Liquid stitches, also known as tissue adhesives or surgical glues, are a modern approach to closing wounds. Applied directly to a wound, this colorless, sticky liquid holds torn skin edges together. As it dries, it forms a protective film, sealing the wound and offering an alternative to traditional sutures or bandages. This adhesive provides a quick, often less painful method for wound closure.
Understanding Liquid Stitches
Liquid stitches are primarily composed of medical-grade cyanoacrylate adhesives. These synthetic compounds are designed for safe use on human skin, differing significantly from household glues. Common types include 2-octyl cyanoacrylate and n-butyl cyanoacrylate. Upon contact with moisture, the cyanoacrylate monomers rapidly polymerize, forming long, solid chains. This process creates a strong, flexible, and sterile bond.
Application and Mechanism
Application involves a precise process. After the wound is thoroughly cleaned and dried, the healthcare provider gently brings the edges of the cut together. The liquid adhesive is then spread over the top of the wound, completely covering the approximated edges. The adhesive must be applied only to the skin’s surface, not inside the wound, as this can hinder healing.
The adhesive typically dries and reaches maximum strength within minutes. It forms a strong, flexible, and water-resistant barrier. This barrier holds the skin edges in place, protecting the wound from external contaminants. This polymerization, occurring upon contact with skin’s moisture, creates a durable film that promotes natural healing.
Indications and Contraindications
Liquid stitches are suitable for certain types of wounds, typically small, clean cuts with straight edges that are not deep or gaping. They are often used for superficial lacerations in areas of low skin tension, such as the face or groin. This method is useful for children, as it avoids the discomfort of needles.
However, liquid stitches are not suitable for all wounds. They are not appropriate for deep, jagged, or actively bleeding wounds, or those with embedded debris. Wounds over joints or areas of high movement, like knuckles, elbows, or knees, are not ideal unless immobilized. Liquid stitches are also contraindicated on infected wounds, animal bites, puncture wounds, or mucous membranes due to moisture and potential irritation.
Post-Application Care
Proper care after the application of liquid stitches ensures optimal healing. Keep the treated area dry for the first 24 to 48 hours. After this initial period, showering is permissible, but avoid direct water flow and scrubbing the wound. Soaking the wound in baths, swimming pools, or during dishwashing should also be avoided.
The liquid stitch will naturally peel off as the wound heals, typically within 5 to 10 days. Avoid picking or scratching the adhesive, as this can cause premature detachment. Ointments, lotions, or antibiotic creams should not be applied over the adhesive, as they can soften the bond and lead to early detachment. Signs of infection, such as increased redness, pain, warmth, swelling, or yellow/green pus, warrant immediate medical attention.
Distinctive Features of Liquid Stitches
Liquid stitches offer several unique characteristics that set them apart from traditional sutures. Their application is needle-free, reducing discomfort and anxiety, particularly for younger patients. The process is quicker than suturing, as the adhesive dries rapidly. Unlike traditional stitches, there is no need for a follow-up visit for removal, as the adhesive naturally sheds from the skin.
The resulting bond is flexible, allowing normal skin movement, and creates a waterproof barrier that protects the wound from infection. This barrier also offers a lower risk of scarring compared to other wound closure methods. These properties make liquid stitches a convenient and effective option for appropriate wound types.