Butterfly closures are flexible adhesive products designed to hold the edges of a small cut together. These sterile strips function as a temporary way to approximate the skin, promoting natural healing without the need for traditional sutures. They are a common component of first-aid kits for managing minor skin breaks. This technique is intended for superficial cuts that do not penetrate deep into the skin’s layers.
When to Use Butterfly Closures
Applying a butterfly closure is appropriate only for minor lacerations that meet specific, low-risk criteria. The cut should be small, generally less than half an inch in length, and relatively shallow, affecting only the skin’s surface layers. Ideal wounds have clean, straight edges that can be brought together easily without significant tension. The wound must also have stopped bleeding after applying consistent, firm pressure for a few minutes.
Butterfly strips are not a substitute for professional medical attention. Never use these strips on deep cuts that expose underlying fat, muscle, or bone, or on wounds that are wide and gaping. Any cut that bleeds profusely or continues to bleed after five minutes of pressure requires immediate medical treatment. Puncture wounds, animal bites, or cuts with ragged, uneven edges should also be assessed by a healthcare professional due to the higher risk of infection.
Preparation and Application Techniques
Successful application depends on a clean, dry wound bed to ensure maximum adhesion. Start by gently washing the cut and the surrounding skin with mild soap and clean water to remove debris or contaminants. Pat the area completely dry with sterile gauze or a clean towel, as the adhesive will not stick reliably to moist skin. Ensuring the skin is fully dry is a critical preparatory step that prevents the strips from peeling off prematurely.
The first strip should be applied across the center of the laceration, positioned perpendicular to the cut. Begin by adhering one half of the strip to one side of the cut, pressing it firmly onto the dry skin. Use your fingers to gently pinch or press the two edges of the skin together, closing the gap. While maintaining this manual approximation, adhere the second half of the strip to the opposite side of the cut.
Avoid stretching the strip itself; the goal is for the strip to hold the skin edges together, not to pull them together with tension. Place subsequent strips above and below the first one, spacing them about 3 millimeters (one-eighth of an inch) apart. This spacing allows for proper drainage and minimizes the risk of moisture buildup. For added security, especially on limbs or joints, you can place a conventional adhesive bandage or medical tape lengthwise over the ends of the applied strips.
Monitoring and Safe Removal
Once applied, the butterfly closures should be left undisturbed for the wound to heal, remaining in place for five to ten days, or until they begin to curl and peel away naturally. Monitor the area closely for signs of infection. Indicators that professional attention is needed include increasing redness, swelling, warmth, pain, pus, or foul-smelling discharge. A fever is also a serious sign of systemic infection.
The strips should be removed gently only when the wound is visibly closed to prevent reopening the healing cut. If the strips have not fallen off after 10 to 12 days, soften the adhesive first. Soak the area in clean water or use a solution of half water and half hydrogen peroxide to loosen the sticky residue. When peeling them off, pull the strip horizontally, parallel to the skin’s surface, peeling from the ends toward the center of the wound. This technique minimizes the tension that could pull the newly formed skin apart.