Dermabond glue contains cyanoacrylate which is a tissue adhesive that forms a strong bond between skin edges to help aid in wound healing. The adhesive cures to anionic substances such as water and blood approximately in 30 to 60 seconds at room temperature. The adhesive should not be applied to wet wounds that are covered in water or alcohol because it inhibits the acceleration of the polymerization rate of drying. Dermabond glue is used commonly for skin closure after a minimally invasive surgical procedures such as a laparoscopic or robotic procedure. In a laparoscopic or robotic procedure, the surgeon only needs to make small incisions to insert the trocars (typically in the abdominal region) that is needed to perform these procedures with surgical instruments. Minimal invasive procedures are becoming more common with medical technology advancements and using topical skin adhesive such as Dermabond glue can help eliminate needle-stick injury by surgeons, reduce operating time, decreased estimated blood loss, lower surgical complications and post-surgical infections, and no post-surgical removal requirements.
There are many benefits using Dermabond glue as a topical skin adhesive (verses sutures or staples) as a surgical dressing for wound closure. The benefits include the application of the adhesive is fast and painless, the adhesive is less likely to scar the skin unlike sutures or staples, the adhesive does not require a follow-up for removal because the glue spontaneously falls off after 5 to 10 days, the adhesive creates a moist environment which is optimal in wound healing, and the adhesive has antimicrobials against gram-positive organisms resulting in less wound infections. Along with the benefits of using Dermabond glue for wound closure there are disadvantages as well. The wound strength decreases by 10% with cyanoacrylates within the glue so at closure it is ideal to use stripped tape for reinforcement. Seros fluid or blood could accumulate underneath the plastic membrane of the glue which decreases wound healing and increase the risk of infections. Ointments, such as bacitracin, cannot be applied with Dermabond glue because ointments can weaken the skin adhesive and cause early peeling. Since ointments cannot be applied with the glue, oral antibiotics can be prescribed to help decrease post-surgical infections and if an infection does develop under the topical skin adhesive, it is recommended to remove the glue, administer standard wound care, and do not reapply Dermabond as a dressing due to its contraindication with infections. Lastly, for facial wounds, it may be contraindicated to use Dermabond glue for cosmetic purposes over conventional sutures.
Just like any other medical product, it can cause side effects when applying Dermabond glue as a surgical dressing. Side effects such as after immediate application of the glue, the patient may feel a sensation of heat or a minor discomfort. The skin can appear red, painful, tender, and swollen. Dermabond can also cause wound dehiscence and either the surgeon can decide to apply more topical adhesive to the wound or suture the wound close. Another contraindication of using Dermabond glue is the adhesive can cause an allergic reaction called Contact Allergic Dermatitis which exhibits symptoms such as shortness of breath, low blood pressure, chest pain, urticaria (hives), and red, itchy or sore lumps at injections sites. Most reactions usually clear up in a few days but if not, it is important to seek medical care.
Post-surgical care and education is important regarding the use of a topical skin adhesive, such as Dermabond, to help promote wound healing and decrease post-surgical infections. One of the benefits of Dermabond glue is the adhesive acts as its own water-resistant bandage and does not need additional wound dressings (such as gauze and Tegaderm) but for children, it may be essential to cover the glue with a band aid to prevent picking the topical adhesive off too soon. The adhesive needs 5 to 10 days to spontaneously peel off (as stated above) or the skin can scar. Post-surgically, patients can take showers but not baths because the glue submerged in bath water for long periods of time may loosen the top epithelial layer of skin and cause premature peeling of the glue or wound dehiscence. This then cause bacteria to get under the glue to the wound which increases developing an infection.
Sources
https://dermnetnz.org/topics/topical-skin-adhesives Assessed and Endorsed by the MedReport Medical Review Board