I have a friend who is not the most wise, and not the most graceful. He is brave though! Combining those traits, he’s taken to supergluing himself back together rather than going in to the emergency room every other week. Is this actually a good option for wound care for preppers, or another one of his not-quite-brilliant ideas?
(For other options and tips on closing wounds, there’s another post here.)
Tissue adhesives are a good option for closing some wounds
The emergency med people don’t like to call their stuff superglue, because it’s not just like the stuff we use for fixing china and they don’t want folks doing what my friend does. It is similar though (more on the differences later); and they use it a lot for particular kinds of wounds. (I say ‘they’ by the way because I am not myself a doctor and don’t give medical advice. What I do is read the medical literature and share what I learn.)
Tissue adhesives are used to close certain small lacerations, and have also been used to dress burns and abrasions. (1) They not only hold things together (if the tension isn’t too high), but serve as a barrier to microbes and a waterproof dressing.
For a cut to be a good candidate for closing with tissue adhesive, it should: (2,3)
- Be small (5 cm or less; roughly 2 in)
- Have straight edges. Jagged wounds are not closed this way.
- Be on a spot with low tension. Head wounds usually do well with tissue adhesives.
Other wounds are bad choices for using tissue adhesive: (2,3,4)
- Wounds that are still bleeding
- Explosion wounds (includes gunshot wounds and wounds from flying debris from detonations; more on these in a later post)
- Infected wounds
Some kinds of wounds are questionable targets for tissue adhesive use: (2,3,4)
- Damp areas like mouths, armpits, and groins. Some sources don’t recommend glue use on these; others have had some success with it. I got ‘it might work, might not’ out of it.
- High tension areas, where the wound is likely to get stretched. Wounds around hands and knees are a great example. Some sources talked about using glue on these, but only after stitching the deeper tissue layers; or they said they’d use the glue but splint the area to limit its motion until it had healed.
Tissue adhesives isn’t really superglue, or Krazy Glue
They’re similar compounds, but tissue adhesives (also called surgical glues, which I shorten to ‘glue’ a lot in this piece) have been formulated to reduce some of the problems of regular superglue use. Here’s how tissue adhesives behave differently: (1)
- Less toxic. Superglue kills more cells.
- Produces less heat when it bonds. Particularly in damper areas, superglue can create enough heat that it actually burns the tissues it’s supposed to be bonding.
- Less irritating. Normal superglues provoke more redness, pain, swelling.
- Slightly slower bonding. Raise two glued-together fingers if you’ve ever discovered that superglue can be a little too fast on occasion. Tissue adhesives give you about a ten second grace period to wipe off runaway fluid before it sticks everything together. (A physician’s assistant friend admits that it can still be challenging when using tissue adhesive not to glue one’s glove to the patient.)
- Often have a dye indicator included so you can see where the stuff’s going.
- More flexible. Superglue is rigid and prone to cracking once it sets; tissue adhesives have more give.
When I looked to buy tissue adhesives on the web, the human versions such as DermaBond required a medical practitioner license number to order. I did however find a veterinary version called VetBond for open sale, about $18 for a small bottle
How tissue adhesives are used
Here are some tips for using tissue adhesives: (1,2,5)
- Wait until bleeding has stopped and the wound has been cleaned and patted dry.
- Angle the part to be glued so it is flat; you don’t want run-off.
- Get the wound edges pushed together so they touch. Wounds that don’t want to close this way may need stitches for the deeper tissue layers. This may also take a second pair of hands, so one person can push the skin in from both sides to seal the wound while the other applies the glue.
- Apply the glue as a bridge to hold the two sides together, but avoid getting glue down into the wound.
- If you have run-off, wipe it off immediately. You’ve got about ten seconds to get this done.
- Multiple layers may be needed. Three if often suggested, with the second and third layers applied as widening ovals around the first.
- It takes about 2.5 min for the first layer to set well. Additional layers take longer. Don’t bother blowing on it; it won’t speed up the process.
- Once dry, bandage the area only if it’s in a spot likely to get dirty.
- If the cut is in a mobile area, splint it.
- If you accidentally bonded eyelids together, either apply a lot of eye ointment or just let it be until it peels off itself. Don’t get vigorous such as pulling out eyelashes.
- Tissue adhesives peel off in 5-10 days, so there’s no need for active removal.
- If pus starts coming out of the wound, remove the adhesive and clean the wound. Don’t re-glue it.
- Some places say to keep it dry for 5 days, but most places said once the glue was dry, it was ok to let the area get wet briefly. Everyone agreed that letting the wound stay wet for long could cause the wound to re-open.
Want to learn more about wound care? This is intended to be the first of a series, so check back later. Here’s hoping you never need this information!
(1) Cascarini, L., & Kumar, A. (2007). Case of the month: Honey I glued the kids: tissue adhesives are not the same as “superglue.” Emergency Medicine Journal : EMJ, 24(3), 228–229. http://doi.org/10.1136/emj.2006.036392
(2) Bruns TB1, Worthington JM.Using tissue adhesive for wound repair: a practical guide to dermabond.Am Fam Physician. 2000 Mar 1;61(5):1383-8.https://www.aafp.org/afp/2000/0301/p1383.html
(3)What is skin glue? NHS: Choices. Accessed 12-14-17. https://www.nhs.uk/chq/Pages/2552.aspx?CategoryID=72
(4)Leaper, D. J. (2006). Traumatic and surgical wounds. BMJ : British Medical Journal, 332(7540), 532–535.
(5)How do I care for a wound treated with skin glue? NHS Choices. Accessed 12/14/17. https://www.nhs.uk/chq/Pages/2553.aspx
*By ragesoss (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons