Use of Dermabond® adhesive for wound closure at the scene

Abstract

Topical skin adhesives (TSA) are commonly used in hospital accident and emergency (A&E) settings for the closure of simple, minor lacerations. An observational study was conducted in a UK ambulance trust to assess health resource use associated with the management of simple lacerations when using Dermabond® TSA at the accident scene, compared with its use in A&E after transportation of the patient to hospital (standard of care (SOC)). A decision tree model mapped both treatment pathways to establish full costs to the NHS. Call-out times and staff interventions were recorded. Treatment of patients at the scene with Dermabond® TSA reduced the call-out time (mean reduction 32.64%, median reduction 31.91%). Total cost per patient pathway for patients treated at the scene was £200.81 with Dermabond® TSA and £611.43 for patients receiving SOC. Treatment at the scene with Dermabond® TSA resulted in a total saving to the Merseyside Ambulance Service of £345 327 over the 5-month study. The use of Dermabond® TSA by emergency care practitioners at the scene for the closure of simple, minor lacerations is acceptable, cost effective, and provides NHS trusts with the opportunity to work towards government initiatives for reducing the number of patients treated within the acute hospital setting.