4種常見的wound closure方法：Tape, Tissue Adhesive(Glue), Metal Staples, Sutures
TAPE
1. Indication
(a) Superficial straight lacerations under little tension (forehead, chin, malar eminence, thorax, non-joint extremities)
(b) Delayed suture removal (e.g. under plaster casts)
(c) Flaps and grafts in place, particularly over fingers, flat areas of extremities, and trunk
(d) Pretibial area
(e) After early suture removal (i.e. on the face)
(f) Areas due to vascular insufficiency or altered by prolonged steroid use
2. Contraindication
(a) Naturally moist areas (axilla, palm, sole & perineum)
(b) Secretions, copious exudates, or persistent bleeding
(c) High concentration of hair follicles (scalp)
3. Pearls & Pitfalls
(a) 傷口周圍一定要乾，止血要做好
(b) 先從傷口的中間開始貼， 要覆蓋傷口以外的2.5公分
(c) 不要整條傷口都被覆蓋 (?原因)
(d) 結束時要在貼紙的末端再貼上和傷口平行的貼紙 (避免tape ends blistering of skin)
Staples 最大的優點 -- Speed of closure
1. Indication: Linear lacerations with straight, sharp edges (superficial scalp lacerations)
2. Contraindication: Face, neck, hands or feet
3. Pearls & Pitfalls
(a) 傷口在approximation時要維持eversion (因為stapling會造成inversion)
(b) 不要用力往傷口壓 (以免造成ischemia within staple loop; 理想是離皮膚約2~3mm)