From the Guidelines
Dermabond (2-octyl cyanoacrylate) is appropriate for use in closing small, clean wounds with minimal tension, particularly in pediatric patients or for facial wounds where cosmetic outcome is important, as it provides a painless closure and a waterproof antimicrobial barrier. When considering the use of Dermabond, it is essential to evaluate the wound type and location, as it is most suitable for superficial lacerations less than 5 cm in length with straight, easily approximated edges, and not located in high-mobility areas 1. The application process involves thorough wound cleaning and hemostasis, followed by the application of the liquid adhesive in thin layers, allowing for drying time between applications. This method creates a protective barrier that lasts 5-10 days before naturally sloughing off.
Key Considerations for Dermabond Use
- Wound type: Suitable for small, clean wounds with minimal tension
- Wound location: Avoid high-mobility areas and areas with dense hair
- Contraindications: Infected wounds, animal bites, puncture wounds, mucous membranes, and areas with high tension or movement
- Patient considerations: Hypersensitivity to cyanoacrylates, pediatric patients, and cosmetic outcomes for facial wounds
Advantages of Dermabond
- Faster application compared to sutures
- No need for removal
- Creation of a waterproof antimicrobial barrier
- Reduced pain during application, making it particularly useful in pediatric patients or for facial wounds where cosmetic outcome is important, as noted in the context of minimizing pain and anxiety in procedural care 1.
From the Research
Appropriate Use of Dermabond
Dermabond (2-octyl cyanoacrylate) is a tissue adhesive that can be used for wound repair, including incisional or laceration repair. The following are scenarios where Dermabond is appropriate to use:
- Small, superficial lacerations: Dermabond is best suited for small, superficial lacerations, as it provides a flexible water-resistant protective coating and eliminates the need for suture removal 2.
- Larger wounds with subcutaneous sutures: Dermabond can also be used with confidence on larger wounds where subcutaneous sutures are needed 2.
- Orthopedic surgery: Dermabond has been used in orthopedic surgery, such as total ankle arthroplasty, to close wounds, although it may have higher wound complication rates compared to traditional sutures 3.
- Abdominoplasty, mammoplasty, and arthroplasty: Dermabond Prineo, a combination of a skin adhesive and a polyester mesh, has been used in these surgical procedures to reduce closure time and improve wound healing 4.
Benefits of Using Dermabond
The benefits of using Dermabond include:
- Reduced time for wound closure: Dermabond has been shown to reduce the time taken for wound closure compared to traditional methods of wound closure 4.
- Improved cosmetic results: Dermabond has been associated with improved cosmetic results compared to sutures, with higher patient satisfaction for wound cosmesis 3, 4.
- Antibacterial properties: Dermabond has been shown to have bactericidal properties against Gram-positive bacteria, which may reduce the risk of postoperative wound infection 5.
Considerations for Using Dermabond
When using Dermabond, the following considerations should be taken into account:
- Wound preparation: Dermabond is relatively easy to use following appropriate wound preparation 2.
- Patient acceptance: Patients, especially children, may readily accept the idea of being "glued" over traditional methods of repair 2.
- Potential for allergic reactions: There is a potential for allergic reactions to Dermabond, as seen in one case of allergic contact dermatitis in a study of total ankle arthroplasty patients 3.