Butterfly stitches, more accurately known as adhesive wound closure strips, are a common component of home first-aid kits. They function as a temporary solution for managing small cuts and lacerations. These strips are designed to approximate the edges of a wound without the need for traditional sutures or needles. This non-invasive method holds the skin together, aiding the body’s natural healing process for minor injuries.
Mechanism of Wound Closure
The effectiveness of adhesive wound closure strips stems from their ability to physically pull and hold the edges of a laceration together. The strips are typically made from a porous, non-woven material, often reinforced rayon or polyamide, which allows the skin to breathe and prevents the buildup of moisture. A hypoallergenic, pressure-sensitive adhesive, frequently acrylic-based, coats the strip and provides a strong bond to the skin surrounding the injury.
When applied correctly, these strips reduce the tension across the wound, minimizing scar formation and promoting faster healing. By keeping the skin edges closely aligned, the strips facilitate healing by primary intention, where the wound closes cleanly. The reinforcement filaments embedded within the backing material provide the necessary tensile strength to keep the cut closed even with minor movement. This stabilization allows the underlying tissue to repair itself without being pulled apart.
When Butterfly Strips Are Effective
Adhesive strips are most effective for small, shallow, and clean cuts with straight edges that are under minimal tension. They are well-suited for minor lacerations typically less than half an inch long that have stopped bleeding and do not extend deep into the dermal layer. These strips are also frequently used to provide additional support to a wound after traditional sutures or staples have been removed, ensuring the newly formed tissue remains intact.
The limitations of adhesive strips are determined by the severity and nature of the injury. They are not appropriate for deep cuts that expose fat or muscle, wounds that are gaping open, or those with ragged, uneven edges that cannot be easily approximated. Cuts located over highly mobile areas, such as joints, or in regions that are moist or hairy, may also not adhere properly, making traditional sutures a more secure option.
When to Seek Medical Attention
Wounds that bleed profusely for more than five minutes after applying pressure, or those contaminated with dirt or foreign objects, require immediate professional medical attention. Seeking medical care is mandatory for any deep, puncture, or animal-related wound, regardless of its size, to ensure proper cleaning and evaluation for infection or underlying damage.
Applying and Caring for the Wound
Proper preparation begins by washing your hands thoroughly and gently cleaning the wound with cool water to remove debris. The surrounding skin must then be cleaned with soap and water and dried completely, as the adhesive will not bond securely to wet or oily skin. Applying a liquid adhesive product to the surrounding skin can further maximize the strips’ adherence, though this is optional.
To apply the strips, the wound edges must be held together manually to achieve the closest possible alignment. The strip is then placed perpendicularly across the cut, with the center of the strip bridging the laceration. Secure one half of the strip to the skin, then gently pull the other half across to maintain the approximation of the edges before pressing it firmly onto the opposite side. Additional strips should be placed across the wound, spaced about one-eighth of an inch apart, until the entire laceration is supported.
After the strips are in place, the area should be kept clean and dry, especially for the first 48 hours, to ensure maximum adhesion. If the ends of a strip begin to loosen, it is safer to trim the loose edges with scissors rather than pulling them, which could reopen the wound. The strips can typically remain in place for up to 12 days, and they should be allowed to fall off naturally if possible. If manual removal is necessary, it should be done gently by loosening the ends and peeling the strip back parallel to the skin surface, which minimizes the risk of tearing the newly healed tissue.