Finger Laceration; Dermabond

Patient

Q: I cut my middle finger (between the first and second knuckle) on a pop-top tin can about 3 weeks ago. It was late on a Friday, so my wife and I cleaned the wound out with peroxide and put antibiotic ointment on it for the night. The next day we went to Urgent Care, and since we waited, Dermabond was applied to the wound rather than sutures (after my hand soaked for a bit in an antiseptic solution).I use a splint to keep the finger from bending and causing the glue to come off too soon, and put gauze on it whenever I go out (I take the gauze off when I'm at home at night to let the wound breathe). It has been 3 weeks since the Dermabond was applied, and there aren't any obvious signs of infection (no odor, redness or fever, although there is a fair amount of swelling), but it hasn't shown any signs of coming off. Should I be concerned, or is the Dermabond just taking a little longer, as the wound hasn't closed yet.

Symptoms:  Swelling of affected hand
Images: 
Finger Laceration; Dermabond-1
Doctor

A:   Thank you for your question.

In the presence of a cut, skin when approximated by dermabond usually takes about 5 days to heal over. The glue may remain in place for several days thereafter before falling off. i am unclear as to whether or not there is a gap between the wound edges underneath the dermabond. Either way, I think it is time to remove the dermabond to see, assess and clean the area. If there is still an open wound, you should see your family doctor or an urgent care center for direction on dressings. If the wound is deep, you may seek the consult of a plastic surgeon through an emergency room to ensure proper healing of such a functionally important area. Also, it is important to be tested to ensure that you do not have a cut in the tendons or the nerves in the finger, which may also need to be repaired.

Lastly, please ensure your tetanus status is up to date. If you were not given one at the time, your family doctor can arrange to have that done for you.

Good luck

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