From the Guidelines
Dermabond (2-octyl cyanoacrylate) glue is indicated for small, clean, low-tension wounds with straight edges in non-mobile areas, while sutures are preferred for larger, deeper, or high-tension wounds in mobile areas, as supported by the most recent evidence from 2024 1.
Key Considerations
- Dermabond works well for facial lacerations, small cuts (less than 5cm), and wounds in children where avoiding needles is beneficial, as it provides essentially painless closure for low-tension wounds 1.
- It should not be used on mucous membranes, areas with high moisture or friction, infected wounds, or in patients with known cyanoacrylate allergies.
- Sutures are better for wounds that are deep, gaping, have jagged edges, are located over joints or high-tension areas, or require layered closure, as they provide better tensile strength and are essential for wounds requiring precise edge alignment.
Application Techniques
- When applying Dermabond, ensure the wound is clean, dry, and edges are well-approximated; apply 3-4 thin layers allowing 30 seconds between applications.
- For sutures, proper technique includes appropriate suture material selection, sterile technique, and removal at the appropriate time (typically 5-14 days depending on location).
Decision Making
- The decision between these closure methods should consider wound characteristics, location, patient factors, and cosmetic outcome goals, with a focus on minimizing pain and anxiety, as highlighted in the 2024 study 1.
- A prospective, non-inferiority, randomized controlled trial comparing skin adhesive with traditional suturing for the management of first-degree perineal lacerations found that cosmetic and functional results of skin adhesive use were not inferior to those of suturing, and skin adhesive was associated with a shorter procedure time, less pain, and greater satisfaction 1.
From the Research
Indications for Using Dermabond
- Dermabond (2-octyl cyanoacrylate) glue is marketed to replace sutures that are 5-0 or smaller in diameter for incisional or laceration repair 2
- It is best suited for small, superficial lacerations, and may also be used with confidence on larger wounds where subcutaneous sutures are needed 2
- Dermabond has been shown to save time during wound repair, provide a flexible water-resistant protective coating, and eliminate the need for suture removal 2
Comparison with Sutures
- The long-term cosmetic outcome with Dermabond is comparable to that of traditional methods of repair 2
- Dermabond has demonstrated superiority over traditional subcuticular skin sutures in terms of closure time, cosmetic appearance, and patient satisfaction 3
- However, the cosmetic outcome of cutaneous excisional surgery wounds closed with standard suturing was found to be superior to that of wounds closed with octyl cyanoacrylate 4
Specific Uses
- Dermabond can be used for surgical wound closure, with advantages over conventional sutures on cosmetic outcomes, cost benefits, and operative times 3
- It can be used for wound closure after laparoscopy intervention, with similar cosmetic results to those closed with monofilament sutures 5
- Dermabond can also be used for the closure of excisional wounds in children and adolescents, although the cosmetic outcome may not be superior to that of standard sutures 4