Fragile or thin skin can tear while suturing under tension. Tissue adhesive tapes such as Steri-StripsTM are helpful, but may not have the tensile strength necessary for wound closure. The following technique combines the strength of suture material with the use of adhesive tape.
Medium- to high-tension wounds in patients with fragile skin such as the elderly or chronic steroid users.
Allergy to skin adhesive tape.
Lay tissue adhesive tape in parallel to the wound along the wound edges
Throw the needle through the tape to suture the wound closed using the simple interrupted technique
An alternative technique with adhesive tape oriented perpendicular to the wound.
Lay tissue adhesive tape perpendicular to the wound on one wound edge
Using tension, pull the wound closed with the tape and secure the tissue adhesive on the far side of the wound
Repeat steps one and two until the wound edges are opposed
Suture through the tape to further reduce tension using the simple interrupted technique
Advise patients to keep their wounds dry to avoid prematurely removing the adhesive tape. Use with caution in patients at high risk of infection because it will be more difficult for them to monitor for erythema or drainage.