Principles of Wound Management Indiana University Department of Emergency Medicine Nurse Practitioner Lecture Series

Closure Materials Band-Aids® Steri-Strips® – Trim lifting edges with nailclippers… Tissue adhesive – N-butyl-2-cyanoacrylate (Dermabond®) – Will not work in areas with wound tension – Use 24 ga. needle to draw out, then inject on approximated wound edges

Closure Materials Staples – Least risk of infection (even less than best suture) – Less time consuming to use – Good tensile strength – Uncomfortable on pressure points – Avoid in areas that need good cosmetic closure

Closure Materials Suture Classified as absorbable and non-absorbable – Absorbable suture loses all tensile strength within 60 days Sized by diameter – 4-0 or 5-0 generally used on extremities and body – 6-0 used on face Suture is a foreign body… – Synthetic fibers are incite less immune response than natural fibers – Monofilaments have less risk for infection than braided suture

Suture Materials Nonabsorbable – Monofilament Nylon Prolene® – Polyfilament (braided) Ethibond® Mersilene® – Silk Absorbable – Plain Gut – Chromic Gut – Vicryl® – Dexon®

Instruments Needle driver

Instruments Forceps (Adson’s) Iris scissors