II. Indications
- Laceration Repair of well-approximated, low tension, superficial Lacerations with linear edges
III. Contraindications
- Lesions near the eye
- Deep wounds
- Complex, jagged edged wounds
- High tension wounds (e.g. over joints, hands)
- Active bleeding
- Contaminated wound
- Infected wound (leave open)
- Bite wound
- Wounds >12 hours old
IV. Efficacy
- Alternative to suturing
- Highly effective in <5cm low tension Laceration Repairs
- Excellent cosmetic results (similar result to Suture)
V. Precautions
- Do not cover with Antibiotic ointment or petrolatum (dissolves the tissue glue)
- Petrolatum can be used to remove glue from unwanted areas (e.g. Eyelid)
- Avoid Tissue Adhesive near the eye
- Risk of Cyanoacrylate Eye Injury
- Higher risk of secondary Wound Infection with Periorbital Cellulitis (6 fold increased risk)
- Do not substitute ethyl cyanoacrylate (e.g. Crazy Glue)
- Ethyl cyanoacrylate polymerization is too fast (Burn Injury risk) and it degrades too quickly
VI. Preparations
- n-butyl-2-cyanoacrylate (Histoacryl Blue, PeriAcryl)
- 2-octyl cyanoacrylate (Dermabond, Surgiseal)
VII. Techniques: Wound Apposition
- See Hair Apposition Technique (Scalp Lacerations)
- Steri-strip technique
- First: Align and approximate the wound edges with steri strips
- Next: Apply the Tissue Adhesive
VIII. Techniques: Skin Protection
- Indications
- Protect adjacent areas from Tissue Adhesive spread (e.g. eye)
- Tilt bed/body
- Position patient in trendelenberg, reverse trendelenberg or lateral recumbent position)
- Adhesive glue follows gravity to drain away from a sensitive area
- Petroleum-based barrier (e.g. petrolatum, Vaseline) technique
- Apply at the margins of the wound area to prevent spill-over to adjacent sensitive areas
- Tegaderm (Transparent Film Dressing)
IX. Techniques: Drying base
- Indications
- Peristently draining sites (e.g. Paracentesis site)
- Technique
- Oxygen by Nasal Cannula with prongs directed to blow onto wound site at 10-15 L/min assists in keeping the site dry
- References
- Lin in Herbert (2013) EM:Rap 13(11): 9
X. References
- Lin in Herbert (2015) EM:Rap 15(2): 6-7
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Related Studies
Definition (MSH) | A group of compounds having the general formula CH2=C(CN)-COOR; it polymerizes on contact with moisture; used as tissue adhesive; higher homologs have hemostatic and antibacterial properties. |
Concepts | Organic Chemical (T109) |
MSH | D003487 |
SnomedCT | 79549001 |
English | Cyanoacrylates, Cyanoacrylates [Chemical/Ingredient], cyanoacrylate, cyanoacrylates, Cyanoacrylate, Cyanoacrylate (substance), Cyanoacrylate, NOS |
Swedish | Cyanoakrylater |
Czech | kyanoakryláty |
Finnish | Syanoakrylaatit |
Russian | TSIANOAKRILATY, ЦИАНОАКРИЛАТЫ |
Polish | Cyjanoakrylany |
French | Cyano-acrylates, Cyanoacrylates |
Norwegian | Cyanoakrylater |
Spanish | cianoacrilato (sustancia), cianoacrilato, Cianoacrilatos |
German | Cyanacrylate |
Italian | Cianocrilati |
Portuguese | Cianoacrilatos |
Ontology: Tissue Adhesives (C0040277)
Definition (MSH) | Substances used to cause adherence of tissue to tissue or tissue to non-tissue surfaces, as for prostheses. |
Concepts | Biomedical or Dental Material (T122) |
MSH | D014014 |
English | Adhesive, Tissue, Adhesives, Tissue, Tissue Adhesive, TISSUE ADHESIVE FOR SOFT TISSUE APPROXIMATION, Tissue Adhesives [Chemical/Ingredient], tissue adhesive, tissue adhesives, adhesive tissue, Tissue adhesives, Tissue Adhesives |
French | Colles tissulaires, Colles biologiques, Adhésifs pour tissus organiques, Colles cutanées, Adhésifs tissulaires |
Swedish | Vävnadslim |
Czech | tkáňová adheziva |
Finnish | Kudosliimat |
Russian | TKANEVOI KLEI, ТКАНЕВОЙ КЛЕЙ |
Polish | Kleje tkankowe |
Norwegian | Vevslim |
German | Gewebekleber, Gewebeklebstoffe |
Italian | Adesivi per tessuti |
Dutch | Lijm, weefsel-, Weefsellijm |
Portuguese | Adesivos Teciduais |
Spanish | Adhesivos Tisulares |
Ontology: DERMABOND (C1530215)
Concepts | Organic Chemical (T109) , Biomedical or Dental Material (T122) , Pharmacologic Substance (T121) |
MSH | C100832 |
English | DERMABOND, Dermabond |