Synthetic adhesives used for wound closure:
(1) isobutyl cyanoacrylate (early)
(2) n-butyl-2-cyanoacrylate (Hystoacryl Blue)
(3) 2-octylcyanoacrylate (Dermabond)
(4) Superglue (by nonmedical people in a pinch)
Advantages:
(1) does not require local anesthesia
(2) no sutures need to be removed
(3) fast to apply
(4) minimal discomfort
Best applied on sites with minimal tension.
Locations where it can be used:
(1) face
(2) extremities and torso
(3) minor lacerations on hands or feet
Locations where not recommended:
(1) not on lips
(2) not on mucosal surfaces
(3) not on hands or feet (unless minor lacerations)
(4) not recommended near or over joints or sites subject to stress
(5) not where it can be easily washed off (hands, elsewhere)
Procedure:
(1) The skin about the laceration should be clean and dry.
(2) The edges of the laceration are held together with the fingers and the adhesive is used to tack the edges of the laceration together.
(3) The edges of the laceration are held together for about 30 seconds to let the adhesive polymerize.
Putting the adhesive within the wound is not recommended. This causes tissue damage, interferes with wound healing, and more wound infections.
Special precautions:
(1) If used next to the eyes, the eyes should be closed and covered prior to application.
(2) Deep wounds through the fascial injury require deep sutures.
(3) Not effective in controlling hemorrhage associated with an actively bleeding vessel.
(4) Soaking or repeated washing will remove before healing is complete.
(5) The adhesive can be removed with fingernail polish remover (acetone or other solvent). This can also help separate fingers that have become stuck together.
