While at Pittsburgh we looked at the modified transthecal block in children. While we did not include the use of tissue adhesive to reattach the nail plate in the paper, we did have great success doing so.
While I've heard of some trying the tissue adhesive on the nail bed itself, it didn't make intuitive sense to me because often times the nail bed edges had curled up and could only be brought together with suture.
Furthermore, as someone described in a prior response, the tissue adhesive doesn't typically work so well on a non-dry surface. I suppose, however, that the complexity of the nail bed lac would be the important variable in this equation.
As a cheap plug, I've attached our digital block study! :))
Peter Antevy MD
Pediatric Emergency Department
Joe DiMaggio Children's Hospital
(954) 707-2692 Cell
(954) 660-3525 Office
(954) 653-3792 Fax
On Jan 28, 2013, at 11:15 AM, John M. Howard, DO wrote:
> Good morning,
> Does anyone have experience using tissue adhesive for nail bed lacerations prior to reinsertion of fingernail?
> I have one source, see below, that mentions this method:
> I find that in my 2-3 yr old pts who slam their fingers in doors, the nailbed laceration is typically very small and is prone to tearing when using the smallest gut suture/needle I can find. Glue may be a way to have a better outcome (and quicker, too.) I didn't know if anyone else has experience with it?
> John Howard, DO
> Alexian Brothers Health Network
> Hoffman Estates, Illinois
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: