Is adhesive glue or steri-strips (sterile strips) preferred for a small superficial laceration less than 0.5 cm lateral to the right eyebrow?

Adhesive Glue vs. Steri-Strips for Small Superficial Laceration Near the Eyebrow

For a small superficial laceration less than 0.5 cm lateral to the right eyebrow, adhesive glue (tissue adhesive) is preferred over steri-strips due to shorter procedure time, less pain, and comparable cosmetic outcomes. 1

Rationale for Using Tissue Adhesive

Advantages of Tissue Adhesive

• Reduced Pain: Tissue adhesives cause significantly less pain compared to suturing and are comparable or better than steri-strips 2, 3
• Faster Application: Application time is shorter than traditional suturing 3
• Comparable Cosmetic Results: Multiple studies show similar cosmetic outcomes between tissue adhesives and other closure methods 2
• No Need for Removal: Unlike sutures, tissue adhesives do not require a follow-up visit for removal 1
• Reduced Patient Anxiety: Particularly beneficial in areas near the face where patient comfort is important 4

Ideal Wound Characteristics

The laceration you've described is an excellent candidate for tissue adhesive because it is:

• Small (less than 0.5 cm)
• Superficial
• Located in a facial area
• Likely a low-tension wound

Application Technique

1. Wound Preparation:

   • Clean and irrigate the wound thoroughly
   • Ensure complete hemostasis before application
   • Make sure the area is completely dry 1
   • Consider de-epithelialization of wound edges if needed

2. Application Method:

   • Apply the least amount of adhesive necessary to seal the wound
   • Can use a 30-gauge needle, wooden end of cotton applicator, or micropipette for precise application 1
   • Hold wound edges together for approximately 30 seconds after application

3. Post-Application Care:

   • Keep the area dry for 24-48 hours
   • No need for additional dressing in most cases
   • The adhesive will naturally slough off in 5-10 days

Important Considerations

Contraindications

Avoid tissue adhesive in these situations:

• Active infection at the site
• Grossly contaminated wounds
• High-tension areas or areas under significant mechanical stress
• Mucosal surfaces
• Areas with high moisture content
• Areas with dense hair 1

Wound Assessment

Before applying adhesive, ensure:

• No foreign bodies are present in the wound (glass is a common concern in lacerations) 5
• The wound is clean and free of debris
• Edges can be easily approximated without tension

Potential Complications

• Wound dehiscence (rare with properly selected wounds)
• Infection (uncommon with clean wounds)
• Allergic reaction to adhesive (rare)

Alternative Options

If tissue adhesive is unavailable or contraindicated, consider:

• Steri-strips: While shown to have similar cosmetic outcomes to tissue adhesives in some studies 2, they may be less secure in areas near the eyebrow where facial movement occurs
• Suturing: Consider for deeper wounds or those under tension, but requires anesthesia and removal

Follow-up Recommendations

• No routine follow-up is needed unless complications develop
• Patient should return if signs of infection develop (increasing redness, warmth, drainage)
• The adhesive will naturally slough off as the wound heals

By following these guidelines, you can achieve excellent cosmetic and functional outcomes for this small superficial laceration near the eyebrow.