Tissue Adhesive Tape

Surgical tape for closure of traumatic wounds is an old technique that we often neglect to consider in the ER.  Tapes are most useful for superficial lacerations under little tension–but don’t forget about undermining and placement of deep dermal sutures to minimize tension, which can allow tape closure for the superficial layer.

In recent years, combination techniques including use of tissue adhesive glue or sutures with tape have been described as means to reinforce a wound and minimize tension.  Tape is also an ER go-to method for thin, fragile skin, such as closing skin tears in the elderly.

Advantages of using tapes: they are quick, easy and painless to apply, they don’t leave marks as sutures can, there is no need for an office or ER visit for removal, and they are more infection resistant than sutures or staples.

Disadvantages of using tape: they don’t work well when tension is significant. They are difficult to apply on irregular wounds, convex surfaces, or in areas of marked tissue laxity. They don’t stick well in moist or hairy areas, such as mucosal surfaces and areas that tend to sweat, like the axilla and groin.  Exudative wounds are also at risk of tape dehiscence.  And I’d be very careful about choosing tape in a young child–though it is tempting as they are painless and much less scary, everyone knows that kids love to peel off and play with “stickers.”

Multiple commercial brands are available for use. The most familiar to me are steri-strips, but I have no financial interest in this brand or any product.

The video above demonstrates proper application of tissue adhesive tapes, and some of the important principles to keep in mind in their application. Disclaimer: they don’t stick as well to a slimy pig’s foot as compared with properly prepared human skin!

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