Dermabond Nail Bed Repair

One injection or two.

Dermabond nail bed repair. The key to success is achieving hemostasis and making sure. This typically also requires the crushed fingernail to be removed. Rct has demonstrated quicker repair time using 2 octylcyanoacrylate dermabond instead of suture with comparable cosmetic and functional results. A prospective randomized controlled trial of 2 octylcyanoacrylate.

Over the years i have been frustrated by how inelegant finger nailbed closure is. Roser se gellman h. 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. J hand surg am.

Cannon b et al. Now i am having difficulty suturing it back in place. The use of 2 octylcyanoacrylate dermabond for the treatment of nail bed injuries in children. Not every nail bed laceration requires nail removal and repair.

It was a small study with only 40 patients and repair was done by orthopedic residents but definitely a consideration. Post updated may 26 2014 22 47 pst 1. A study in 2008 used dermabond for nail bed laceration repair showed similar follow up cosmetic and functional outcomes. Double dorsal versus single volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department.

Soak nail in betadine while repairing nail bed. Amazingly i still see residents perform intricate repairs with nylon sutures that have to be removed. Using dermabond took about 1 3 of the time. Repair nail bed with 6 0 or smaller absorbable suture.

9 5 minutes using dermabond and 27 8 minutes using sutures. 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. Just because a nail bed laceration is present it doesn t mean nail removal with obligate repair is indicated. Strauss e weil w jordan c paksima n.

Martin sp et al. Cosmesis is never ideal because pieces of the nailbed are often missing as seen in the photo above. Check out more details on the technique at dr. Ok so i removed the nail to repair the nail bed laceration.

The actual nail bed repair should be accomplished with absorbable sutures usually 6 0 size. Nailbed lacerations are often sustained by a major crush injury resulting in a stellate and irregular laceration pattern. If the nail is firmly adherent and disruption of surrounding tissue is minimal there is likely to be a good cosmetic outcome without primary nail bed repair.