Using Steri-Strips to Approximate Loose Skin Edges After Single Suture Placement
Yes, applying Steri-Strips to approximate loose skin edges after a single suture is appropriate and clinically beneficial, particularly when dealing with thin or poor-quality skin where the suture alone may cut through tissue. 1, 2
Primary Recommendation
The combination of sutures with Steri-Strips is specifically designed for situations like yours where skin quality is compromised or wound edges are difficult to approximate. The Steri-Strip prevents the suture from cutting through thin or loose skin while the tied suture removes tension from the Steri-Strip on the epidermis, preventing shearing forces that could damage fragile tissue. 2
Technical Application for Your Scenario
- Apply Steri-Strips perpendicular to the wound to hold the loose skin edges in proper approximation 1, 2
- The existing suture provides deep tissue support while the Steri-Strips distribute tension across a broader surface area, preventing the suture from tearing through compromised skin 2
- This combination technique is particularly valuable in thin-skinned patients where skin contracture and edema prevent easy opposition of wound edges 2
Evidence Supporting Combined Closure
Adding Steri-Strips to buried dermal sutures provides no additional benefit in normal-quality skin, but your situation differs because you have loose, folded skin that requires edge approximation support. 1 The American College of Surgeons recommends Steri-Strips for wound closure as they offer comparable or superior outcomes to traditional methods with lower wound complications 1
Critical Application Guidelines
- Facial wounds: Keep Steri-Strips in place for 5-7 days due to excellent blood supply 1
- Body wounds (trunk, arms, legs): Maintain for 10-14 days, with high-tension areas requiring the full 14-day duration 1
- Keep the wound completely dry for 24-48 hours to allow proper adhesion 1
- Avoid ointments, creams, or lotions near Steri-Strips as these loosen the adhesive 1
Daily Monitoring Requirements
- Check daily for increasing pain, redness, swelling, warmth, or discharge indicating infection 1
- Monitor for wound dehiscence, though this is rare with proper application 1
- Pain disproportionate to injury severity after 2-3 days indicates deeper complications requiring immediate evaluation 1
Important Caveats
- Premature removal risks wound dehiscence due to inadequate tensile strength development 1
- Prolonged application beyond recommended timeframes increases risk of adhesive dermatitis 1
- If wound edges separate despite Steri-Strips in place, this requires immediate medical attention 1
When This Approach May Be Insufficient
High-tension wounds may require additional suture support rather than relying on a single suture with Steri-Strips, as adhesive strips alone cannot provide sufficient tensile strength in mechanically demanding areas 1, 3