Butterfly stitches, also known as Steri-Strips or wound closure strips, are a simple, non-invasive method for managing minor skin lacerations. These narrow adhesive strips hold the opposing edges of a cut together, closing the wound without traditional sutures. Their primary purpose is to promote natural healing, reduce infection risk by sealing the injury, and minimize scarring. These strips are a temporary solution intended for superficial injuries that can be safely managed outside of a professional medical setting.
Deciding If Butterfly Stitches Are Appropriate
The decision to use adhesive strips depends on a careful assessment of the injury, as they are only suited for specific minor wounds. The cut must be relatively shallow, involving only the top layers of skin, and should have clean, straight borders that come together easily. The wound should also be small, typically no longer than half an inch in length. Any bleeding must be minimal or easily stopped with light pressure within five minutes, allowing the strips to provide sufficient support for healing.
However, certain signs indicate the wound requires immediate professional medical attention and is not suitable for at-home treatment. Seek care immediately if the wound is deep, gaping open, or if you can see fat or muscle tissue inside the injury. Any cut that continues to bleed profusely after applying direct pressure for ten minutes, or a wound located on a major joint like the knee or elbow, should be evaluated by a healthcare provider. Puncture wounds or cuts with ragged, uneven edges also necessitate professional assessment because of the higher risk of deep tissue damage or infection.
Preparing the Wound and Surrounding Skin
Before applying wound closure strips, preparation of the injured area is necessary to prevent infection and ensure proper adhesion. Begin by washing your hands thoroughly with soap and water to minimize bacteria transfer. Next, gently cleanse the wound using mild soap and clean running water to flush out debris or foreign particles. Avoid using harsh antiseptics like hydrogen peroxide or alcohol directly on the cut, as these can damage healthy tissue and delay healing.
Once the wound is clean, firmly apply gentle pressure with a sterile gauze pad to stop any residual bleeding. The most important step for successful strip application is ensuring the surrounding skin is completely dry. Adhesion is compromised by moisture or natural skin oils, so pat the area dry with a clean towel or gauze, and allow the skin to air-dry. Poor preparation can cause the strips to lift prematurely, potentially leading to the wound reopening.
Step-by-Step Application Technique
With the wound cleaned and the surrounding skin dry, you can begin the application process, which focuses on bringing the edges of the cut into close contact. The first strip should be applied at the center of the wound, acting as the anchor for subsequent strips. Secure one half of the strip to the skin on one side of the cut, ensuring it is positioned perpendicular to the laceration.
Next, use your fingers to gently push the two sides of the wound together, bringing the edges flush with each other. While holding the edges tightly approximated, pull the second half of the strip smoothly across the cut and adhere it to the opposite side. Avoid stretching the strip during application, as this creates tension that may cause blistering or premature lifting. The goal is simply to let the strip hold the approximated skin edges together naturally.
Place additional strips on either side of the first one until the entire length of the wound is closed. Each subsequent strip should be spaced roughly one-eighth of an inch (about three millimeters) apart to allow for minor drainage and provide continuous support. If the wound is long or subject to movement, consider placing a final “anchor” strip lengthwise over the ends of the perpendicular strips on both sides. This extra strip helps secure the ends and maintains the integrity of the closure.
Follow-Up Care and Safe Removal
Proper aftercare is necessary to encourage healing and avoid complications once the strips are in place. For the first twenty-four to forty-eight hours, keep the wound site completely dry to allow the adhesive to fully bond with the skin. After this initial period, you can shower, but gently pat the area dry immediately afterward and avoid scrubbing or rubbing the strips. Monitor the wound daily for signs of infection, such as increasing redness, swelling, warmth, or pus discharge, and seek medical advice if these symptoms develop.
The strips are designed to remain in place for five to ten days, or until they begin to loosen and fall off naturally. They should not be forcefully removed while adhering strongly, as this risks pulling on the newly formed tissue and reopening the cut. If the strips have not fallen off after ten days, gently loosen them by applying a small amount of water or petroleum jelly to the ends. To remove them safely, slowly peel each one back from the ends, pulling parallel to the wound line rather than pulling away from the skin. This technique minimizes stress on the healing incision and preserves the wound’s closure.