How should a scalp laceration that continues to bleed after 15 minutes of direct pressure be treated?

When a scalp laceration continues to bleed after 15 minutes of direct pressure, it indicates that the bleeding is likely due to deeper vascular structures being involved, which may not be adequately addressed with just pressure alone. The appropriate management for such a wound is the use of simple interrupted sutures.

Suturing is beneficial as it allows for the effective approximation of the wound edges, aiding in hemostasis and promoting optimal healing. The scalp is richly vascularized, meaning that if bleeding persists, the likely vessels causing the hemorrhage can be addressed directly by suturing the tissue layers back together. This technique reduces the space in which blood can pool and facilitates clot formation.

While other options such as staples, adhesive strips, or electrocautery can be used in certain circumstances, simple interrupted sutures offer a reliable method for achieving hemostasis and ensuring functional and cosmetic closure of the laceration. Staples might be quicker but aren’t always ideal for all types of lacerations, particularly those with irregular edges or where precise alignment is necessary. Adhesive strips may be useful for superficial injuries but would not effectively handle a deep laceration that is actively bleeding. Electrocautery could potentially control bleeding, but it does not provide the structural