From the Research
Scalp lacerations should not be closed with staples or sutures beyond 24 hours of injury, as the risk of infection increases significantly after this time window. The decision to close a scalp laceration with staples or sutures depends on various factors, including the time elapsed since the injury, the wound's cleanliness, and the presence of signs of infection.
Key Considerations
- The risk of infection increases significantly after 24 hours, making primary closure less ideal beyond this timeframe 1.
- For patients presenting between 24-48 hours after injury, closure may still be considered after thorough cleaning and irrigation, but with caution and possibly prophylactic antibiotics.
- Beyond 48 hours, primary closure is typically not recommended, and the wound should be left to heal by secondary intention (healing from the inside out) 2.
- The scalp's rich blood supply promotes good healing but also increases infection risk when closure is delayed.
Management Strategies
- If a wound cannot be closed primarily, keeping it clean with gentle soap and water, applying antibiotic ointment, and covering with a sterile dressing will help manage it until it heals naturally.
- For very contaminated wounds or those with signs of infection (redness, warmth, purulent discharge), closure should be delayed regardless of timing.
- The use of staples or sutures should be based on the individual case, considering factors such as wound size, location, and patient health status 3.
- Absorbable sutures can provide the same cosmetic and functional results as non-absorbable sutures, and their use can reduce patient returns and save resources 4.