RECOMMENDATIONS FOR CLINICAL PRACTICE
Using hair apposition with tissue adhesive appears to be an effective technique for closing simple scalp lacerations. It is faster and better tolerated than suturing, and appears to result in less scarring. The superficial apposition provided by this technique will not be adequate in those cases were deep sutures are required. Using the hair apposition technique appears to be a practical method of treating scalp lacerations.
Ann Emerg Med 2002; 40:19–26.
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| Contraindications to Use of Skin Adhesives |
| Jagged or stellate lacerations Bites, punctures or crush wounds Contaminated wounds Mucosal surfaces Axillae and perineum (high-moisture areas) Hands, feet and joints (unless kept dry and immobilized) |
| Steps in Use of Dermabond |
| 1. Apply topical anesthetic as needed. 2. Prepare wound with antiseptic. 3. Appose wound edges. 4. Crush Dermabond vial and invert. 5. Gently brush adhesive over laceration. 6. Avoid pushing adhesive into wound. 7. Apply three layers of adhesive. |
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