Modified hair apposition technique as the primary closure method for scalp lacerations

The aim of this study is to report the usability of our modified hair apposition technique (modHAT) in repairing scalp lacerations.

Data were collected prospectively over a 36-month period regarding our routine repair of scalp lacerations: those in areas with hair 1 cm or longer were repaired with our modHAT technique (10-15 hairs bundled and twisted with clamps) using cyanoacrylate glue, whereas wounds in areas with hair less than 1 cm long, with irregular wound edges, or which continued to bleed after pressure, were repaired with sutures or staples. Two days later, a wound check was performed. At least 30 days later, all patients were contacted again by telephone to assess satisfaction with care, preference regarding the method of repair in the future, and occurrence of any complication, infection, or need for additional health care.

One hundred two consecutive patients (ages 2-92 years) with scalp lacerations (mean length, 24 mm; range, 4-100 mm) presented for care. Wound closure was accomplished with the modHAT technique in 66%. Sutures were used in 32% and staples in 2% because of baldness/short hair in 6% and continued bleeding after pressure in 28%. Satisfaction in both hair apposition technique and suture groups was high, and no patient sought further health care.

Most scalp lacerations can be repaired with the modHAT technique primarily. Care should be taken to apply the glue to the twist of hair only and avoid excess glue running onto the scalp or into the wound. Wider use of this inexpensive, quick technique should be encouraged.