Wound closure can be accomplished with sutures, staples, adhesives, tapes, and specialized dressings. The best option can depend on the nature of a wound and the care provider’s personal experience. In some cases, a wound care specialist may be consulted to discuss the nature of an injury and develop a treatment plan to close and treat the wound. Patients discussing wound closure with their care teams may want to ask about risks such as scarring and infection with different options to determine the best choice for their needs.
In all cases, before wound closure can occur, the site needs to be carefully prepared. A care provider may need to flush the wound to clean out any debris and potentially infectious material. At home, washing the area with warm soapy water may be sufficient for mild cuts and scrapes. Some serious wounds require the placement of drains to allow exudate to flow out of the wound during healing. This can prevent the development of abscesses.
Sutures are among the oldest of wound closure technologies. With sutures, a care provider places a series of stitches at the wound site to draw the edges together and promote healing. A number of materials can be used to make sutures, some of which may be absorbed so the patient doesn’t need to visit a doctor for removal. They can be concealed with subcutaneous stitching techniques. Various injury types can be safely and successfully sutured closed.
Another option is surgical staples, which may be necessary for large injuries or wounds with a lot of tension. Staples are also much faster than sutures. Their primary disadvantage is that they tend to leave scars, which may not be desirable. Another option is a surgical adhesive, in which the edges of a wound are glued together with bio compatible materials. Adhesives are invisible, can reduce scarring, and may be suitable for a variety of injuries.
Tapes are used with some types of wound closure. In this case, the tapes are mounted across the wound to hold the edges together. This is usually not suitable for deep, severe wounds, but can work for small cuts and scrapes. Specialized dressings are also available. These include hernia repair meshes, used internally to prevent the recurrence of herniation.
Vacuum-assisted wound closure may be considered for very deep wounds that resist treatment with other methods. In this technique, a special sponge is placed into the wound, connected to tubing, and covered in a dressing. Fluid is drawn up into the sponge and into the tubing, while gentle pressure encourages the wound to close and granulate, forming healthy new tissues to fill in the space. Over time, the dressing size can be reduced, until the wound is small enough to manage with other methods.