Tricks of the Trade: Tissue adhesives and tegaderm

Photo courtesy of Dr. Hagop Afarian (UCSF-Fresno)

Tissue adhesives for wound closure often seem to intentionally make a bee-line straight for high-risk areas such as the eye. To avoid inadvertent application of the tissue adhesive, Dr. Hagop Afarian (UCSF-Fresno) utilizes a transparent tegaderm tape with an oval cut out of the center to provide a protective barrier. Immediately after application of the tissue adhesive, the tegaderm can be carefully peeled off to reveal a still-drying, well-circumscribed aliquot of glue over the wound. Be sure that the wound is dry, and the edges are well-apposed prior to tissue adhesive application.

This clinical pearl was highlighted in one of the 2008 ACEP News Tricks of the Trade columns which I co-authored with Hagop.

Question for you: What tricks of the trade do you have for keeping tissue adhesives away from high-risk areas during wound closure?