Paul Prescott wrote:
Had an 11 month old bitten on the face by the family dog. The worst
wound was only 1 cm long and apparently not very deep. Local ER closed
it with Dermabond. By the end of the week a large draining abcess had
formed under it. I drained about 4cc of pus, cleansed it well, and
Steri-stripped it, to follow daily.
ER says they have used Dermabond on many animal bites without bad
results.
Any comments?
Now that we've slain the computer virus, we can speak to the substance of
the post.
Dermabond seals a wound no less than sutures. (In fact, we can easily argue
that it seals the wound to a greater extent.) I would expect the risk of
infection in a wound closed with Dermabond to be at least equal to a wound
that is closed with sutures. Bites are among the wounds at highest risk for
infection when they are closed primarily. But with the wound being on the
face, I think the ER doc would have been hard-pressed not to close it to try
to give the best cosmetic outcome. I do wonder if closing it "a little
loose", with sutures rather than Dermabond, would have resulted in no
infection. Of course, it goes without saying, that these wounds must be
irrigated with copious volumes of saline. I think prophylactic antibiotics
for 3-5 days makes sense also.
Bob Mauro, MD
Greenwood Pediatrics
Littleton, CO