472.A 9-year-old girl is brought to the ED by her parents after sustaining a
forehead laceration. Her dad reports that the patient hit her forehead against
a doorknob. On examination the patient is cooperative but anxious about the
upcoming anesthetic injection. She has a 0.5-cm laceration on the midfore-
head with clean edges. The parent’s parents inquire about “skin glue” they
heard about on TV. Which of the following statements is true regarding cyano-
acrylate tissue adhesives?
a. It cannot be applied to mucous membranes and areas with thick hair.
b. Tissue adhesives have a higher rate of infection and tissue dehiscence than
sutures.
c. Tissue adhesives are best suited for forehead lacerations between 5 and 10 cm
in length.
d. Tissue adhesives are applied inside the wound to pull skin edges together.
e. Tissue adhesives must be covered with topical antibiotics and bandages to prevent
sloughing.
473.A 45-year-old woman presents to the ED with multiple facial lacerations.
She was sitting by her window when the neighbor’s kid hit a baseball through
her window. The shattered glass caused multiple superficial lacerations. The
most notable laceration is 1 cm on the right eyelid. You rule out the presence
of a foreign body and give her a tetanus shot. Which of the following statements
regarding eyelid trauma is correct?
a. A slit-lamp examination is unnecessary since it does not help evaluate the eyelid.
b. Tissue adhesives can be used to close eyelid laceration since they are usually small.
c. Lacerations causing ptosis require ophthalmology consultation.
d. Ptosis following an eyelid laceration is common.
e. A lacrimal duct injury should be suspected in a laceration to the lateral canthus.
512 Emergency Medicine