sutures

Greatest tensile strength
Meticulous closure
Low dehiscence rate

Staples

Rapid application

Painful
Removal needed
Slow application
Increased tissue reaction
Risk of needlestick
(clinician)
Not for use on face (less
meticulous closure)

Tissue adhesive

Tape strips

Low cost
Low tissue reaction
Rapid application
Painless
No removal needed
Low cost
No risk of needlestick
(clinician)
Rapid application
Painless

Lower tensile strength
Not for use on joints
Not for use on bite wounds

High risk of dehiscence
Not for use in moist areas,
young children

Low cost
Low infection risk
Least tissue reaction
Tissue adhesives should be used only to close skin of superficial wounds. For
many lacerations, deep absorbable sutures will also be needed because the glue
has less strength than most sutures. Skin glues should not be used for wounds
subject to great tension, such as on the hands or joints, or bite injuries in which
occlusive closure increases the risk of infection. Table 110.3 summarizes
advantages and disadvantages of several techniques available for wound closure.