Dermabond Nail Bed Repair

Soak nail in betadine while repairing nail bed.

Dermabond nail bed repair.

Over the years i have been frustrated by how inelegant finger nailbed closure is. Nailbed lacerations are often sustained by a major crush injury resulting in a stellate and irregular laceration pattern. Just because a nail bed laceration is present it doesn t mean nail removal with obligate repair is indicated. Cannon b et al.

9 5 minutes using dermabond and 27 8 minutes using sutures. Rct has demonstrated quicker repair time using 2 octylcyanoacrylate dermabond instead of suture with comparable cosmetic and functional results. Martin sp et al. Not every nail bed laceration requires nail removal and repair.

Cosmesis is never ideal because pieces of the nailbed are often missing as seen in the photo above. Double dorsal versus single volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department. Roser se gellman h. Ok so i removed the nail to repair the nail bed laceration.

Repair nail bed with 6 0 or smaller absorbable suture. A prospective randomized controlled trial of 2 octylcyanoacrylate. A study in 2008 used dermabond for nail bed laceration repair showed similar follow up cosmetic and functional outcomes. It was a small study with only 40 patients and repair was done by orthopedic residents but definitely a consideration.

Results of a prospective series of 30 patients november 2009 journal of children s orthopaedics 4. Check out more details on the technique at dr. Amazingly i still see residents perform intricate repairs with nylon sutures that have to be removed. Replacing the nail is the easiest way to protect the healing nail bed pack the nail fold and provide a natural splint for the healing injury.

One injection or two. J hand surg am. Comparison of nail bed repair versus nail trephination for subungual hematomas in children. The key to success is achieving hemostasis and making sure.

The actual nail bed repair should be accomplished with absorbable sutures usually 6 0 size. The use of 2 octylcyanoacrylate dermabond for the treatment of nail bed injuries in children. Nail bed repair with dermabond and likely all tissue adhesive glues may be a reasonable alternative to sutures for both nail bed laceration repair itself as well as to hold the nail in place. Post updated may 26 2014 22 47 pst 1.

However the study did find a difference in the time it took providers to complete the repair. Using dermabond took about 1 3 of the time. Now i am having difficulty suturing it back in place.