How long should sterile strips (steri-strips) stay in place for a facial laceration?

Duration of Steri-Strips for Facial Lacerations

Steri-Strips for facial lacerations should remain in place for 5-7 days to ensure proper wound healing while minimizing scarring. 1

Rationale for Timing

• Facial skin has excellent blood supply and heals more rapidly than other body areas, allowing for earlier removal of wound closure materials 2
• Facial wounds are often considered an exception to standard wound closure timing guidelines and can be managed differently than wounds in other locations 1
• Facial lacerations typically require shorter healing time before removal of closure materials compared to high-tension areas like the anterior tibia (which requires 14 days) 2

Benefits of Steri-Strips for Facial Lacerations

• Steri-Strips provide essentially painless closure for low-tension wounds on the face 1
• They are less expensive than tissue adhesives like Dermabond while providing similar cosmetic outcomes 3
• Steri-Strips are particularly useful for facial wounds that need gentle approximation to minimize scarring 1

Proper Application and Removal

• Steri-Strips should be applied after thorough wound cleansing with sterile normal saline 1
• For facial wounds, approximation of the margins by Steri-Strips allows for optimal cosmetic results 1
• When removing Steri-Strips after 5-7 days, assess the wound for:
  • Complete wound edge approximation 2
  • Absence of significant swelling or erythema 2
  • No signs of infection or drainage 2

Special Considerations

• For children or uncooperative patients, Steri-Strips may be particularly advantageous as they cause less pain and distress than sutures 4
• A novel technique combining continuous locking sutures with Steri-Strips has shown better aesthetic results and less pain during removal compared to simple interrupted sutures 4
• In some cases, combining tissue adhesives with underlying Steri-Strips may be beneficial for wound approximation, though this takes longer to apply 5

Potential Complications of Improper Timing

• Removing Steri-Strips too early (before 5 days) may result in wound dehiscence due to inadequate tensile strength 2
• Leaving Steri-Strips in place too long on the face may increase the risk of skin irritation or adhesive-related dermatitis 1
• Unlike high-tension areas that require longer healing time, facial wounds may develop more noticeable scarring if closure materials remain in place too long 2

Alternative Closure Methods

• For facial lacerations, other options include tissue adhesives (like octylcyanoacrylate) or absorbable sutures, which show similar 9-12 month cosmetic outcomes compared to non-absorbable sutures 6
• The choice between Steri-Strips and tissue adhesives should consider wound characteristics, with Steri-Strips being preferred for longer or more complex facial lacerations 3