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Pediatric tongue laceration repair using 2-octyl cyanoacrylate (dermabond(®))

Massoud G Kazzi, Mark Silverberg
Journal of Emergency Medicine 2013, 45 (6): 846-8

BACKGROUND: Tongue lacerations provide a challenge for emergency physicians, especially in the case of pediatric patients. Traditional wound closure typically involves local anesthesia or procedural sedation in children, which is time consuming and often anxiety provoking for providers, patients, and parents. 2-Octyl cyanoacrylate (Dermabond(®); Ethicon, Inc., Sommerville, NJ) has been used in the context of the emergency department for successful repair of lacerations, however, is not marketed for use on mucosal or intraoral surfaces. This case report describes an alternative manner of tongue laceration repair by the use of 2-octyl cyanoacrylate.

OBJECTIVE: 2-Octyl cyanoacrylate is generally not indicated for intraoral use. Our case demonstrates a situation in which it was used safely and effectively to repair a tongue laceration.

CASE REPORT: A 7-year-old boy presented to the emergency department after sustaining a large tongue laceration requiring repair. The boy's parent refused traditional wound repair with suturing due to concerns regarding the pain of local anesthesia administration, as well as risks posed by procedural sedation. The wound was repaired using the tissue adhesive 2-octyl cyanoacrylate. The patient tolerated the procedure well and there were no complications in the patient's course. Good cosmetic results were achieved using this method.

CONCLUSIONS: Tongue lacerations and other intraoral lacerations are challenging to repair, especially in pediatric patients. The use of tissue adhesives such as 2-octyl cyanoacrylate is very likely safe and may provide an expedient manner in which to repair such lesions with good cosmetic results.


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