Butterfly wound closures are a simple method for managing minor cuts and lacerations. These adhesive strips are common in first-aid kits, offering a temporary solution to bring skin edges together. They promote natural healing by keeping the wound approximated, which can also help reduce scarring. Understanding their proper application and limitations is important for effective at-home wound care.
Understanding Butterfly Closures
Butterfly closures are adhesive strips, typically made from a porous, non-woven backing with hypoallergenic adhesive. They are designed with a narrow center and wider adhesive pads on either side, resembling a butterfly shape. Their primary function is to apply gentle tension across a minor cut, drawing skin edges closer together. This mechanical approximation stabilizes the wound, allowing natural healing mechanisms to bridge the gap and form new tissue. By holding the wound closed, they facilitate a cleaner healing process.
When to Use and When to Avoid
Butterfly closures are suitable for small, shallow cuts with clean, straight edges that are not actively bleeding. They are suitable for minor lacerations or incisions less than about 1/2 inch long and not very deep. They are a good choice for superficial wounds where edges can be easily brought together without significant tension.
However, butterfly closures are not appropriate for all wounds. Avoid them for deep cuts where fatty tissue or muscle is exposed, gaping wounds, or those with ragged or uneven edges. Wounds that are actively bleeding, or continue to bleed after 5 to 10 minutes of direct pressure, require medical attention. They are also not effective for puncture wounds, animal bites, or cuts in areas of high movement like joints, as they may not adhere properly or provide adequate support.
Applying Butterfly Closures Step-by-Step
Initial Placement
Before applying a butterfly closure, thoroughly wash your hands with soap and water to prevent contamination. Next, gently clean the wound with cool water to remove dirt or debris. Also clean the surrounding skin with mild soap and water, then allow the entire area to dry completely, as adhesive sticks best to clean, dry skin.
Securing the Closure
Once the wound and surrounding skin are clean and dry, carefully hold the two sides of the cut together, bringing edges as close as possible. Take a butterfly closure strip and remove its backing to expose the adhesive. Place one half of the adhesive pad on the skin to one side of the cut, ensuring the non-sticky, narrow center is positioned directly over the wound.
With the first half secured, gently pull the other adhesive pad across the wound, applying enough tension to bring skin edges together without excessive puckering or discomfort. Press the second half firmly onto the skin on the opposite side of the cut. The closure should be applied perpendicular to the cut, not lengthwise, to effectively approximate the wound margins.
Additional Closures and Security
For longer wounds, apply additional butterfly closures about 1/8 inch apart, alternating their placement above and below the first strip to ensure consistent wound approximation. An optional step involves placing additional strips of adhesive tape horizontally over the ends of the butterfly closures for extra security, especially in areas prone to movement.
After Application and Seeking Medical Care
After applying butterfly closures, keep the wound area clean and dry, avoiding excessive movement of the affected body part, as this can cause the strips to loosen or fall off prematurely. Butterfly closures remain in place for up to 12 days, or until they begin to loosen on their own. When it is time for removal, or if the strips remain after 12 days, do not forcefully pull them off. Instead, soak the area with a solution of half water and half hydrogen peroxide to loosen the adhesive. Gently lift the edges of the strips and slowly peel them off in the direction of the wound to avoid reopening the healing skin.
Seek medical attention if the wound continues to bleed after applying pressure for 5 to 10 minutes, or if you observe signs of infection such as increasing redness, swelling, warmth, pus, or worsening pain. Other indicators for medical evaluation include a wound that is very large or deep, has jagged edges, involves an animal bite, or if you experience loss of feeling or movement in the affected limb.