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Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries

Dowling, Sean Taylor BA; Lin, Brian Wai MD, FACEP, FAAEM

doi: 10.1097/01.ASW.0000521049.72160.37
Features: Case Series

OBJECTIVE: A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication.

SETTING: Emergency department of Kaiser Permanente Medical Center, San Francisco, California.

MATERIALS AND METHODS: Six patients were treated in the emergency department for fingertip dermal avulsion injuries using a tourniquet and tissue adhesive glue (Dermabond by Ethicon, Somerville, New Jersey). Patients were subsequently contacted to assess healing and satisfaction with cosmetic outcome through interview and photographs of their wounds at 9 months following the date of injury.

RESULTS: All 6 patients were satisfied with the cosmetic outcome of treatment, and none received a diagnosis of serious complications.

CONCLUSIONS: This series demonstrates cosmetic outcomes for injuries treated with the technique, highlights potential problems that may be perceived by patients during their clinical course, and creates the groundwork for a larger clinical study examining the use of the technique.

Sean Taylor Dowling, BA, is Clinical Research Coordinator, Department of Medicine, University of California San Francisco, San Francisco, California. Brian Wai Lin, MD, FACEP, FAAEM, is an Attending Physician, Department of Emergency Medicine, Kaiser Permanente, and Assistant Clinical Professor, Department of Emergency Medicine, University of California San Francisco, San Francisco, California.

The authors disclose that they discuss the use of tissue adhesive glue (specifically, Dermabond by Ethicon, Somerville, New Jersey) for dermal avulsion wound hemostasis, which is an off-label indication. This is specifically stated in the present manuscript, and reference is made to a previous publication where this is addressed in more detail. A central aim of the current manuscript is to provide safety data for this off-label indication.

Submitted January 26, 2016; accepted in revised form June 3, 2016.

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