Watching breaking bad today and there was a scene where Jesse gets beat up, then is shown with these tiny little bandages covering his scar and wounds. It was a series of small white stripe that are placed far enough apart so that you can see the wound underneath and how bad it is.
So that got me thinking, I’ve seen a lot of people with their faces/heads bandaged like this in tons of different movies and tv shows. The bandage appears to be a series of little white strips that are not attached to each other (they’re too haphazardly placed), but why wouldn’t you use a bandage that covers the entire wound? Because putting tiny little strips of tape on it at intervals shows that the person received medical treatment while keeping their horrific wound visible for dramas sake.
My question is: where did this come from? Surely they’ve never used these tiny little strips as bandages in real life? Or am I just blissfully unaware of a revolutionary type of tiny little Band-Aid that for some reason never became popular at any hospital or doctors I’ve ever been to? Are they a reliv from, say, the 1940’s, when there was a gauze/tape shortage?.
Those are butterfly bandages. They’re used to join cut skin back together instead of using stitches or staples when the would is not too deep. It allows the skin to grow back together without leaving a wide scar.
I was always told if the wound was straight (not jagged) and clean and if direct pressure could hold the flesh together to form a good seal, a Dr might decide to use this method for faster healing.
The scars left behind end up looking straight and not like “railroad tracks on a map”.
Some become almost invisible over time.
Steri-Strips is the 3M name for them. When I had my gallbladder removed those were the only “sutures” I had where the laparoscopic equipment was used, including the larger incision in my belly button. Two years later and there may be light scars but I can’t find them.
So yeah, OP, you’ve been under a rock on this one!
As others have said, they’re butterfly bandages and quite common. My issue is when when someone gets a cast (or huge bandage) either has their pants cut in a way where there’s no way they could get them on or off over the cast or, worse, has the cast on over their pants. That’s just bad wardrobing/FXing, and such a simple fix too. A pair of shorts or a skirt would do the trick. Even baggy pants or sweat pants cut up nice and high would work well.
FTR, I’m not talking about a walking/air cast or a brace, but a regular plaster cast. If you look at it and say ‘that doesn’t make sense’, someone messed up and it should have been caught.
Using the little strips instead of stitches makes sense but is there a reason you wouldn’t then cover the wound/strips for sake of cleanliness? Not asking from a movie perspective just seems odd that you’d leave it exposed.
It’s not really exposed. It scabs over and the wound should be sealed. The application of topical antibiotic is recommended. I think the idea is that healing is faster if the would is exposed to the air, but not sure about that.
You’re mostly right - last time I was told they don’t want people using antibiotic ointment for small/shallow/clean cuts any more either, because people are growing resistant to the medicines.
“Clean, open to the air, dry” is what my doctor said is the current medical preference.
So that’s good from a tv perspective - it’s actually correct for the butterflies to be all that’s on the wound.
For Steri-Strips, I was able to take showers when they were on, so that undoubtedly helped a lot in keeping the wound clean. This was an extensive surgical wound, over 12" long, and I had no problems with infection at all. The only issue was the blistering from the strips themselves.
Only certain wounds benefit from being covered, only the type that need to be “wet” to heal such as burns and where granulating is needed. Those are often accompanied by whatever salve or ointment is most beneficial to that type of healing, too, and the bandage keeps the medication + moisture trapped. Normal type scrapes and cuts should stay open to the air and allowed to scab. Being covered traps any moisture (sweat/body oils) along with bacteria and keeps the scab soft. Great recipe for infections.
I work in an environment (animal medicine) where people get cuts and scrapes all the time. We only cover our wounds while working if they’re on the hands (most common) because all the hand washing we do will definitely impede healing and make it worse, so covering will actually keep it drier than not covering. When shift is over, bandages come off. Cuts and scrapes elsewhere generally stay uncovered unless actively bleeding.
My friend recently got a single suture strip for a dog bite on her hand. The doctor told her to change the bandage and apply appointment daily for best results but it was hard for her because the wound was on her hand and her other hand had also been wounded. She pretty quickly transitioned on her own to no bandage and exposed suture strip. I imagine a meth dealer in a high stress situation might be similarly lackadaisical about proper wound care regardless of how he was instructed.
As a rule of thumb, you use as few steri-strips as possible such that the wound is brought together without excessive tension on any individual strip. A lot of shear loading on an individual strip tends to promote skin breakdown there. You could pave the whole wound over with strips, but for a non-surgical wound, you want to leave portions unoccluded by strips so that fluids or sloughed/infected material can drain from the wound. Plus, the more surface area covered by the adhesive, the worse the outcome if a person has a sensitivity reaction.
A steri-strip also allows the stress on the skin to be spread over a larger area, to skin farther back from the edge of the wound. The full extent of tissue damage from a bad contusion/laceration may not be immediately apparent, and it’s not uncommon to have the tissues at the raggedy edge of a wound die back a bit and slough away later. Putting a lot of mechanical strain on such marginal tissue by using it to anchor a suture just guarantees that it won’t survive. It’s better to put the strain load farther away from the wound margin, which either means a stitch placed farther away or a steri-strip that overlaps healthy skin farther out.
So, it’s a judgement call: use as few strips as are necessary to bring the wound edges into good-enough approximation without too much tension while allowing for unimpeded drainage of material from the wound. ‘Good enough’ approximation is a balance between cosmetic and pragmatic concerns.
