How to Use Cyanoacrylate Surgical Skin Glues for First Aid

Dermabond advanced for sale

Has anyone ever told you to put super glue on a cut? Have others told you that it is toxic and causes burns?

Both facts are true, but now we have special types of medical super glue that are non-toxic and seal cuts as well as stitches.

Medical super glue, also called surgical glue or skin glue, is mainly used in operating rooms on both people and animals to seal surgical incisions, but it has lots of potential for improving the quality of emergency medicine as well. These glues stand apart from other liquid bandage products because they start to harden instantly on contact with skin and create a strong skin-to-skin bond that holds the cut closed.

Index:

How to Seal A Cut With Surgical Skin Glue

  1. Stop the bleeding by holding pressure.
  2. Try to line up the edges of the wound as best you can. This is easiest with a clean cut like from a knife.
  3. Carefully uncover one end of the cut while still holding pressure. As you uncover the cut, apply glue, and wait until it dries.
  4. Carefully uncover more of the cut and repeat the process until the cut is completely sealed.

As you uncover the cut, it will probably start to bleed despite your best efforts. The blood will mix with the glue, forming hardened bubbles and lumps. This is normal, and while it may not look pretty, the main goal is to stop the bleeding.

A Quick Guide to Cyanoacrylate Glues:

Dermabond

Dermabond cyanoacrylate skin glueDermabond is No Longer Available for Purchase. See Vetbond Surgical Glue
  1. 2-octyl-cyanoacrylate
  2. .7mL, single-use applicator (12/box)
  3. FDA approved for skin closure on humans
  4. Sterile
  5. Hardens flexible
  6. Use 2 - 3 coats letting dry 30 seconds between layers
  7. Strongest skin glue (4x stronger than Vetbond), as strong as thin stitches (size 5-0 and smaller)[4]
  8. Most expensive skin glue

Learn here: How to use Dermabond surgical skin glue

Vetbond

  1. n-butyl-cyanoacrylate
  2. 3mL, multi-use plastic squeeze bottle
  3. Safe for skin closure, but not FDA approved
  4. Marketed for use on animals
  5. Hardens somewhat flexible
  6. Cures on contact (15 seconds to cure completely)
  7. Use 2 - 3 coats letting dry 15 seconds between layers
  8. About 1/4 the strength of Dermabond/5-0 stitches[4]
  9. Cheapest skin glue
  10. Very thin liquid

Read here: How to use Vetbond

GLUture

  1. 40% n-butyl-cyanoacrylate, 60% 2-octyl-cyanoacrylate
  2. 1.5 mL aluminum tube
  3. Safe for skin closure, but not FDA approved
  4. Non-sterile
  5. Multiuse
  6. Cures at about the rate of Dermabond
  7. Less expensive than Dermabond but more expensive than Vetbond

Surgi-Lock 2oc

  1. Exactly the same glue as Dermabond in a different package
  2. 2-octyl-cyanoacrylate
  3. 2 mL glass bottle
  4. Not FDA approved for human use
  5. Multiuse
  6. Marketed for veterinary use
  7. Requires separate pipette to apply adhesive

Super Glue/Krazy Glue

  1. ethyl-cyanoacrylate
  2. Not good for skin repair, can cause burns, cytotoxic
  3. Hardens stiff and brittle
  4. Dries in 1 - 5 minutes
  5. Cheapest cyanoacrylate

When to Use Surgical Glue:

In the hospital setting it’s not always advisable to use surgical glue. Using Vetbond or Dermabond on infected cuts, puncture wounds, or injuries with ragged edges can seal bacteria inside the body compounding the problem and delaying healing. In the emergency setting things are a bit different because we are only worried about the short term. Stop the bleeding, and let the doctors figure out the rest.

When doctors treat wounds with ragged edges they have to think about minimizing the scar tissue after the wound heals. In an emergency the #1 priority is to stop blood flow until you can get to a hospital. Do your best to line up the wound edges, and the emergency room doctor can decide how to proceed. The glue is dissolvable in triple antibiotic ointment in a matter of minutes, so don’t worry about any permanent consequences from screwing up.

When Not to Use Surgical Glue:

Do not use surgical glue:

  • On wounds where you can’t pull the edges together.
  • On large area wounds.
  • On animal bites.
  • On wounds that don’t bleed much.
  • On burns.
  • On the eyes.
  • On subcutaneous cuts.

Surgical Glue vs Stitches:

Surgical Glue

  • Found to promote significantly more granulation tissue growth during animal studies[2].
  • Cheaper[1]
  • Less scarring[1]
  • Seals wound against infection[1]
  • Can be used by non-professionals
  • Sloughs off naturally in 5 - 7 days
  • Pain free
  • Not for use inside the body

Stitches

  • Much stronger than Vetbond[1]
  • Easier to use if cut is bleeding profusely
  • Better for use on ragged cuts

The Bottom Line:

Surgical glue is one of the most frequently used items inside my first aid kit for both medical and non-medical applications.

Dermabond dries strong and flexible. It is FDA approved for use on humans, and it is an excellent first aid product. The downside is that it is expensive and comes in single-use applicators.

Vetbond dries extremely fast, but it isn't as strong or as flexible as Dermabond. It can easily hold a wound closed, but the patient needs to be careful to avoid rubbing it off. Vetbond's two main benefits are that it is much cheaper than dermabond and comes in a multi-use bottle.

GLUture tries to be the best of both worlds by mixing the two cyanoacrylate glues together. If you're looking for a stronger glue than Vetbond in a multi-use container, GLUture may be perfect for you. However, it is more expensive and doesn't dry as quickly as Vetbond. GLUture may have a shorter shelf life than Vetbond since the n-butyl-cyanoacrylate is mixed with 2-octyl-cyanoacrylate.

Surgi-lock 2oc is a cheaper, non-FDA approved version of Dermabond. Its packaging is a bit annoying because you need a seperate pipette to apply the glue, but it will certainly save you money. 2-octyl-cyanoacrylate (Surgi-lock 2oc) also has a shorter shelf life than n-butyl-cyanoacrylate (Vetbond).

Tips:

  1. Cyanoacrylate glue can be dissolved using triple antibiotic ointment (Neosporin), so don't worry about causing problems with stitches at the hospital or doing a poor job closing the wound. The goal is to stop bleeding as soon as possible.
  2. Use 3M Medical Transpore tape to pull the cut together after it's glued. This will take some of the tension off the glue and protect it from rubbing off too soon.
  3. Dermabond is single-use and too expensive for non-emergencies, but Vetbond works great to seal and protect ripped cuticles or skin cracks.
  4. Povidone iodine or chlorhexidine should be used to clean cuts before applying surgical glue because other antiseptics may interfere with the integrity of the glue.

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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.