From the Guidelines
For laceration closure, apply Steri-strips before Dermabond. This approach allows for precise wound edge approximation with the Steri-strips, followed by the application of Dermabond as a reinforcing layer to provide additional protection and security to the wound closure 1.
Key Considerations
- Clean and dry the wound thoroughly before applying Steri-strips to ensure proper adhesion and minimize the risk of infection.
- Apply Steri-strips across the laceration, ensuring accurate wound edge approximation to facilitate optimal healing.
- Once the Steri-strips are in place, apply a thin layer of Dermabond liquid adhesive over the Steri-strips and surrounding skin, extending about 1-2 cm beyond the wound edges to reinforce the closure.
- Allow the Dermabond to dry completely, which usually takes about 30 seconds, to ensure it forms a strong and protective barrier over the wound.
Benefits of This Approach
- Enhances wound closure strength by combining the mechanical closure of Steri-strips with the adhesive properties of Dermabond.
- Reduces the risk of infection by providing a protective barrier over the wound.
- Minimizes pain and anxiety associated with laceration repair, as both Steri-strips and Dermabond are essentially painless when applied correctly 1.
Important Precautions
- Avoid getting Dermabond into the wound itself, as this can interfere with the healing process.
- Ensure the wound is clean, dry, and free of debris before applying Steri-strips and Dermabond to optimize the effectiveness of the closure and minimize complications.
From the Research
Application of Dermabond and Steri-Strips
- The order of application of Dermabond (2-octyl cyanoacrylate) and Steri-Strips (reinforced adhesive strips) for laceration closure is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, a study comparing the cosmetic outcomes of simple facial lacerations closed with Steri Strip Skin Closures or Dermabond found that both methods provided similar cosmetic outcomes 4.
- Another study compared the wound-bursting strengths of octyl-cyanoacrylate (Dermabond), butyl-cyanoacrylate, and surgical tape (Steri-Strips) in rats, and found that Dermabond had a higher wound-bursting strength than Steri-Strips 5.
- A review of wound management options discussed the use of staples, sutures, Steri-Strips, and tissue adhesives (such as Dermabond) for wound closure, but did not specify the order of application 6.
- A study on the management of pretibial lacerations described a technique using deep reinforced suturing through Steri-Strips, but did not mention the use of Dermabond 2.
- Another study presented a technique using a combination of Steri-Strips and sutures for the management of lacerations in thin-skinned individuals, but also did not mention the use of Dermabond 3.