From the Guidelines
For a finger laceration closed with cyanoacrylate (medical glue) in the ER, keep the wound clean and dry for the first 24-48 hours, and follow proper hand hygiene techniques as outlined in the guidelines for infection control 1. After this initial period, you may shower briefly but avoid soaking or scrubbing the area. Do not apply ointments, lotions, or other products directly to the glued area as these can break down the adhesive prematurely. The glue will naturally slough off in 5-10 days as your wound heals. Some key points to consider for discharge instructions include:
- Keeping the wound clean and dry
- Avoiding activities that could stress the wound
- Watching for signs of infection
- Proper hand hygiene techniques, such as using an alcohol-based hand rub or washing with soap and water, especially before and after patient contact 1. Take acetaminophen (Tylenol) 650mg every 6 hours as needed for pain; avoid aspirin or NSAIDs like ibuprofen for the first 48 hours as they may increase bleeding risk. Watch for signs of infection including increasing redness, warmth, swelling, pus, fever, or worsening pain. Keep the finger elevated above heart level when possible for the first 24-48 hours to reduce swelling. You may use the finger for light activities but avoid heavy lifting or activities that could stress the wound for about a week. Return to the ER if the wound reopens, shows signs of infection, or if you develop severe pain or numbness in the affected finger. The medical glue creates a waterproof barrier that holds the wound edges together while natural healing occurs underneath, eliminating the need for suture removal. It's also important to note that hand hygiene is a critical component of infection control, and should be performed before and after every patient contact, using either an alcohol-based hand rub or soap and water 1.
From the Research
Discharge Instructions for Finger Laceration Closed with Glue
- The patient should keep the wound clean and dry to promote healing and prevent infection 2, 3.
- The use of occlusive or semiocclusive dressings can help wounds heal faster by maintaining a moist environment 2.
- The patient should be advised to avoid submerging the wound in water until it is fully healed, but wetting the wound as early as 12 hours after repair does not increase the risk of infection 4.
- Tetanus prophylaxis should be provided if indicated, based on the patient's vaccination history and the type of wound 2, 3.
- The patient should be instructed to monitor the wound for signs of infection, such as redness, swelling, or increased pain, and to seek medical attention if these symptoms occur 2, 3.
- Follow-up care may be necessary to remove any sutures or adhesive strips, but this is not typically required for wounds closed with glue 2, 4.
- The patient should be advised to avoid using harsh soap or other abrasive cleaners on the wound, and to pat it dry gently after cleaning 3, 4.
- Topical antibacterial agents may be used to help prevent infection, but white petrolatum ointment is also effective in post-procedure care 4.
- Patient education on wound care and potential complications is crucial for a successful recovery 4.