Can Dermabond be used on open wounds?
The tissue adhesive, Dermabond, can be used as an alternative for 5-0 or smaller sutures to close wounds. It can be used to close wounds on the face, extremities and torso. The doctor may prefer Dermabond over sutures depending on their level of comfort and experience. There is better healing of the wounds on hands, legs (extremities) and torso when under the skin (subcutaneous) sutures are placed first.
Dermabond should not be used to close the wound in cases of
- Contaminated wounds or wounds with obvious signs of infection
- Jagged or stellate lacerations
- Bites, punctures or crush wounds
- Wounds on mucosal surfaces or mucocutaneous junctions (where skin and mucus membranes meet) like the inside of the mouth or lips.
- Wounds on high moisture areas, such as the armpits and groin.
- Wounds on hands, feet and joints (unless kept dry and immobilized in a splint to prevent premature adhesive peeling).
If using Dermabond for scalp wounds, the patient should take care to not allow excess adhesive to run through the hair. The adhesive should be kept dry in this area for at least 5 days for normal healing.
What is Dermabond?
Dermabond (2-octyl cyanoacrylate) is a cyanoacrylate tissue adhesive that forms a strong bond across opposed wound edges that allows normal healing to occur below. This topical tissue adhesive is FDA approved and marketed to replace sutures that are 5-0 or smaller in diameter for wound (incisional or laceration) repair. Besides saving time during wound repair, Dermabond provides an excellent flexible water-resistant protective coating that eliminates the need for suture removal.
Dermabond bears less toxicity and almost four times the strength of its predecessor N-butyl-2-cyanoacrylate. It also has been provided with more flexibility due to the use of special plasticizers in its formulation. It attains maximum bonding strength within just two and a half minutes. The strength of Dermabond is similar to that of healed tissue seven days after repair.
Dermabond is best suited for small and superficial lacerations. Depending on the doctor’s discretion and expertise, it may also be used on larger wounds that require subcutaneous sutures.
What are the advantages of Dermabond over sutures?
Dermabond has several advantages over sutures such a:
- The maximum bonding strength is achieved at two and a half minutes.
- It saves time during wound repair.
- Its strength is equivalent to healed tissue at seven days post repair.
- It can be applied using only a topical (over the skin) anesthetic without any need for needles.
- It has better acceptability by patients, especially children.
- It provides a strong water-resistant covering.
- It eliminates the need for suture removal.
- It is easy to use.
- Its long-term cosmetic outcome is similar to the traditional methods of wound repair.
Cost, however, is a concern while using Dermabond instead of sutures. The cost of a vial of Dermabond is around $24 with a shelf life of 2 years. The sutures are commonly used in ambulatory care settings and cost around $5 per package. Also, Dermabond may not be suitable for closure of certain types of wounds, such as those inside the mouth, contaminated wounds and crush wounds. Sutures, however, can be used to repair these wounds as well.
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