Gluing blood vessels together, just like gluing a cut garden hose together, does not seem like a great idea at first, but Stanford researchers just might have figured out how to do this safely and effectively.
Over the past century and still currently used today is to hand-sew the cut ends of the blood vessel together using stitches. This method of reattaching blood vessels is time-consuming and tedious, especially when the blood vessels are tiny.
In this new glue method which is FIVE times faster, a special substance is Read more »
*This blog post was originally published at Fauquier ENT Blog*
Bioadhesives are a reasonable alternative to sutures for repair of perineal lacerations sustained during childbirth, according to a poster presentation at last week’s annual meeting of the Society for Maternal-Fetal Medicine.
Researchers at the Hadassah Hebrew University Medical Center in Jerusalem randomized women with first degree perineal tears to either 2-octyl cyanoacrylate (Dermabond) adhesive glue or suture for wound closure. While healing and incisional pain was similar, women who received the adhesive closure were more satisfied than those who were sutured.
In Portugal, bioadhesives have been studied for closure of the top skin layer of an episiotomy repair, and found to shorten the duration of the procedure with similar outcomes to suture in terms of pain, healing, and infection.
Biologic adhesives are chemically related to Super Glue, which is ethyl-cyanoacrylate. Midwives have been using Super Glue for perineal wound repair for some time, according to Anne Frye, who has authored a book on wound closure for midwives, and who gives instructions for its use in repair of perineal lacerations. Apparently Super Glue was also used by the military during Vietnam for wound closure.
A PubMed search on Dermabond finds multiple studies of its use, from plastic surgery to mastectomy, surgical wound closure, retinal surgery, lung and gastric leak closure, and even on esophageal varices. RL Bates mentions Dermabond as an option to repair skin tears in elderly patients. This stuff is turning into the duct tape of the medical profession.
It’s important to remember that adhesives are only for superficial skin closure, as use in deeper layers can cause irritation and burning of tissues. Side effects of their use include irritation and allergic reactions and of course wound infections, and pain can always occur no matter how one closes a wound.
*This blog post was originally published at The Blog That Ate Manhattan*
In the comments, a question was posed from reader “Seattle Plastic Surgery on Lake Union” (an online handle that is as unwieldy as it is descriptive). He asks:
I would like to hear your opinion on a topic that is rapidly growing near and dear to my heart…the scenario is thus:
I’m on call, the local plastic surgeon, for the local ER. You are seeing a nice family with a child that has sustained a simple facial laceration. No fractures, no missing tissue, just a simple, linear, forhead laceration.
The Mom asks that a plastic surgeon be called to come in from home and close the wound. You reply that you are able to do the closure, the child is medically stable, and that a you are qualified to close the wound. The family presses you: call the plastic surgeon.
Can you tell me, from an ER doc’s standpoint- what is the most appropriate response from the on call plastic surgeon? Read more »
*This blog post was originally published at Movin' Meat*
I recently read a post that reminded me of an incident. depending on which side of the eyelid you found yourself that day, it could have been funny…or not.
I was doing casualty sessions after hours. It was a way of making ends meet while I was specialising, but mostly I just hated it. Anyway one night, between the snotty noses and neurotic parents a patient actually came in with a casualty-worthy complaint. He had a small laceration on his forehead. We decided to glue it together with dermabond because it was so small. I decided to leave it to the sister. After all the unit was full to overflowing with snotty noses and paranoid parents that I was required to work through and get rid of.
After a while the sister came to me. She had terror written all over her face. Read more »
*This blog post was originally published at other things amanzi*