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Dermabond is a cyanoacrylate tissue adhesive that forms a strong bond across apposed wound edges, allowing normal healing to occur below. It is marketed to replace sutures that are 5-0 or smaller in diameter for incisional or laceration repair. This adhesive has been shown to save time during wound repair, to provide a flexible water-resistant protective coating and to eliminate the need for suture removal. The long-term cosmetic outcome with Dermabond is comparable to that of traditional methods of repair. Best suited for small, superficial lacerations, it may also be used with confidence on larger wounds where subcutaneous sutures are needed. This adhesive is relatively easy to use following appropriate wound preparation. Patients, especially children, readily accept the idea of being "glued" over traditional methods of repair. (Am Fam Physician 2000;61:1383-8.)
Physicians have long sought an efficient method of wound repair that requires little time and minimizes discomfort for their patients, yet produces a good cosmetic outcome. Dermabond, the newest tissue adhesive to be labeled by the U.S. Food and Drug Administration (FDA), may well meet those criteria. Cyanoacrylate tissue adhesives have been around for more than 20 years but have only recently become available for use in this country for incisional and laceration repair, They have been shown to have negligible histotoxicity, to form a strong bond to wound edges and to provide long-term cosmesis equivalent to, or better than, traditional methods of repair. In addition, they require less than one half the time for wound closure. Table 1 summarizes the benefits of tissue adhesive over sutures.1-11
History and Characteristics of Cyanoacrylates
Cyanoacrylate tissue adhesives combine cyanoacetate and formaldehyde in a heat vacuum along with a base to form a liquid monomer.9 When the monomer comes into contact with moisture on the skin's surface, it chemically changes into a polymer that binds to the top epithelial layer. This polymer forms a cyanoacrylate bridge, binding the two wound edges together and allowing normal healing to occur below. The conversion from monomer to polymer occurs rapidly, preventing seepage of the adhesive below the wound margins as long as the edges are well apposed. Heat is often generated during the change from monomer to polymer, and this heat may be felt on occasion by patients...