Is it acceptable to use Dermabond (2-octyl cyanoacrylate) on a finger laceration caused by a kitchen knife?

From the Guidelines

I strongly advise against using Dermabond on a finger laceration from a kitchen knife at home. For kitchen knife cuts, you should first apply direct pressure with a clean cloth to stop bleeding, then clean the wound thoroughly with soap and water, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. It is also reasonable to cover clean superficial wounds and abrasions with an occlusive dressing to promote wound healing 1. However, given the potential for contamination and the complex anatomy of the hand, it is crucial to seek medical attention for proper evaluation, especially if the cut is deep, gaping, continues to bleed heavily, or affects finger movement or sensation.

Some key considerations include:

• The risk of infection, which can be higher in hand wounds due to their complex anatomy and potential for contamination
• The need for professional assessment to evaluate for tendon or nerve damage and determine if stitches are needed
• The importance of proper wound cleaning and evaluation by healthcare professionals before applying any adhesive or closure method
• The potential for improper use of Dermabond to seal in bacteria, leading to infection, or create other complications

Healthcare providers can assess the wound and determine the best course of treatment, which may include the use of Dermabond, but only after proper cleaning and evaluation. The guidelines for the diagnosis and management of skin and soft tissue infections also highlight the importance of proper wound care and the potential risks associated with improper closure of wounds, especially in high-risk areas like the hand 2.

From the FDA Drug Label

WARNINGS For external use only. Do not use on damaged or broken skin. The FDA drug label does not answer the question.

From the Research

Laceration Repair with Dermabond

• The use of Dermabond, a tissue adhesive, is a viable option for laceration repair, especially in low-tension skin areas 3, 4.
• Studies have shown that tissue adhesives are similar to sutures in terms of patient satisfaction, infection rates, and scarring risk in low skin-tension areas 4.
• However, the decision to use Dermabond should be based on the type and location of the wound, as well as the patient's overall health status.

Considerations for Finger Lacerations

• Finger lacerations are common, and the use of kitchen knives can increase the risk of injury 5.
• When repairing finger lacerations, it is essential to consider the type of wound, the level of contamination, and the patient's tetanus status 3, 6.
• The use of local anesthetics with epinephrine in a concentration of up to 1:100,000 is safe for use on digits, including fingers 3.

Wound Care and Management

• Wounds heal faster in a moist environment, and occlusive or semiocclusive dressings should be considered when available 3.
• The timing of suture removal depends on the location of the wound and is based on expert opinion and experience 3.
• Patient education and appropriate procedural coding are essential after the repair 4.