Butterfly closures (Steri-Strips) are specialized adhesive strips used to manage minor cuts and lacerations. They function as a non-invasive alternative to traditional sutures, holding the edges of a wound together. These strips provide temporary support to the skin, facilitating a clean healing process for injuries that do not require professional medical intervention. They are a staple in first aid kits, allowing individuals to quickly and effectively close small wounds.
How Butterfly Closures Promote Healing
Butterfly closures mechanically aid the body’s natural healing process by reducing tension across the wound site. They are applied perpendicular to a cut, pulling the separated skin edges into close alignment. This action promotes healing by “primary intention,” the most efficient form of wound repair, which occurs when edges are neatly approximated. The strips stabilize the tissue, creating a bridge that allows new cellular components, such as collagen, to span the gap. Keeping the wound closed and immobilized minimizes the width of the scar tissue that forms, helping to achieve a better cosmetic outcome.
Determining When to Use Closures
Butterfly closures are suitable only for specific types of minor injuries that meet criteria for home care. The wound should be a clean, straight cut or incision, such as a shallow laceration, with edges that can be easily brought together. These closures are effective for superficial wounds generally less than half an inch long. The wound must not be actively bleeding heavily; blood flow must be controlled with direct pressure for at least five minutes before application.
Medical attention is necessary for any cut that is deep, gaping, or has jagged, irregular edges that cannot be neatly approximated. Wounds that expose deeper tissues, such as yellow fatty tissue or dark red muscle, require immediate professional care. Injuries caused by animal or human bites, puncture wounds, or those showing early signs of infection (like increased warmth, redness, or drainage) must also be evaluated by a healthcare provider.
Step-by-Step Application and Removal
Proper preparation is essential for successful closure. Begin by thoroughly cleaning the wound with cool water to flush out debris. The surrounding skin must then be gently washed with mild soap and water and patted completely dry, as the adhesive will not stick to wet skin.
To apply the strips, gently pinch the edges of the cut together to approximate the skin. The first closure should be placed across the center of the wound, securing one half to one side before pulling the other half over the cut to adhere to the opposite side. Additional strips are then applied parallel to the first one, spaced approximately one-eighth of an inch apart, until the entire wound is securely closed.
The strips are generally left in place until they begin to loosen or fall off, which can take up to 12 days. They must be kept dry for the first 48 hours. When removal is necessary, it should be done carefully to avoid tearing the delicate, newly formed skin. Soaking the strips in water can help loosen the adhesive. Peel them off gently, pulling from the ends toward the incision line, to prevent the wound from reopening.