Use of a skin stapler to repair penetrating cardiac injury

sutures to platysma routinely and deep dermal sutures only if the wound edges require approximating. The surgical field is cleaned and dried. Dermabond™ is applied along the wound, and forceps used to maintain skin edge eversion if necessary. Two further applications are made. No further dressing is required; after 3 min the glue is dry and fully waterproof. DISCUSSION Skin closure with sutures can be time-consuming, and removal can be distressing for the patient. Cosmetic outcome is variable, depending on the accuracy and tension of the closure. Dermabond™ is quick to apply and no foreign material is left within the skin. It is waterproof, allowing patients to shower from day one, and requires minimal input from nursing staff. A randomised, controlled trial of 111 patients showed Dermabond™ to have a superior cosmetic outcome at 1 year compared with sutures, with no increase in complications. 1 A recent study looking at wounds greater then 4 cm found Dermabond™ provides equivalent wound closure to sutures, with a decreased incidence of wound infection. 2 In our experience, both patients and nurses find this method of closure preferable to sutures, with good cosmetic results (Figs 1 and 2).