Bio-adhesives are a reasonable alternative to sutures for repair of perineal lacerations sustained during childbirth, according to a poster presentation at last week’s annual meeting of the Society for Maternal Fetal Medicine. Researchers at the Hadassah Hebrew University Medical Center in Jerusalem randomized women with first degree perineal tears to either 2-octyl cyanoacrylate (Dermabond) adhesive glue or suture for wound closure. While healing and incisional pain was similar, women who received the adhesive closure were more satisfied than those who were sutured.
In Portugal, bioadhesives have been studied for closure of the top skin layer of an episiotomy repair, and found to shorten the duration of the procedure with similar outcomes to suture in terms of pain, healing and infection.
Biologic adhesives are chemically related to Superglue, which is ethyl-cyanoacrylate. Midwives have been using Superglue for perineal wound repair for some time, according to Anne Frye, who has authored a book on wound closure for midwives, and who gives instructions for its use in repair of perineal lacerations. Apparently Superglue was also used by the military during Vietnam for wound closure.
A Pub Med search on Dermabond finds multiple studies of its use, from plastic surgery to mastectomy, surgical wound closure, retinal surgery, lung and gastric leak closure, and even on esophageal varices. RL Bates mentions Dermabond as an option to repair skin tears in elderly patients. This stuff is turning into the duct tape of the medical profession…
It’s important to remember that adhesives are only for superficial skin closure, as use in deeper layers can cause irritation and burning of tissues. Side effects of their use include irritation and allergic reactions, and of course wound infections and pain can always occur no matter how one closes a wound.
Are all the glues used to close the top layer of skin after surgery or tearing basically the same as to chemical composition?
My surgeon used glue to close the top layer of skin after my lap chole and I had an allergic reaction to it – had big itchy hives every place it was used. If they aren’t all the same I think I should find out what type he used so I can tell any future surgeon that I’m allergic to that one.