Butterfly strips (often known as Steri-Strips) are specialized adhesive bandages designed for minor wound care. These strips function as a non-invasive way to approximate the edges of a clean, minor laceration. By holding the skin firmly closed, the strips stabilize the wound, promoting quicker tissue regeneration and minimizing the risk of scarring. They also provide a mechanical barrier that helps prevent the entry of external contaminants and bacteria.
Assessing the Wound for Closure
Before applying any closure strips, assess the injury to determine if it is suitable for home treatment. Butterfly strips are appropriate only for small, shallow cuts that have clean, straight edges and are not gaping widely when the skin is relaxed. The wound must be relatively clean, and any active bleeding must be controlled with firm, direct pressure for at least five minutes before the strips are applied.
Professional medical attention is required for any injury that is deep, longer than about half an inch, or shows fatty (yellow) tissue or muscle (dark red). Cuts that have jagged or irregular edges, are the result of a bite, or have foreign material embedded in them require professional cleaning and closure. Wounds located over joints or other areas with significant movement are also generally not suitable, as the motion can cause the adhesive to fail and the wound to reopen.
Detailed Steps for Applying Butterfly Strips
Before beginning the application process, the area surrounding the cut must be prepared to ensure optimal adhesion. The wound itself should be rinsed with clean water to remove any debris. The skin immediately around the laceration needs to be cleaned gently with mild soap and then dried completely. A dry surface is necessary for the adhesive to stick properly and maintain the tension required to hold the wound edges together.
The application should begin with the center-most strip placed perpendicularly across the laceration. Start by adhering one half of the strip to one side of the cut, pressing it down firmly onto the intact skin. With the first half secured, use your fingers to gently press the separated wound edges together, bringing them as close as possible without overlapping the skin. Once the edges are approximated, apply the second half of the strip to the opposite side of the cut, pressing it down firmly onto the dry skin.
It is important not to stretch the strip across the wound, as this can cause tension blisters on the surrounding skin. Subsequent strips should be added, alternating above and below the first strip, spaced approximately one-eighth of an inch (3 millimeters) apart, until the entire length of the laceration is covered.
For additional security, especially on limbs or areas prone to movement, shorter “anchor” strips can be placed parallel to the laceration, running across the ends of the perpendicular butterfly strips. This technique reinforces the closure and helps prevent the main strips from peeling up prematurely. The intentional gaps between the perpendicular strips allow for any minor wound drainage to escape and prevent moisture buildup, which could harbor bacteria.
Monitoring the Wound and Safe Strip Removal
Once the strips are applied, the wound should be kept clean and dry, especially for the first 24 to 48 hours, to allow the adhesive to fully set and maintain wound integrity. The strips are typically left in place for five to ten days, or until they begin to curl and fall off on their own. If the ends of a strip start to peel up before the full healing period, they can be carefully trimmed with small scissors to prevent the entire strip from being pulled off.
Daily monitoring of the site is necessary to check for signs of infection. If any of these signs develop, or if the wound reopens, medical consultation is necessary. The strips should not be forcefully removed, as this risks tearing the newly formed skin tissue and reopening the cut.
Signs of Infection
- Increasing redness
- Swelling
- Warmth
- Pain
- Presence of pus or a foul-smelling discharge
If the strips have not naturally fallen off after the recommended period, soaking them in warm water or a saline solution will help to loosen the adhesive. To remove a strip, gently peel it back horizontally, parallel to the wound line, rather than pulling straight up. Pulling parallel reduces the tension on the wound edges, minimizing the chance of disrupting the fragile healing tissue.