How to Use Dermabond Surgical Skin Glue

Dermabond advanced surgical skin glue and tissue adhesive
Note: Dermabond is no longer sold to general consumers. To buy Dermabond you must be a licensed medical professional and open an account directly with Ethicon. Here you can find links to several high-quality Dermabond alternatives.

Dermabond (2-octyl-cyanoacrylate) is one of the only surgical glues that is FDA approved for use on humans. It comes in sterile, single-use applicators and is the glue of choice for surgeons closing incisions after an operation. It is sterile, nontoxic, produces very little heat as it cures, remains flexible after hardening, hardens in about 30 seconds, and is as strong as 5-0 stitches[1].

Because of its many benefits, Dermabond is the most expensive surgical glue on the market. In order to be labeled as sterile for medical use it is sold in .7mL (.02oz), single-use applicators. A glass seal has to be broken before using each applicator, and any glue left inside will harden, becoming unusable.

See here for more information on other surgical glues.

Index:

How to Use Dermabond:

  1. Dermabond comes in a single-use applicator. To open, point the applicator downwards, squeeze the bulb to break the inner glass container, then squeeze again to moisten the internal filter.
  2. First try to make sure the cut is clean. If everything works out, the cut will heal completely without the Dermabond needing to be removed. Bleeding pushes dirt and bacteria out of the wound site and prevents infection, so if the cut is bleeding there is less chance of infection; use your best judgement. Stop the bleeding with sterile gauze and direct pressure to the cut. If the cut is on a joint, move the body so the skin is slack. For example, if there is a gash on your knee, straighten your leg to relieve the tension on the cut.
While keeping pressure on the wound, slide the gauze off the wound site to expose the edge of the cut. Try to line up the wound edges as accurately as possible, and apply Dermabond to the wound. Wait until the glue has hardened enough to stop the bleeding, and then repeat the process down the length of the cut until it is completely glued.

Dermabond only requires one layer for maximum strength, unlike Vetbond. Use medical tape or butterfly stitches to pull the skin together around the wound after the glue is dry, relieving any tension if possible.

  1. While you're applying the glue to a cut it will probably still be bleeding despite your best efforts. Some of the glue might wash away or mix with blood to form a big hard clump. This is normal and won't stop the wound from healing properly. Even if it looks messy, as long as the bleeding stops, it's okay. The glue will slough off by itself over the course of 5 - 7 days.

Do not apply more than a thin layer to prevent the glue from running.

Try to keep the glued area dry while the cut is healing. Surgical glue is resistant to water, but it will slough off faster if it's being held in the shower or washing dishes. Do not use triple antibiotic ointment (Neosporin) on the wound, as triple antibiotic ointment is petroleum based and causes it to dissolve.

Dermabond in Surgery

Thanks to its effectiveness and FDA approval, Dermabond has become the surgical glue of choice in the United States. While it does not replace stitches in all circumstances, it works both as an alternative and complementary to stitches in many cases. Dermabond can be used to replace stitches that are 5-0 or smaller, or it can be used as an outer seal for absorbable subcutaneous stitches in larger incisions.

Dermabond surgical glue:

  • Decreases wound repair time
  • Provides a flexible water-resistant coating
  • Protects against infection
  • Eliminates the need for suture removal
  • Eliminates suture tracks, improving scar appearance
  • Is tolerated more readily by children than needles

Dermabond should not be used on:

  • Subcutaneous incisions
  • Dog bites, puncture wounds, or contaminated wounds
  • Mucosal surfaces
  • Jagged or stellate lacerations
  • Axillae, perineum, or other high moisture areas
  • Hands, feet, or joints which are not immobilized[1]

Dermabond Removal

Dermabond is a cyanoacrylate glue, like Super Glue, and is dissolved by petroleum based gels and liquids. Triple antibiotic ointment (Neosporin) is a good choice because it is petroleum based and a disinfectant. To remove Dermabond from the skin or from a cut:

  1. Soak the glue in triple antibiotic ointment for a few minutes or cover the glued area completely.
  2. Rub the glue gently to break it up and help the ointment work.
  3. Repeat until the glue is gone. This may take several applications for complete removal.

Other products for removing dermabond include:

  • Acetone (dilute as necessary)
  • Warm soapy water
  • Vaseline

For Dermabond in hair, other options include:

  • Vinegar
  • Vegetable oil
  • Tea tree oil

Dermabond Allergies and Complications:

Allergies:

In rare cases Dermabond skin glue can cause an allergic reaction called contact dermatitis. The symptoms of contact dermatitis are:

  1. Flaky, dry, scaly skin
  2. Oozing blisters
  3. Hives
  4. Dark or leathery skin
  5. Redness around the glued area
  6. A burning sensation that doesn't go away or gets worse over time
  7. Sun sensitivity
  8. Extremely itchy skin
  9. Swelling/inflammation

NOTE: It is natural to feel a slight burning sensation as the glue is applied, but it should go away quickly.

Contraindications:

  1. Do not use Dermabond if you have a known allergic reaction to cyanoacrylates or formaldehyde.
  2. Dermabond is for use on the outside of the body only.

Complications:

  1. Reopening of the wound can happen due to physical strain on the wound site, poor blood circulation to the healing site, or patients who pick too much at the wound.
  2. Glue runoff happens when too much glue is applied at once. The glue can accidentally stick fingers, eyelids, and other parts of the body together.
  3. A wound can become infected when the glue is applied without proper cleaning of the wound site.

Dermabond Alternatives

Although Dermabond is not available to the general public, alternative products exist with the same or similar active ingredients. Dermabond is part of a class of glues called cyanoacrylates. The two most commonly used cyanoacrylates in medicine are 2-octyl-cyanoacrylate (Dermabond) and n-butyl-cyanoacrylate. Use the below list to find the Dermabond alternative most suited to your needs.

  1. Vetbond: 100% n-butyl-cyanoacrylate
  2. Surgi-Lock 2oc: Same active ingredient as Dermabond (2-octyl-cyanoacrylate)
  3. GLUture: 40% n-butyl-cyanoacrylate, 60% 2-octyl-cyanoacrylate

How to Care for a Glued Cut

Dermabond is a type of occlusive dressing, not an antibacterial agent. It and other cyanoacrylate glues create an air-tight, water-tight barrier that seals the wound completely. This can prevent bacteria and dirt from getting in, but it can also seal them inside. Before gluing a cut, make sure that it is properly cleaned. Do not put any ointments on the cut before applying Dermabond.

After gluing the cut, nothing else needs to be done.

Do not:

  • Pick at the glue
  • Wash or scrub the glued area
  • Put antibiotic ointment on the area

If the glue comes off before the cut is healed, simply apply another coat of Dermabond.

Tips

  1. Make sure you protect Dermabond applicators. If the glass seal breaks, the glue will dry out and be unusable.
  2. Dermabond can be dissolved in minutes using triple antibiotic ointment or other petroleum based products.
  3. Dermabond can be used on the inside of the mouth, but special care should be taken to prevent the glue from running to other parts of the mouth.

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About Peter Oldani - Author of Inside First Aid

About the author

Peter Oldani graduated college with a B.S. in biomedical engineering, worked as an EMT to gain hands on experience in emergency medicine and completed active shooter training as part of New York State’s initiative to prepare civilian organizations for disaster response.