II. Precautions

  1. Exclude significant Closed Head Injury
  2. Hemostasis is critical

III. Management

  1. Hemostasis is primary initial concern
    1. Scalp Wounds bleed heavily
    2. Apply direct pressure
    3. Consider Raney Clips or Running O-Suture to temporize closure
    4. Consider figure of eight subcutaneous stitch to stop focal heavy bleeding
  2. Galeal Laceration >0.5 cm should be repaired (2-0 or 3-0 Absorbable Suture)
  3. Skin closure with staples (often preferred), or Nylon Suture (3-0 or 4-0)
    1. Staples should have a 1 mm space above skin to allow for easier removal

IV. Technique: Hair Apposition

  1. Indications
    1. Linear Scalp Laceration <10 cm
    2. Minimum of 3 cm scalp hair
    3. Clean wound
  2. Technique
    1. Hold several strands of hair from each side of a Scalp Laceration
    2. Cross the two strands, twist for one full rotation and then pull each to either wound edge
    3. Apply several drops of Tissue Adhesive where the hairs cross
    4. Repeat once or twice along the course of the Laceration
  3. Follow-up
    1. Hair may be washed after 48 hours of procedure
  4. Advantages
    1. Less scarring than with standard suturing
    2. No shaving or suturing needed
    3. No increased risk of infection or bleeding
  5. Resources
    1. Hair Apposition Technique
      1. https://lacerationrepair.com/alternative-wound-closure/hair-apposition-technique/
    2. YouTube
      1. https://www.youtube.com/watch?v=sV8zbMoDkbc
  6. References
    1. Ong (2002) Ann Emerg Med 40:19-26 [PubMed]
    2. Hock (2002) Ann Emerg Med 40(1): 19-26 [PubMed]

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Related Studies

Ontology: Scalp laceration (C0240937)

Concepts Injury or Poisoning (T037)
SnomedCT 274166008
English scalp tissue injury laceration, laceration of scalp (physical finding), laceration of scalp, scalp laceration, lacerations scalp, laceration of scalp (diagnosis), Scalp laceration, Scalp laceration (disorder)
Spanish Laceración del cuero cabelludo, laceración de cuero cabelludo (trastorno), laceración de cuero cabelludo
Portuguese Laceração do couro cabeludo
Italian Lacerazione dello scalpo
German Lazeration der Kopfhaut
French Lacération du cuir chevelu
Dutch laceratie van hoofdhuid
Czech Lacerace skalpu
Japanese 頭皮裂傷, トウヒレッショウ
Hungarian Hajas fejbőr laceratio