What to Do about Bleeding from the Skin Edges

1. Apply pressure. Most bleeding from skin edges stops on its own
after pressure is applied over the area for a few minutes with a
gauze pad.
2. If you have access to an electrocautery device. An electrocautery
device applies an electrical current that coagulates the tissue and
stops bleeding. When this device is used, the patient must be attached
to a grounding pad. Wipe away the blood, and touch the
bleeding spot with the cautery device. The bleeding usually stops. If
you see bleeding from a small blood vessel, grab it with the tips of a
metal clamp. Then touch the clamp with the cautery device. Be sure
that the clamp is not touching any surrounding tissue. The current
will pass through the clamp and burn the surrounding tissue as well.
Caution: Be sure that your gloves are intact before touching the clamp
with the cautery device. If you have a hole in the glove on the hand holding
the clamp, you will get zapped when you touch the clamp with the
cautery device. You may experience a painful, small burn in your finger
or even feel the electric current pass through your body.
3. Close the wound with a continuous locking suture. This technique
places more tension on the skin edges than the usual continuous closure
and often stops the bleeding. A continuous locking suture is
often quite useful to control a bleeding scalp wound.
How to Place Continuous Locking Sutures
For the typical continuous suture technique, the thread should always
remain behind the needle. With the locking technique, the thread lies in front
of the needle as it comes out of the tissues. The suture, therefore, comes out
of the tissues inside the loop. When the stitch is pulled through the
loop, it places the suture material along the outside skin edge, putting
pressure on the tissue. The pressure helps to control bleeding.


Top, Continuous locking suture. Bottom, Continuous nonlocking suture. Note
the differences in where the suture loop comes out of the skin relative to the
needle as well as the appearance of the sutures on the skin.