Lacerations comprise a significant number of emergency department referrals for pediatric patients. Management of
lacerations with
sutures involves the use of needles and the injection of
local anesthetic and represents a unique challenge in the
wound management of an already distressed and frightened child.
Octylcyanoacrylate, a new-generation, medical-grade
tissue adhesive, has been found to be an effective alternative to replace skin
sutures on virtually all facial
lacerations and has been employed in low-skin tension
wound management. Its use, however, has generally been avoided in the management of high-skin tension
lacerations. Over the last 10 months, 32 children with high-skin tension (hand, feet, and over joints)
lacerations were managed at our center by
octylcyanoacrylate tissue adhesives. Skin closures and
splints were applied to restrict movement of the affected area to overcome the limitation of adhesive application.
Octylcyanoacrylate adhesive applied with optimal immobilization was found to be an effective method of skin closure in high-skin tension
lacerations. Advantages of
tissue adhesives for incision and
laceration include quick application, excellent cosmetic results, patient preference, and cost effectiveness.