Butterfly wound closures, often called Steri-Strips or skin closure strips, are specialized adhesive bandages designed to secure and approximate the edges of a minor cut. These strips serve as a non-invasive alternative to traditional sutures for certain injuries, working by holding the two sides of a laceration together. The primary function of these strips is to encourage optimal healing by minimizing the tension across the wound, which can significantly reduce the potential for scarring. They are a common component of first aid kits due to their ease of application and effectiveness on small, clean injuries.
When to Use Butterfly Closures
These adhesive strips are suitable only for superficial cuts that are shallow and have clean, straight edges. A good indicator for appropriate use is a wound that is less than a half-inch in length and stops bleeding after a few minutes of direct pressure. Butterfly closures are designed to work on lacerations where the skin edges can be easily brought together without significant force or tension. They are also frequently applied to support a wound after professional sutures or staples have been removed.
Cuts that are deeper than a quarter-inch, gape open widely, or expose underlying fatty tissue or muscle are too severe for this treatment. Wounds with ragged or jagged edges, those resulting from animal bites, or any injury that continues to bleed heavily after five minutes of continuous pressure need immediate medical assessment. Using closure strips on an inappropriate wound may increase the risk of infection and lead to poor healing outcomes.
Necessary Wound Preparation
Preparing the injury site properly is paramount, as the success of the closure strip relies on maximum adhesion to the skin. First, ensure any minor bleeding has stopped by applying gentle, firm pressure with a clean cloth or gauze for several minutes. Next, the wound itself should be cleaned by gently rinsing it with cool, clean water to flush out any debris or foreign material. Cleaning the surrounding skin with mild soap and water is necessary to remove oils and dirt, but care must be taken to avoid getting soap directly into the open cut.
The most common reason for closure strip failure is moisture, so the surrounding skin must be completely dry before application. Use a clean towel to gently pat the skin area immediately around the cut until it is fully arid. The adhesive will not bond effectively to damp or oily skin, preventing the strip from maintaining the necessary tension for healing.
Step-by-Step Application Guide
Begin the application by perfectly aligning the two edges of the laceration with your fingers to approximate the skin surfaces. The first strip should be applied across the midpoint of the cut, as this centrally placed strip will establish the initial tension for the closure. Stick one half of the strip onto the skin on one side of the cut, pressing the adhesive down firmly to secure it. Do not allow this first half to cross the wound yet.
While holding the wound edges together, gently pull the second half of the strip across the cut so that the skin edges meet without overlapping. Avoid stretching the strip itself; the goal is to hold the skin edges that have already been brought together. Press the second adhesive end firmly onto the opposite side of the wound, ensuring the strip runs perpendicular to the length of the cut.
Continue applying additional strips along the length of the cut, working outward from the center strip toward both ends of the wound. Each subsequent strip should be placed approximately one-eighth of an inch (about 3 millimeters) away from the neighboring strip. This spacing ensures continuous support along the entire length of the laceration while allowing the skin to breathe. The final strips should be placed near the very ends of the wound to prevent the corners from pulling apart.
Aftercare and Safe Removal
Once the strips are in place, they should be kept as dry as possible, particularly for the first 48 hours, to maintain adhesive strength. The strips typically remain in place for approximately five to ten days, and it is usually best to allow them to fall off naturally. If the edges of a strip begin to curl up and become loose, you may carefully trim the loose portion with clean scissors to prevent accidental pulling on the wound.
Monitoring for Infection
Monitor the wound daily for any signs that could indicate an infection is developing beneath the closures. Seek medical advice if you notice increasing redness, swelling, warmth, or the presence of pus leaking from the wound.
Safe Removal
When it is time to remove the strips, soften the adhesive by soaking the area in warm water or applying a half-and-half solution of water and hydrogen peroxide. To avoid reopening the cut, gently peel each strip off by pulling the ends toward the incision line, rather than pulling them away from the wound.