Sunday, February 20, 2011

Reply: Superglue for Small Wounds

Hi Ferfal, really enjoy your blog and your book as well; currently my dad has my copy. I'm a registered nurse working in an OR up here in America, so I deal with wound closures every day. I would suggest to you and your readers that you not glue wounds any deeper than 1/4", rather than the 3/4" recommended in the post (maybe a typo?). There's just too much risk for infection or for uncontrolled bleeding. Your circumstances will dictate, but generally the shallower and cleaner the wound the more appropriate for gluing.

Your point about leaving an opening for drainage is spot on. As you said, if you start to see any significant drainage, warmth, discoloration, or discolored streaks from the wound, it's past time for a professional. Supergluing things yourself is a good option if you're desperate, but if you have access to formal medical care that's of course your best option for treating whatever injury.

Keep up the great work, and take care,

Graham

Hi Graham. Thanks for the correction. I was actually thinking of some of the head cuts ERs around here fix with superglue. You're right, that's around 1/4 inch, not half an inch. Sorry for that, we use metric around here. :-)
The lip that I saw pictures of glued together though, that was a serious wound and the doctor still used superglue. Guess the lesson is that while it can be done, when used so extensively you need a doc. When doing it yourself just stick to smaller wounds.

Mr Aguirre
 
About 15 years ago I had inner ear surgery. 
The way they get to the inner ear is to cut the outside of the ear almost all of the way off and then tape it to
your nose to get it out of the way....then drill (or moto-tool) a hole in your skull above the ear canal to reach the inner ear.
After doing the repair, they used medical super glue to glue my ear back on.  There was  a large compression dressing over the ear that I had to leave on for 24 hours...and had to be carefull for several
more days, but it healed perfectly.
For a few months little pieces of the cyanacrolate would work their way out of the incision area if I scratched or washed it.  No pain, very little swelling---overall excellent result--and (unfortunately) my ears are no small piece of flesh and cartilage.  Super glue is good stuff.
 
Mark    Dayton, Oh
Thanks Mark for your email. Seems that its used a lot for soft tissues.
This is the PDF document I referred to beofre: Lip suture with isobutyl cianoacrylate (Graphic Warning!:shows actual wounds)
Click on it, its worth reading  and it  shows how isobutyl cianoacrylate is actually used. Notice Dr. Blanco actually puts the glue INSIDE the wound, THEN presses the sides together. Of course the wound shouldn't be bleeding much so as to achieve this correctly. Again, for this type of larger wound, go to the doctor. Its still interesting to understand how this works.
Take care,


 FerFAL

2 comments:

Anonymous said...

Ferfal, I sell a medical grade skin glue for a major company. Do not put the glue inside the wound. The wound edges have to be touching for healing to occur. If you put glue inside the wound edges, you will end up with a huge gap as the wound finishes healing.
The biggest thing about closing a wound is careful cleaning of the wound. That is more important than the closure method. If the wound is deep, you have to have deep sutures or the glue will not hold and the wound will tear apart. If it is a non-deep wound, careful cleaning of the wound, adequate hemostasis (stopping bleeding), then clean and dry the skin before holding the skin edges together and applying a topical glue. Hold the skin edges touching until the glue sets up completely.
The problem with super glue is that it will fracture and break off. It is a different formulation than surgical skin glues. The surgical grade glues are octylcyanoacrylates, they flex with the skin, and they are not washed off with water.
Having said that, if you have nothing else, clean the wound, use the topical glue, cover with a dressing. Skin takes 5-7 days to heal.

ghpacific said...

I read that the proper way to use superglue for wound closure is not to put the glue in the wound but to glue closure strips on one side of the wound and then close the wound and glue the strips to the other side. Then use nail polish remover to remove the glue. I put superglue in a small wound once and it hurt like hell. No way I'm gonna do that again.