HEMIGARD™ ARS Clinical Cases

The HEMIGARD® ARS device allowed us to close this wound on the arm. The patient had a very tight defect that could not be approximated with digital pressure as shown. The HEMIGARD® ARS device allowed us to use very high tension with our 0 nylon retention suture without ripping the skin. Once the wound was approximated, we used 4-0 Polysorb dermal sutures for the initial layer of closure. After the HEMIGARD® device and dermal sutures, there was minimal residual wound tension. We used only GLUSEAL® acrylate glue for the superifical layer. This step provides not only mechanical support, but also antimicrobial support, fewer percutaneous punctures than sutures or staples and seals the wound for easier postop care. A dry nonadherent dressing (ie: Telfa) and wrap were used without any topical ointments. Patient kept wound dry for one week.

The HEMIGARD™ Adhesive Retention Suture Device used to avoid facial skin flap. Defect under tension. Clipped hair to allow for landing strip for each HEMIGARD™ strip. Limited undermining. 4-0 Polysorb deeps and GluSeal GluStitch Inc. on top. Why is avoiding a flap such a big deal? Flaps require additional wounds so more healing and more risk of things going wrong. Plus, this patient is on an anticoagulant putting him at risk of greater for a hematoma.

65 year old female with basal cell carcinoma removed from ankle. We wanted to avoid second intent healing or skin graft. This large defect was under very high tension. We apposed wound edges with two pairs of HEMIGARD™ ARS and 2-0 nylon retention suture. Deep sutures 4-0 Polysorb. Top closure with acrylate glue and steristrips.

90 year old male with melanoma in situ removal from upper arm. Very fragile skin was closed with single pair of HEMIGARD™ ARS strips and 3-0 nylon retention suture. Deep sutures 4-0 Polysorb. Top closure acrylate glue and steristrips.

57 year old female with wound from nodular basal cell carcinoma removed with three stages of Mohs surgery. We wished to avoid a skin graft or flap, but the wound was under considerable tension. Used a single pair of HEMIGARD™ ARS strips and 0 nylon retention suture to relieve tension. Used 4-0 Polysorb deep sutures. Top closure with acrylate glue and steristrips.

68 year old female with shin wound following Mohs surgery for removal of squamous cell carcinoma. Fragile skin apposed with single pair of HEMIGARD™ ARS strips and 0 nylon retention suture. Deep sutures using 4-0 Polysorb. Top closure with acrylate glue and steristrips.

90 year old male with defect following Mohs surgery for a squamous cell carcinoma. He wished to avoid a skin graft or flap. We used a single paint of HEMIGARD™ ARS strips and 2-0 nylon retention suture to relieve wound tension and appose wound edges. Deep suture 4-0 Polysorb. Top closure with 4-0 nylon interrupted nylon sutures.

92 year old man with defect following excision of melanoma in situ. Very fragile skin apposed with a single pair of HEMIGARD™ ARS strips and 3-0 nylon retention suture. Deeps sutures with 4-0 Polysorb. Top closure with 4-0 nylon interrupted nylon sutures.

63 year old female with shin defect following Mohs surgery for removal of a basal cell carcinoma. Used a 2-0 bi-directional barbed suture (Quill, Surgical Specialties Corporation) dermal running suture. Then, placed a single pair of HEMIGARD™ ARS strips to relieve tension. Applied tension to each end of suture to lock the barbed suture. Top closure with 4-0 nylon sutures.