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Specific approvals vary with jurisdiction. The appropriate governmental agency should be consulted if in doubt about approved indications. GluStitch inc. will not be held responsible for "off label use." In Canada Glustitch has been approved for topical use on broken skin. Ayton J Polar Hands: Spontaneous Skin Fissures Closed With Cyanoacrylate (Histoacryl Blue) Tissue Adhesive in Antarctica Arctic Medical Research (1993) 52:127-130 A series of thirteen patients with "polar hands", painful fissuring of fingertips, is documented in Antarctic medical practice together with the results of treatment by cyanoacrylate (Histoacryl Blue) human tissue adhesive. Reduction in tenderness and pain allowing improved finger function and a quicker resolution was observed. Cyanoacrylates are useful adjuncts in the treatment of painful cracks and fissures. Quinn J and Kissick J Tissue Adhesives for Laceration Repair During Sporting Events Clinical Journal of Sport Medicine (1994) 4:245-248 Physicians covering sporting events are often required to repair lacerations. Traditionally these lacerations have been sutured. Some of these lacerations may be closed with a tissue adhesive. Tissue adhesives have been available for many years. The benefits and potential problems of these substances are discussed as well as proper wound selection and application. Craven M and Telfer N An Open Study of Tissue Adhesive in Full-thickness Skin Grafting Journal of the American Academy of Dermatology (1999) 40:604-611 Background: Securing full-thickness skin grafts (FTSG) by suturing is a time-consuming procedure, even in experienced hands. The advent of tissue adhesives has led to their use in a variety of surgical procedures, providing an acceptable alternative to conventional suturing. Objectives: Our purpose was to identify whether the tissue adhesive n-butyl-2-cyanoacrylate (NBCA) can be used to secure FTSG and to compare to outcome with the conventional suturing. Methods:Twenty-one patients with defects after Mohs micrographic surgery were enrolled into the study. An initial pilot study of 8 patients compared NBCA and sutures within individual grafts: the subsequent 13 patients had grafts secured with between 4 and 8 cardinal sutures and NBCA alone. Results: No differences in healing, complications, or cosmetic appearance were observed between the sides secured with NBCA and with sutures in the pilot study. Of the grafts in the subsequent 13 patients, 2 patients experienced superficial necrosis with subsequent healing and a good cosmetic outcome, the remainder healed in place without complications, with excellent cosmetic outcome. Conclusion: NBCA is suitable for securing selected FTSG and provides a significant timesaving over the traditional approach of suturing such grafts into place. Osmond M et al A Randomized, Clinical Trial Comparing Butylcyanoacrylate With Octylcyanoacrylate in the Management of Selected Pediatric Facial Lacerations Academic Emergency Medicine (1999) 6:171-177 Objective:To compare two tissue adhesives, butylcyanoacrylate and octylcyanoacrylate, in the treatment of small (<4 cm) superficial linear traumatic facial lacerations in children. Methods: This was a randomized, clinical trial with parallel design. 94 children <18 years of age seen in the ED of tertiary care pediatric hospital with a facial laceration suitable for tissue adhesive closure underwent laceration closure using either butylcyanoacrylate or octylcyanoacrylate. The primary outcome was the cosmetic result at three months rated from photographs by a plastic surgeon on a visual analog scale (VAS). Secondary outcomes included the time to procedure, the pain perceived difficulty by the patient, and wound evaluation score at ten to 14 days and three months. Results: Ninety-four patients were randomized with 47 in each group. The two groups were similar for baseline demographic and clinical characteristics. There was no differences in the three-month cosmesis VAS (median, 70.0 mm for n-butyl-2-cyanoacrylate vs 67.5mm for octylcyanoacrylate, p = 0.84). There was no difference between the groups for time to complete the procedure (p = 0.88), parent/patient-perceived pain of the procedure 9p =0.37), or physician-perceived difficulty of the procedure (p=0.33). Similarly, there was no difference difference between the groups for the percentage of early (p =0.58) or late (p = 0.71) optimal wound evaluation scores. Conclusions: In the closure of small linear pediatric facial lacerations, octylcyanoacrylate is similar to butylcyanoacrylate in ease of use and early and late cosmetic outcomes. The superior physical properties of octylcyanoacrylate appear to add little benefit to the management of these selected lacerations. Physician preference and differing costs may dictate use for these small selected lacerations. Rivers J.K. N-2-butylcyanoacrylate (GluStitch™) Skin Therapy Letter Vol. 4 No. 5 Cyanoacrylates are surgical adhesives that provide another option for wound closure. When compared to sutures, cyanoacrylates were found to be as effective as sutures in low tension lacerations and for the attachment of some full-thickness skin grafts. In addition, clinical practitioners have found cyanoacrylates easier to apply, time saving, and more economical. There are a number of surgical adhesives either currently or under development. The presently available butylcyanoacrylates and octylcyanoacrylates are reviewed. |
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