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By Michelle Lin

Specialty: Emergency Medicine

Blog: http://academiclifeinem.blogspot.com

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Michelle Lin's Twitter Updates

@precordialthump I totally forgot about the EKG library! Awesome stuff. Keep up the great work (when do you sleep?!) 258 days ago

@emeducation Perfect, thanks for the suggestions! Turns out one is co-authored by Jeff Tabas. He already gave them all books. 258 days ago

Recommendations for an EKG resource to review bread & butter cases for senior residents? Pre-graduation panic setting in for our residents. 258 days ago

@danipedia Good point. I use the studies to convince the trauma consults NOT to get c-spine imaging on EVERYONE (citing distracting injury)! 263 days ago

@doctorflash Hi there. Just wanted to drop a note to thank you for all the extra traffic you're sending to blog. Much appreciated!! 273 days ago

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Trick of the Trade: Tie-over dressing for scalp lacerations

Posted Dec 20 2011 12:00am

Scalp lacerations are apparently a hot topic these days. This is the third post now on how to apply a bandage to a scalp laceration.

Trick of the Trade:
Tie-over dressing technique

After suturing a laceration in place, leave the suture tails 6-8 cm long.
Roll up a piece of gauze.
Place the gauze roll on top of the sutured laceration.
Secure the gauze using the long tails of the sutures.
After 1-2 days, the patient should cut the tied-over knots to remove the gauze. This allows the wound to be inspected and cleaned.

For step-by-step photos, check out Dr. Gemma Morabito et al's Medicinadurgenza website post .

I have a question though:
I suture scalp lacerations only if the patient is balding or bald in the area. How would I bandage if you use staples instead of sutures for the scalp? I imagine my options

Beanie hat approach
Hair braid dressing
Place 2-3 sutures to help close the laceration (interspersed amongst the staples) just to do a tie-over dressing
Don't bandage. Just cover up the staples with the overlying hair.

Thanks to Dr. Gemma Morabito (Rome, Italy) and Vincenzo Peloponneso (head nurse in Rome, Italy) for the idea and images!

Reference
Ginzburg A, Mutalik S. Another method of tie-over dressing for surgical wounds of hair-bearing areas. Dermatol Surg. 1999 Nov; 25(11):893.

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