Provider Prepared's Weekly Pearl of Wound Wisdom #4 - Dermabond vs. Sutures
Does this laceration really need sutures? For short (<4cm) lacerations literature supports the use of tissue adhesives, such as DERMABOND. After properly cleaning and preparing the wound, as discussed in previous Weekly Pearls of Wound Wisdom, determine if the wound has low or high tension against it. Wounds that are of a low tension tend to hold themselves in close approximation. High tension wounds will be gaping open and should be closed with sutures. Additional criteria for tissue adhesive use includes wounds that have low risk of infection, are linear in shape, and in a dry location. Tissue adhesive should not be used on hands, feet, or joints unless they are immobilized and able to stay dry for several days.
Clinically in our Emergency Medicine practice we typically do not use tissue adhesive to repair lacerations greater than one centimeter. Larger lacerations are more technically challenging to maintain a perfect cosmetic outcome. Tissue adhesive is applied in thin layers as the wound edges are held in appropriate cosmetic approximation. This should be done with no oozing of blood from the wound. The wound must be held stable for at least 10 seconds as the adhesive sets and obtains its tensile strength to secure the wound edges in place. Provider Prepared Laceration Repair kits equip you with the Dermabond Advanced Pen in your arsenal of wound repair tools. Click HERE to order today! Arrives within 3-4 business days.
Lipsett, SU. et al Minor wound repair with tissue adhesives. UpToDate Sep 2017.
Dr. Nate Whittaker, MD
- Dr. Nate Whittaker, MD Emergency Medicine Specialist