Abstract
The use of 2-octylcyanoacrylate (OCA) has been evaluated for the treatment of nail bed injuries in adults. We propose to validate this technique in a continuous paediatric population of 30 children. Patients with nail bed injuries associated with displaced fractures of the distal phalanx were excluded from the study. However, parcellar fractures of the tuft were included. After removal of the nail, wound detersion and anatomic positioning of the nail bed was done and maintained under the nail plate using a single dose of OCA. Follow-up evaluation was done at day 7 and 1 and 3months. The mean delay between the trauma and the surgery was 13.5h. The nail bed lesion was a single transversal wound in 27 cases. A pulpar wound was associated in 22 cases. At 3 months control (final follow-up), no pain or functional impairment was noted. The cosmetic result was excellent for the patient and his family in 30 out of 31 cases. It was excellent for the surgeon in 25 cases and good in six cases. In the OCA technique, meticulous primary detersion and exact anatomic positioning of the damaged nail bed is mandatory before applying the cyanoacrylate adhesive. In our experience, we found that the OCA technique provided a fast and safe result in nail bed lesions. The final cosmetic appearance, function and patient satisfaction were good in our series. In these lesions, discomfort and inconvenience associated with suture removal could be avoided by the use of OCA.
Highlights
Fingertip injuries, especially those affecting the nail bed, are among the most common traumatic conditions presenting to paediatric surgeons and paediatric emergency departments [1, 2]
We propose to validate this technique in a continuous paediatric population of 30 children
In the OCA technique, meticulous primary detersion and exact anatomic positioning of the damaged nail bed is mandatory before applying the cyanoacrylate adhesive
Summary
Especially those affecting the nail bed, are among the most common traumatic conditions presenting to paediatric surgeons and paediatric emergency departments [1, 2]. Removal of the nail plate and meticulous repair of nail bed lacerations with replacement of the nail has been shown to prevent long-term cosmetic and functional disability [3,4,5]. The use of OCA, more commonly known as Dermabond (DermabondÒ; Ethicon, Inc., Somerville, NJ, USA) has been evaluated for the treatment of nail bed injuries in adults [13,14,15]. The rate of healing, cosmetic appearance and functional results were prospectively evaluated in a continuous series of 30 patients
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