How to Use Dermabond Surgical Skin Glue

Dermabond advanced surgical skin glue and tissue adhesive

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.

Dermabond 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].

Front and back view of the Dermabond applicator package

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.

Contents

How to Use Dermabond

How to open the Dermabond applicator
  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.
  3. Stop the bleeding with sterile gauze and direct pressure to the cut.
  4. While keeping pressure on the wound, slide the gauze off the wound site to expose the edge of the cut.
  5. Try to line up the wound edges as accurately as possible, and apply Dermabond to the wound.
  6. 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.
  7. 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. Dermabond only requires one layer for maximum strength, unlike Vetbond.
  8. Use medical tape or butterfly stitches to pull the skin together around the wound after the glue is dry, relieving any tension if possible.
How to use properly Dermabond glue

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.

Tips and Recommendations

Close up view of the applicator
  1. Do not use triple antibiotic ointment (Neosporin) on the wound, as triple antibiotic ointment is petroleum based and causes it to dissolve.
  2. Make sure you protect Dermabond applicators. If the glass seal breaks, the glue will dry out and be unusable.
  3. Dermabond can be dissolved in minutes using triple antibiotic ointment or other petroleum based products.
  4. It 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.
  5. Safety: Cyanoacrylates, including Dermabond, can cause powerful exothermic reactions when they mix with cotton, leather, or wool. When using the cyanoacrylates including Superglue, Vetbond, or Dermabond be careful not to let the glue come in contact with clothing made from these materials.

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.

View of the Dermabond applicator package

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
Using Dermabond for Surgeries

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: Acetone (dilute as necessary), Warm soapy water, Vaseline

For Dermabond in hair: Vinegar, Vegetable oil, Tea tree oil

Dermabond Allergies and Complications:

Dermabond advanced package

Allergies:

In rare cases Dermabond skin glue can cause an allergic reaction called contact dermatitis.

Symptoms of contact dermatitis: flaky, dry, scaly skin, oozing blisters, hives, dark or leathery skin, redness around the glued area; a burning sensation that doesn't go away or gets worse over time, sun sensitivity, extremely itchy skin, 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

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.

Read more: How to Use Vetbond Tissue Adhesive

2. Surgi-Lock 2oc

Same active ingredient as Dermabond (2-octyl-cyanoacrylate).

Read more: Surgi-Lock 2oc - A Dermabond Equivalent

3. GLUture

40% n-butyl-cyanoacrylate, 60% 2-octyl-cyanoacrylate.

Read more: GLUture Skin Glue – Combining Dermabond with Vetbond Surgical Glue

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.

A summary about how to use Dermabond:

Infographic about the use of Dermabond to seal wounds

Additional Resources

  1. How to Care for a Cut Sealed with Dermabond
  2. A Guide to Dermabond
  3. Dermabond Data Sheet
  4. The Use of Topical Tissue Adhesives for Surgical Procedures

References

  1. Bruns, Thomas B., and J. Mack Worthington. "Using tissue adhesive for wound repair: a practical guide to dermabond." American family physician 61.5 (2000): 1383-1388.

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