Drs Singer and Hollander raise several important issues about the proper use of tissue adhesives. More than 40 different types of sutures are used to close wounds and incisions.1 It would be naive to think that a single adhesive could replace all sutures. Current tissue adhesives can only close the skin of wounds and should only be applied topically. Tissue adhesives cannot replace deep sutures and should not be used on areas prone to premature sloughing of the adhesive (ie, hands, feet, and over joints). I agree that approximately 30% of lacerations treated in the ED may be amenable to skin closure with tissue adhesives. We have shown that the new octylcyanoacrylate formulation used in our study also can be used to close the skin of surgical incisions.2 Approximately 12 million patients with lacerations present yearly to EDs, and 90 million surgical procedures are performed each year.3
Quinn JV. Tissue Adhesives for Laceration Closure-Reply. JAMA. 1997;278(9):703–704. doi:10.1001/jama.1997.03550090027024
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