I regularly use glue to close the skin in scrotal, groin, and abdominal incisions but I think it is a poor choice for circumcisions. When the glue is applied to a surgical wound, some of the glue makes its way into the tissue below the skin and bonds these tissues to the skin. In the wounds I utilize glue, penetration into the deeper tissues is not problematic. In the penis, the layer beneath the skin is a thin muscle layer called Dartos fascia. This layer of fascia lies between the penile skin and the functional structures of the penis, the two corpora cavernosa (erectile bodies), and the corpus spongiosum (structure on the underside that contains the urethra). The fascia is a vital tissue layer because it is the structure that allows the penile skin to slide over the functional components of the penis. When skin glue gets into this layer it will penetrate the fascia and bond the skin to the functional components of the penis so that it will no longer slide. Studies using glue for circumcision were done in children who were too young to be bothered by this factor. The other problem with using glue for circumcision wounds is that it does not bring the skin edges as close together as sutures do. This means the scar will be wider and more visible. The key for an ideal circumcision wound is to carefully place sutures close to the skin edges, the use of very fine suture material, and carefully tying of the sutures to prevent cutting off the blood flow to the skin edges as the wound heals.