Management of Head Laceration Requiring Staples
For scalp lacerations requiring closure, use metal staples as the primary closure method—they are faster, equally effective, and safer than sutures while producing comparable cosmetic outcomes.
Initial Wound Assessment and Preparation
Before closure, perform a systematic evaluation of the wound:
- Assess wound characteristics including size, depth, degree of contamination, and precise location to confirm staples are appropriate 1
- Irrigate thoroughly with 100-1000 mL of tap water or saline solution to reduce infection risk 1
- Provide adequate anesthesia before any wound manipulation using topical anesthetics (LET solution: lidocaine, epinephrine, tetracaine) or local infiltration as needed 1
Key Pitfall to Avoid
Do not attempt closure without proper anesthesia—this increases patient discomfort and makes proper wound approximation difficult 1.
Staple Application Technique
Staples are the preferred closure method for scalp lacerations based on multiple comparative studies:
- Speed advantage: Stapling is 2.7 times faster than suturing, with significantly reduced procedure time 2, 3
- Pain reduction: Stapling causes less pain during application compared to suturing 2
- Safety benefit: Staples eliminate risk of needle-stick injury to the provider 2, 4
- Equivalent outcomes: No difference in infection rates, wound healing, or cosmetic results compared to sutures 2, 4, 3
The evidence consistently demonstrates that staples are simpler to use and particularly suitable for busy clinical settings 4.
Post-Closure Management
Pain Control
- Use acetaminophen and ibuprofen as first-line analgesics 1
- Apply ice packs to reduce swelling and discomfort 1
- Avoid opiates unless absolutely necessary
Wound Monitoring
- Watch for infection signs: increased pain, redness, swelling, or purulent discharge 1
- Schedule follow-up at 5-7 days for staple removal 2
- Avoid excessive tension during closure to prevent tissue necrosis and poor cosmetic outcomes 1
Staple Removal Timing
Staples should be removed at approximately 5 days post-closure, with no significant differences in ease of removal compared to sutures 3.
Cost Consideration
While staples are more expensive than sutures per unit, the significantly reduced procedure time offsets this cost difference in most clinical circumstances 4, 3.