BACKGROUND:Cyanoacrylates, also known as tissue adhesives or skin glues, are commonly used as sealants for lacerations and incisions and have found utility in excisional and cosmetic surgeries in both outpatient and operating room settings. OBJECTIVE:To review the surgical literature on the utilities, advantages, disadvantages, and special uses of cyanoacrylates applicable to dermatology. MATERIALS AND METHODS:PubMed was reviewed for relevant articles related to cyanoacrylates and their use in skin closures. Articles unrelated to cutaneous closures were excluded. RESULTS:Tissue adhesives polymerize to a water resistant, pliable film after application to approximated wound edges and have antibacterial properties. Adhesives slowly slough off as the wound heals, typically after 5 days. Compared with 5-0 nonabsorbable suture, adhesives provide similar tensile strength and similar patient and surgeon satisfaction. Although slightly more expensive than sutures, tissue adhesives obviate the need for wound dressings and suture removal. They do not perform as well as sutures for wounds under higher tension or in the setting of moisture and inadequate hemostasis. CONCLUSION:Cyanoacrylates serve as a safe and effective suture alternative in appropriate dermatologic surgeries and procedures.

n-Butyl-cyanoacrylate is an effective hemostatic agent. Optimal efficiency depends on local application via a spray to achieve a thin and elastic film. Construction of a spray applicable to the oral cavity is illustrated using a plastic ampule with Histoarkryl as reservoir. This spray has been used in 27 cases of prolonged bleeding to achieve hemostasis. In 18 cases the patients suffered from different hemorrhagic diatheses and general hemostatic procedures would normally have been necessary to achieve hemostasis. In nine patients without hemorrhagic diathesis, the cyanoacrylate spraying replaced more complicated local procedures. In 24 cases the cyanoacrylate spraying was a sufficient hemostatic treatment.