Closure of skin lacerations under tension

We read the technical tip by Nawaz et al with interest. The approximation of skin in thin-skinned individuals is often difficult due to the natural contracture of thin skin coupled with local soft tissue swelling and the potential for suture ‘cut-out’. We have used a technique of applying wide Steri-Strip™ (3M, St Paul, MN, US) skin closures perpendicular to the wound edges to approximate the skin edge and subse-quently suturing through the Steri-Strip™.¹ This technique has been particularly helpful for tibial lacerations with skin flaps and for the dorsum of the hand in patients with thin or poor quality skin. The use of Steri-Strip™ skin closures across and perpendicular to the wound reduces shear forces on the epidermis. The wounds can then be monitored in a ‘soft tissue/dressings’ clinic, with sutures removed after a period of time as outlined by the operating surgeon.