A prospective, randomized, controlled trial of 2-octylcyanoacrylate versus suture repair for nail bed injuries

Abstract

Purpose: To prospectively compare the efficacy of 2-octylcyanoacrylate (Dermabond; Ethicon Inc, Somerville, NJ) with standard suture repair in the management of nail bed lacerations.

Methods: Forty consecutive patients with acute nail bed lacerations were enrolled in this study. Eighteen patients were randomized to nail bed repair using Dermabond (2-octylcyanoacrylate), and 22 were randomized to standard repair using 6-0 chromic suture. At presentation, demographic information and laceration characteristics were recorded. The time required for nail bed laceration repair with each method was documented, and cosmetic and functional outcomes were assessed at 1, 3, and 6 months after injury. Comparisons between treatment groups were made using unpaired Student's t-tests.

Results: The Dermabond repair group was composed of 10 males and 8 females with a mean age of 32.3 years. The suture repair group was composed of 17 males and 5 females with a mean age of 29.5 years. The mean follow-up was 5.1 months (range 4-11 months) and 4.8 months (range 4-11 months) for the Dermabond group and suture group, respectively. There was no difference between the two treatment groups with respect to age, comorbidities, and length of follow-up (p>.05). The average time required for nail bed repair using Dermabond was 9.5 minutes, which was significantly less than that required for suture repair (27.8 minutes) (p<.0003). At each follow-up time point, there was no statistical difference in physician-judged cosmesis, patient-perceived cosmetic outcome, pain, or functional ability between the Dermabond and suture treatment cohorts (p>.05).

Conclusions: Nail bed repair performed using Dermabond is significantly faster than suture repair, and it provides similar cosmetic and functional results. In the management of acute nail bed lacerations, Dermabond is an efficient and effective repair technique.

Type of study/level of evidence: Therapeutic I.