Dermabond Nail Bed Repair

Ok so i removed the nail to repair the nail bed laceration.

Dermabond nail bed repair.

This typically also requires the crushed fingernail to be removed. Double dorsal versus single volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department. Post updated may 26 2014 22 47 pst 1. 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.

Cosmesis is never ideal because pieces of the nailbed are often missing as seen in the photo above. Strauss e weil w jordan c paksima n. Check out more details on the technique at dr. Results of a prospective series of 30 patients november 2009 journal of children s orthopaedics 4.

Repair nail bed with 6 0 or smaller absorbable suture. 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. Using dermabond took about 1 3 of the time. Soak nail in betadine while repairing nail bed.

Cannon b et al. Martin sp et al. Rct has demonstrated quicker repair time using 2 octylcyanoacrylate dermabond instead of suture with comparable cosmetic and functional results. Nailbed lacerations are often sustained by a major crush injury resulting in a stellate and irregular laceration pattern.

Now i am having difficulty suturing it back in place. Just because a nail bed laceration is present it doesn t mean nail removal with obligate repair is indicated. Over the years i have been frustrated by how inelegant finger nailbed closure is. A study in 2008 used dermabond for nail bed laceration repair showed similar follow up cosmetic and functional outcomes.

Amazingly i still see residents perform intricate repairs with nylon sutures that have to be removed. 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. The actual nail bed repair should be accomplished with absorbable sutures usually 6 0 size. However the study did find a difference in the time it took providers to complete the repair.

The key to success is achieving hemostasis and making sure. Not every nail bed laceration requires nail removal and repair. Roser se gellman h. 9 5 minutes using dermabond and 27 8 minutes using sutures.

One injection or two. A prospective randomized controlled trial of 2 octylcyanoacrylate. The use of 2 octylcyanoacrylate dermabond for the treatment of nail bed injuries in children.