Dermabond Vs Stitches for Minimizing Scars?

My 22 months old son fell and his forehead was cut open about 1/2 inches wide. Rushed to ER, they said he needed stitches. I asked if they could glue the wound shut which they did with Dermabond.

Today, I went to the pediatrican and dr. told me that I should have him stitched up instead of glued.

Now my son will have a scar on his forehead for sure. I feel terrible. I've never been in the ER before and didn't know what option I had and what's best method.

Is it true that stitches is better in this case?

Doctor Answers 5

Scarring after dermabond

All full thickness injuries leave scarring.  The goal of plastic surgical closure is to create the most aesthetically acceptable scar.  Tissue glue has the advantage of avoiding painful injections of local anesthesia in a small child.  However, I do not use it as patients come to me for my surgical expertise.  You should monitor the healing of the scar over the coming year.  If you are unhappy with the outcome, see a board certified plastic surgeon.  However, operating on a two year old electively requires general anesthesia and I generally do not recommend scar revision until the child is old enough to tolerate local anesthesia, which tends to be age 10 at the earliest.  Unless there is a trapdoor scar or other interference with function, most insurance companies consider scar revision to be cosmetic.

Stitches versus Dermabond

Thank you for the question.

I would not beat myself up if I were you. There is no way to know with any degree of certainty that your son's scar would have healed better with sutures as opposed to dermabond.  At his age it is likely that he will have a very acceptable scar. At one year after the trauma you may have him evaluated by a board-certified plastic surgeon to see if scar revision might be helpful.

Again, I would not feel too guilty if I were you.

Best wishes.


Dermabond vs. stitches

There was a clinical study done to assess whether stitches or dermabond resulted in better-looking scars after skin surgeries to remove moles and such. The results of the study showed a better cosmetic outcome with stitches as opposed to dermabond. Even though the differences were statistically significant, my impression is that the differences in cosmetic outcome were still not dramatic. 22 month-olds heal very well in general regardless which method is used. Please do not beat yourself up over your decision. In this case with a 22 month-old, the choice of dermabond was very reasonable. At this point, I would certainly leave the wound alone and NOT go back to stitch it up.

I hope this helps.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

Dermabond versus suture

Several factors can effect how an emergency room scar can heal:

1)  If the wound edges were traumatized, were they trimmed back to healthy tissue
2)  If the wound was full thickness through the skin, were some deeper sutures place
3)  If the muscle was involved, was it repaired
3)  Were the skin edges carefully reapproximated.

I often redo ER repairs if some of these factors were not adequately addressed.  Dermabond is a great way to cover a scar, and I use it frequently, but not in-lieu of sutures but in addition to it.

Dermabond vs. Stitches in a 22 month old

Don't be hard on yourself. You spared your child from a potentially traumatic event with anesthesia to repair this wound. There is a profound potential for healing in young children and I would think that this scar will improve a great deal with time. I would not recommend repairing the wound with stitches at this time. Wait till he is old enough to undergo local anesthesia and the scar has fully matured before you seek any treatments. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.