Wound Closure – Sutures, Staples, or Adhesives

Wound Closure – Types

Adhesive glue

• To use adhesive glue, your doctor:
  • Holds the edges of the wound together.
  • Paints the glue onto your skin. You may need more than one layer.
  • Covers your wound with a bandage (dressing) after the glue is dry.
• Adhesive glue may be used for:
  • Wounds that are not deep (superficial wounds).
  • Wounds on the face.
  • Children’s wounds.
• Adhesive glue is not used inside of wounds, or on wounds that are:
  • Deep.
  • Uneven.
  • Bleeding.
• Some benefits of adhesive glue are:
  • It leaves nothing that needs to be removed.
  • You do not need medicine to numb the area.
  • You have less pain than with other types of closure.

Adhesive strips

Adhesive strips are:

• Made of paper that is sticky (adhesive) and has many small holes it in (porous).
• Placed across your wound edges, like a normal bandage.
• Used to close very shallow wounds.
• Sometimes used with sutures to help improve closure.

Sutures

Sutures come in many different materials, strengths, and sizes. Some sutures break down as your wound heals (absorbable). Other sutures need to be removed (nonabsorbable).

To use sutures, your doctor:

• Sews your skin together with sutures and a needle.
• May use one long (continuous) stitch or separate stitches.
• Ties and cuts the sutures at the end.

Sutures can be used for all types of wounds, including under the skin. They can cause a skin reaction that can lead to infection.

Staples

Staples are often used to close surgical cuts (incisions). To use staples, your doctor:

• Holds the edges of your wound close together.
• Places a staple across the wound.
• Uses a tool to secure the staple to the skin.
• Repeats this with as many staples as needed.

Staples are faster to use than sutures, and they cause less reaction from your skin. Staples need to be removed using a tool that bends the staples away from your skin.

Doctors use stitches (sutures), staples, and glue (skin adhesives) to hold your skin together while it heals (wound closure). What your doctor uses depends on your wound.

In most cases, your wound will be closed right away (primary skin closure). Sometimes it may be closed later so that it can be cleaned and then heal naturally (delayed wound closure).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your doctor.
• If you were prescribed an antibiotic medicine, take it as told by your doctor. Do not stop taking the antibiotic even if you start to feel better.

Wound care

• Follow instructions from your doctor about how to take care of your wound and bandage.
• Wash your hands with soap and water before and after touching your wound or bandage. If you cannot use soap and water, use hand sanitizer.
• Do not try to remove your wound closures unless your doctor tells you to do that. You may need a follow-up visit for your doctor to remove your closures.
  • Closures may stay in place for 2 weeks or longer.
  • Absorbable sutures may break down after a few days or weeks.
  • If adhesive strip edges start to loosen and curl up, you may trim the loose edges.
• Do not pick at your wound. Picking can cause an infection.
• Apply ointments or creams only as told by your doctor.
• Check your wound every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Do not take baths, swim, or use a hot tub until your doctor approves. Ask your doctor if you may take showers. You may only be allowed to take sponge baths.
• Do not soak your wound in water.
• Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if you:

• Have any of the following:
  • A fever.
  • Chills.
  • Redness, swelling, or pain around your wound.
  • Fluid or blood coming from your wound.
  • Pus or a bad smell coming from your wound.
• Notice that your wound feels warm to the touch.
• Notice that the edges of your wound start to separate after your sutures come out.
• Notice that your wound becomes thick, raised, and darker in color after your sutures come out (scarring).

Summary

• What your doctor uses to hold your skin together while it heals (wound closure) depends on your wound.
• Your doctor may use stitches (sutures), staples, and glue (skin adhesives).
• Do not try to remove your wound closures unless your doctor tells you to do that.
• Do not soak your wound in water.