Use of a skin stapler to repair penetrating cardiac injury
2006
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).
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