Skin glue or stitches?

You know that feeling—when you least expect it your child manages to get a deep cut—and you know you’re headed for a long night in the ER.  The good news is that the field of pediatrics has new and better ways to minimize pain and improve cosmetic outcome of skin wound treatments.

Skin glue is often an alternative to stitches.  The main advantage of skin glue is that it is quick and virtually painless to use.   Your child doesn’t need any injections of pain mediation and there are no needles involved.  Skin glue can be a great option for a young child who would have to be sedated or restrained for a repair with stitches.  Sometimes the cosmetic outcome may not be as good as a sewn repair, especially if the wound is in a high tension area.  There are times when skin glue may not be possible, or may not be the best choice.  Wounds that usually are not closed with skin glue include:

 

1)      Wounds in areas of high skin tension such as the arm, leg or forehead.

2)      Wounds in areas that stretch, move, or change such as over joints.

3)      Wounds within a hairline such as scalp or through an eyebrow.

4)      Wounds that have a high risk of infection such as animal bites.

5)      Wounds that are particularly deep or large or involve damage to underlying muscle or tendons.

6)      Wounds to mucus membranes, lips, and genitalia.

 

Skin numbing cream is also available and, for smaller wounds, can be the only medication needed to numb the area before stitches.  This eliminates the need for injectable numbing medicines.  The down-side to skin numbing creams is that they have to sit for at least 20-30 minutes before they are fully effective.  But for small wounds that are not a candidate for skin glue, numbing cream and a few dissolving stitches means a nice cosmetic outcome with little or no trauma.  Some doctors will also give a small, weight-adjusted dose of a narcotic and/or anxiety medicine to help make the process easier.

 

For larger wounds that need a lot stitches, some pediatric emergency rooms offer sedation.  Your child can be put to sleep with IV medicine during the repair.  If you think this might be necessary, call your ER first as not all facilities offer this service.

 

Some, but not all, ERs have a plastic surgeon on call.  Other ERs have a list of plastic surgeons that they can call but do not guarantee that a plastic surgeon will be available.  If you think you child may need a plastic surgeon, consider calling your ER first to see what their policy is.

 

No matter how your child’s wound is repaired, it will scar.  If you are displeased with the scar, you can always have it revised by a plastic surgeon.  And remember, the summer sun is the worst things for scars and prevents fading.  Once your child’s wound is well healed, be sure to use liberal sun-screen every day.

Kathleen Berchelmann, M.D. About Kathleen Berchelmann, M.D.

Kathleen M. Berchelmann, M.D., is a pediatrician at St. Louis Children's Hospital and Washington University School of Medicine, director of the St. Louis Children's Hospital Social Media Team, and co-founder of the ChildrensMD hospital physician blog. Her work has been featured in print and online publications including the St. Louis Post-Dispatch, the Chicago Tribune, and TIME magazine. She is a frequent contributor to Fox2 News STL Moms. Kathleen and her husband are raising five children.

Follow Dr. Kathleen Berchelmann on Facebook: ChildrensMomDocs Twitter: @MomDocKathleen and connect with her on .

Comments

  1. My son had his eyebrow glued over six weeks ago and the glue is still stuck to the eye brow. Is there a safe way to release it from the eye brow without pulling off all the hair.

  2. Jackie Ferman says:

    The best approach to this problem is to put petroleum jelly or antibiotic appointment on the skin glue a few times each day and rub it vigorously. The should get the glue off. If this doesn’t work, you should bring your child to his pediatrician. You should also see the pediatrician if there are any signs of infection, such as redness, swelling, or pus from the wound. I hope your son’s eyebrow looks better!

  3. My daughter had the area right above her eyebrow glued this past Friday night. The glue hasn’t come off yet, but our pediatrician said that it should peel off naturally.
    Dawn, is all of the glue still on your son’s eyebrow after 6 weeks? How does the wound look? What is your aftercare plan?

  4. My daughters forehead was glued about a week ago, the glue was still on her skin and she fell again hiting the same area, immideately there was swelling, the glue did not come off but the wound opened just a little bit. I applied neosporin around the glue area, so she does not get infection. Will her skin continue to stay together, or does the glue have to be taken off and the whole thing to be repeated again?

  5. Dear Lulu,

    How frustrating! I’m so sorry your daughter fell twice! You should bring your daughter back to medical care as soon as possible. The wound may well need to be re-glued. I hope she feels better!

  6. My son had is eyebrow clued yesterday and the doctor messed up and put to much and it ran down into his eye and glued it completely shut and got in his eye…the doctor had to pull the eye led completely apart and my son was screaming in pain that his eye was burning and stuff was in it…we spent 3.5 hrs in OP trying to get the glue out he still has tons of glue in his eye lashes I’m taking him today to the eye doctor to make sure his eye is OK…I have no idea how I’m suppose to get the glue out. He is only 4 years old

  7. Where can I buy skin glue?

  8. My 4 year old daughter got a cut above her forehead, in her hair line.
    The doctor put the glue in there and said it’d come off on it’s own in a week or so.
    THIS WAS 4.5 WEEKS AGO!
    Today I was very sad to see that the glue has now peeled away from her skin (I assume with the hair’s growth) and that 1/2 of the hair connected to the glue has been COMPLETELY RIPPED OUT! She has a little bald spot, and I am so scared the other 1/2 will rip off too!
    This is horrible. My poor girl has less hair than your average 4 year old, so I have been so grateful for her finally getting her hair in a bit thicker… and now, a month before Christmas, she has a bald spot on her head!
    How on Earth can I safely remove this?
    I will happily PAY to have the ER use some type of solvent to remove it… but will they have that there??

  9. Ursula Soltys says:

    My earlobe wripped completely down from an earing and it has healed already. I need something to close and seal that earlobe so I can wear earings again. What do you suggest?

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  19. Joanna Milich says:

    My son had 5 stitches in his eyebrow last night. I was given a few samples of bacitracin to put on it daily. They told my husband (he took son to the doc) that neosporin is OK but without the numbing agent. Anyone know why? My husband said there was a reason but he can’t remember. I just want to know!

Trackbacks

  1. [...] think we made the right choice when we opted for surgical glue instead of stitches.  The doctor said either one would work, but we’d need to go to the ER for the stitches and [...]

  2. [...] we went with the glue.  There are many reasons why you would want to use stitches instead – so be sure to have a talk with your doctor about the choice, but if glue is an option – [...]

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