BALTIMORE The cutaneous adhesive Dermabond can be applied to the margins of a wound to buttress atrophied, thin skin enough to achieve adequate primary closure with sutures, Dr. Michael Bain reported at the annual meeting of the American Society of Plastic Surgeons.
Physicians have always had a difficult time suturing lacerations or defects created from the removal of cancer because sutures tear the skin of older patients with steroid-induced skin atrophy or genetically thin skin, said Dr. Bain, a plastic surgeon in private practice in Newport Beach, Calif.
"There are so many patients out there who in the past have needed skin grafting when they got a bad laceration," he said in an interview. "You could also use this technique in infants who have very thin skin."
After a standard wound preparation, Dermabond is applied 3 mm from the wound margins. Simple sutures placed either through or behind the Dermabond close the wound without tearing the skin. "You have to make certain that you don't get any Dermabond into the incision or into the wound because that will prevent healing," he said.
Dr. Bain has used the technique on about 1520 patients without any problems. He said that his colleagues, as well as trauma surgeons, also have begun using the technique successfully.
By allowing the closure of wounds in thin skin, the technique may prevent the need for prolonged wound care, according to Dr. Bain, who presented the method on a poster. He and his coinvestigators have no conflicts of interest with regard to Ethicon Inc., the manufacturer of Dermabond.
The cutaneous adhesive, Dermabond, is applied 3 mm from the wound margins.
The healing wound is shown 3 weeks after the graft-sparing procedure. Photos courtesy Dr. Michael Bain