For this wound we decided to attempt a no-sharps technique using tincture of benzoin on the sides of the wound (not in the wound), tape over the tincture of benzoin, then glue around and over the tape. Presented by Jess Mason, MD and Lisa Serpa, NP.
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What follow up care instructions did you give to the parents? Could that area get wet after a certain amount of time, should they try and remove the strips at some point, let them fall off on their own, etc..
I tell them to dry to keep it dry for at least one day. The more water that gets on it, the quicker the edges are going to lift up. Also, to be realistic, a child is probably going to pick at it! We just need it to stay on for probably 5-7 days, long enough for healing to start, and then the parent could transition to a bandaid if the whole thing came off. If left alone it will start to peel off on its own.
I did this same thing, without seeing your video, one night in frustration, after trying to benzoin and tape an elderly person's large gaping avulsion back down. The glue worked great. The benzoin, for some reason was just not sticking. But using the glue on the tape (there were areas of missing skin) that seemed to hold the viable skin in place well and once dried was covered with non-adherent dressing and coban to protect further. I didn't see it in follow-up , but felt pretty handy that night and the family was pleased.
Seems if you'd trimmed the tape short of the IPJ, ROM would be easier and less likely to cause lift-off? (As-is, flexion fights the stiffness of the glued tape)
Matthw M. - November 1, 2018 6:02 PM
What follow up care instructions did you give to the parents? Could that area get wet after a certain amount of time, should they try and remove the strips at some point, let them fall off on their own, etc..
Jess Mason - November 2, 2018 7:19 AM
I tell them to dry to keep it dry for at least one day. The more water that gets on it, the quicker the edges are going to lift up. Also, to be realistic, a child is probably going to pick at it! We just need it to stay on for probably 5-7 days, long enough for healing to start, and then the parent could transition to a bandaid if the whole thing came off. If left alone it will start to peel off on its own.
Bharat B. - November 14, 2018 3:49 AM
Did you have the chance to follow up on it after to see the cosmetic outcome?
Frederick R. - November 16, 2018 2:11 AM
Great job on the videos! Do you apply LET on the wound before taping/ gluing?
Jennifer C., P.A. - November 17, 2018 9:59 PM
Would love to see the wound on follow up how did it look?
Sandra Jean C. - February 9, 2019 1:04 AM
I did this same thing, without seeing your video, one night in frustration, after trying to benzoin and tape an elderly person's large gaping avulsion back down. The glue worked great. The benzoin, for some reason was just not sticking. But using the glue on the tape (there were areas of missing skin) that seemed to hold the viable skin in place well and once dried was covered with non-adherent dressing and coban to protect further. I didn't see it in follow-up , but felt pretty handy that night and the family was pleased.
Sandra Jean C. - February 9, 2019 1:04 AM
And yes, I applied LET.
Robert L., PA-C - September 11, 2020 1:31 AM
Seems if you'd trimmed the tape short of the IPJ, ROM would be easier and less likely to cause lift-off? (As-is, flexion fights the stiffness of the glued tape)
Alan J. - October 6, 2022 3:19 PM
Any irrigation/wound cleaning before all this was done because the kid would have been traumatized by that anyway?
Jess Mason - October 7, 2022 10:11 AM
Yes all traumatic wounds should be irrigated. It can help to have the parent do this part in the sink so the child is less afraid.