stop the bleeding

March 8, 2009 7:58 AM

I was in the emergency room last night to have a cut on the end of a finger tended to. The doctor used dermabond to repair it...

This morning, I accidentally bumped my finger and now it is seeping a little blood. It's not gushing. Just a slow, tiny seep. I keep dabbing at it in hope of it coagulating enough to stop.

I've seen OTC liquid bandages in the stores. Would one of these be ok for me to do a small, spot repair to the drmabond? Or should I take another hit to my insurance and go back to the ER?

I know, I know...YANMD

posted by Thorzdad to health & fitness (19 comments total)

IANAMD

In my opinion yes. I first read about this here.
posted by snowjoe at 8:03 AM on March 8 [1 favorite has favorites]

IANYD, but if everything is clean and reasonably sterile, I cannot see anything wrong with applying whatever you have available.
In the past I have used balsawood cement (as used in model airplane building) with good success.
IANYD.
posted by lungtaworld at 8:04 AM on March 8

I don't know the nature of the injury, but if it was me, I'd just throw a band-aid on it (like one of those butterfly ones, to hold the skin closed) and be done with it. I'm no midwife or doctor, but to my way of thinking, your goal with an injury like this is to keep the skin closed so it can repair itself. The dermabond is doing most of the work, just back it up with the band aid.

Or, call the emergency room and see what they say- maybe they will just let you pop in there for a second and they can reapply the dermabond and not charge you...
posted by gjc at 8:15 AM on March 8

It doesn't matter how you close the wound - use one of those wound closure strips.
posted by kldickson at 8:23 AM on March 8

Thanks all. Sounds like an OTC liquid bandage is the best way to go.

The nature of the wound is such that the doc advised against putting any strip bandage over the wound, as that could put pressure against the dermabond and cause it to crack...which is sort of what has happened this morning. I called the local CVS and the pharmacist there said that a liquid bandage should work just fine.

BTW...I called the emergency room...their official line is that they are not authorized to give medical advice over the phone. But, I could come in for a re-evaluation. $$$
posted by Thorzdad at 8:30 AM on March 8

Keep in mind that Dermabond is basically medical grade Crazy Glue, so I would use a cyanoacrylate based liquid bandage to do the touchup.

IANAD, but I've crazyglued cuts closed in a pinch.
posted by Cat Pie Hurts at 8:40 AM on March 8 [1 favorite has favorites]

BTW...I called the emergency room...their official line is that they are not authorized to give medical advice over the phone. But, I could come in for a re-evaluation. $$$

In situations like that, I'd be tempted to use Skype to call NHS Direct. (Though your insurer might have its own advice line.)
posted by holgate at 9:05 AM on March 8 [3 favorites has favorites]

IANAD. Of course, your optimal solution is to revisit the ER (or an urgent care facility) to have the wound professionally treated. However, no matter what option you take, please be sure you keep the wound clean:
"Don't dress a wound without first cleaning it as well as possible. Do not dress a wound with visible contamination. If you can't get it clean, leave it open and seek medical attention."
posted by terranova at 9:14 AM on March 8

And, FWIW, many hospitals have a nurse line, where you can call in and get simple medical advice on topics like this for free. In my experience, it usually means a call back an hour or two later, not an immediate reply; and the phone call usually ends with the advice to come in for an appointment anyway (sometimes possibly just to CYA, or in this case, CTA).

Check the business pages under the hospital's name.
posted by IAmBroom at 11:23 AM on March 8

I've had a lot of success using Skin Shield on cuts of the size you seem to be describing.
posted by ignignokt at 12:07 PM on March 8

Get yourself some Johnson and Johnson Butterfly closures. They are available in any drugstore. I've treated some pretty nasty cuts with them with excellent results. In my experience finger cuts are the easiest to close up with these bandages due to the ability to wrap them around with the appropriate amount of tension to keep the wound seamlessly closed.
posted by any major dude at 12:35 PM on March 8

I've had a lot of success using Skin Shield...

Funny you should mention that brand. That's what I picked-up at the CVS. I put down two layers according to directions but, alas, within 30 minutes, the layers failed and I was oozing blood once more. I opted to try an old tube of Super Glue Gel that I found in a drawer and, so far, things seem to be holding.
posted by Thorzdad at 1:23 PM on March 8

Thorzdad, it's kind of funny because a primary component of Liquid Skin is acetone, which is a solvent that, among other things, dissolves superglue :)
posted by Cat Pie Hurts at 3:09 PM on March 8

Ahhhhh...I wondered about that when I read the ingredients. The pharmacist assured me it would work fine. Unfortunately, they didn't have any other type of liquid bandage.
posted by Thorzdad at 4:00 PM on March 8

IANAD, but I have started using crazy glue to close the angled, clean cuts one tends to get from a chef's knife. It closes the wound for ~24 hours, keeping it clean and resisting the "flap got peeled back" event that causes me to wince even as I'm typing about it. It begins to come apart in the shower the next morning, but it's easy enough to reapply.

Good luck!
posted by browse at 4:10 PM on March 8

Keep in mind that Dermabond is basically medical grade Crazy Glue

I too have discovered that cyanoacrylate is a great way to deal with paper cuts and the like. One thing I've learned, though, is that medical glues are generally octyl cyanoacrylate, vs. the commercial crazy glues' methyl cyanoacrylate. The shorter methyl-CA can apparently be a little toxic if you use a bunch of it in a a heavily vascularized area. The octyl-CA (and intermediate-length butyl-CA which seems to be sold mostly for veterinary use) is less so. AFAICT this is really not a concern if you're closing random small skin wounds (as opposed to doing abdominal surgery or something). But IANAD, blah blah.
posted by hattifattener at 4:48 PM on March 8 [2 favorites has favorites]

So...I just got an auto-nag MeMail about this thread. Apparently, I'm to sum-up. Okey-doke...

• The OTC "liquid skin" or "liquid bandage" products apparently dissolve the "super-glue" repairs made in the emergency room. Avoid using them on any dermabond repairs.

• Plain old cyanoacrylate super glue works wonders for quick patching of leaky dermabond repairs.

• My finger is good as new now...save for the apparent layer of scar tissue just beneath the new skin. No biggie.

• Total price for a trip to the emergency room to get the tip of my finger glued back together (by some sort of para-medical professional. No MD actually saw me)...$590.58. After insurance, my bill is $266.00.

Be careful out there, y'all.
posted by Thorzdad at 12:43 PM on April 7

Welllll...it appears I was mistaken. That bill from the hospital wasn't the end of things!

Over the weekend, I received a separate bill from the emergency room physician's corporation that actually mans the emergency room of the hospital. Their pre-insurance bill for the 3 minutes it took their not-a-full-MD to glue my finger (a "minor cut" according to their own billing)...$247. My cost, after insurance...$134.00.

So, to update the totals...the total pre-insurance bill to repair the cut to my finger: $837.58. After insurance, my cost is $400.

(For those keeping box-scores, that $400 or so will apply to my $4000/yr individual deductible. I pay just over $800/month for the insurance itself. It's a family plan. It's more than my mortgage payment.)
posted by Thorzdad at 4:20 AM on April 13 [1 favorite has favorites]

Oh, and for our fellow MeFites who happen to live in a civilized country where healthcare actually works, I feel I need to add a bit of clarification...

"pre-insurance" amounts are the full-price billings on the part of the healthcare providers.
"after insurance" amounts reflect the adjusted price that the insurance company negotiates/strongarms the healthcare providers into accepting. At no time has the insurance company spent a single dime toward any of the costs.
posted by Thorzdad at 5:45 AM on April 13