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Bondok MS, Bondok M, Alharbi AD, Arthurs B, El-Hadad C. Cyanoacrylate glue as a novel skin substitute in periocular skin excisions: case series and literature review. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00212-6. [PMID: 39122233 DOI: 10.1016/j.jcjo.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/02/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE Despite the widespread use of cyanoacrylate glue (CA) as an alternative for wound closure, its potential as a sole skin substitute material in periocular skin surgery remains unexplored. The primary objective was to determine the viability of CA as a sole skin substitute in periocular skin surgery after excision. DESIGN Single-centre retrospective observational case series. METHODS All patients were treated at the McGill University Health Centre from August 2023 to November 2023, where CA served as the sole skin substitute material after periocular skin excision. RESULTS Three female and one male patient, with a mean age of 75 years, received treatment with CA after skin excision for both cancerous and benign skin lesions. Specifically, histopathology revealed 2 cases of basal cell carcinoma, 1 case of squamous cell carcinoma in situ, and 2 benign lesions. The skin defects after excision ranged from 4 × 3 mm to 15 × 30 mm. No complications were observed between CA graft insertion and final skin re-epithelization. Complete re-epithelization was achieved in all patients at final follow-up without evidence of excessive skin contraction. CONCLUSIONS This study presents a novel approach by using CA as a skin substitute material in periocular skin excisions. Its liquid form allows for easy application and conforms well to irregular wound surfaces. CA may offer economic advantages, including lower material cost and shorter surgical operating times, compared with traditional skin substitutes. Further research is needed to comprehensively evaluate CA's role as a skin substitute in periocular skin reconstruction.
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Affiliation(s)
| | - Mostafa Bondok
- Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Abdulmajeed D Alharbi
- Department of Ophthalmology, College of Medicine, Qassim University, Buraydah, Saudi Arabia; Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, QC
| | - Bryan Arthurs
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, QC
| | - Christian El-Hadad
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, QC.
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Harma B, Gül M, Demircan M. The Efficacy of Five Different Wound Dressings on Some Histological Parameters in Children With Partial-Thickness Burns. J Burn Care Res 2020; 41:1179-1187. [DOI: 10.1093/jbcr/iraa063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
An ideal dressing should ensure that the wound remains moist with exudates but not macerated. Currently, there is no dressing available to suit all wounds, at all stages of the healing process. Although silver-containing dressings are the gold standard for burn wound care, few high-level trials have been completed comparing the clinical utilities of these dressings. In our study, five different types of wound dressings: carboxymethyl cellulose hydrofiber dressing with ionized silver (CMCH-Ag), polyethylene-polyethylene terephthalate aqua fiber dressing with elementary silver (PPAF-Ag), calcium alginate (CA), calcium + zinc alginate (CZA), and 0.2% nitrofurazone-embedded (NF) gauze dressings were compared in regard to histopathological parameters. Children aged between 0 and 18 years with small or middle-sized partial-thickness burns that affected less than 30% of the total body surface area were included in this study. The study groups (CMCH-Ag, PPAF-Ag, CA, and CZA) and the control group (NF) were randomly attained. Wound healing was evaluated by punch biopsies on the 21st day. The thickness of the stratum corneum and the epithelium, the number of papillae, and the papillary length were calculated and compared. The histological parameters of healing, except the stratum corneum thickness, did not show any statistical significance among the groups (P > .05). The dressings that included silver, calcium, or zinc showed useful and similar effects in noninfective burn wounds when compared with nitrofurazone-only dressings. Thus, it may be concluded that silver-containing wound dressings should not be considered as the gold standard in noninfective partial-thickness burn wounds in children.
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Affiliation(s)
- Birsen Harma
- Department of Pediatric Surgery, Pediatric Burn Unit, Turgut Özal Medical Center, Inönü University, Malatya, Turkey
| | - Mehmet Gül
- Department of Histology and Embryology, Faculty of Medicine, Inönü University, Malatya, Turkey
| | - Mehmet Demircan
- Department of Pediatric Surgery, Pediatric Burn Unit, Turgut Özal Medical Center, Inönü University, Malatya, Turkey
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Jiang K, Long YZ, Chen ZJ, Liu SL, Huang YY, Jiang X, Huang ZQ. Airflow-directed in situ electrospinning of a medical glue of cyanoacrylate for rapid hemostasis in liver resection. NANOSCALE 2014; 6:7792-8. [PMID: 24839123 DOI: 10.1039/c4nr01412j] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Rapid hemostasis of solitary organs is still a big challenge in surgical procedures or after major trauma in both civilians and on the battlefield. Here, we report the first use of an airflow-directed in situ electrospinning method to precisely and homogeneously deposit a medical glue of n-octyl-2-cyanoacrylate (OCA) ultrathin fibers onto a wound surface to realize rapid hemostasis in dozens of seconds. In vivo and in vitro experiments on pig liver resection demonstrate that the self-assembled electrospun OCA membrane with high strength, good flexibility and integrity is very compact and no fluid seeping is observed even under a pressure of 147 mm Hg. A similar effect has been achieved in an in vivo experiment on pig lung resection. The results provide a very promising alternative for rapid hemostasis of solitary organs as well as other traumas, providing evidence that the postoperative drainage tube may not be always necessary for surgery in the near future.
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Affiliation(s)
- Kai Jiang
- Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, Beijing 100853, P. R. China.
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Davis KP, Derlet RW. Cyanoacrylate Glues for Wilderness and Remote Travel Medical Care. Wilderness Environ Med 2013; 24:67-74. [DOI: 10.1016/j.wem.2012.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 08/11/2012] [Accepted: 08/14/2012] [Indexed: 10/27/2022]
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Fucoidan: A Versatile Biopolymer for Biomedical Applications. ACTIVE IMPLANTS AND SCAFFOLDS FOR TISSUE REGENERATION 2011. [DOI: 10.1007/8415_2011_67] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Pang HT, Chen XG, Ji QX, Zhong DY. Preparation and function of composite asymmetric chitosan/CM-chitosan membrane. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:1413-7. [PMID: 17914636 DOI: 10.1007/s10856-007-3168-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Accepted: 09/25/2006] [Indexed: 05/17/2023]
Abstract
A novel composite asymmetric chitosan/CM-chitosan membrane (C-P-C) was prepared, the top-layer was chitosan (CS), the intermediate was PVA, and the substrate was carboxymethyl chitosan (CM-CS). C-P-C membrane had capability in mechanical strength, light transparence, vapor permeability, and wound skin joining. The CS and CM-CS in C-P-C membrane were selected by series independent experiments, respectively. CS (MW 90,000 Da) had the highest antibacterial activity for E.coli. CM-CS had biocompatibility, no cytotoxicity, and had the activity of promoting growth of human skin fibroblast and inhibiting the growth of keloid fibroblast. The normal skin fibroblast can growth on the CM-CS surface of C-P-C, and have no conglomeration in higher cell density, and the keloid fibroblast could not growth on CM-CS surface of C-P-C. The animal experiment demonstrated that wound, covered with the C-P-C membrane, was hemostatic, healing quickly and had histocompatibility. The results indicated that the C-P-C membrane could be used as dressing of skin repair, and had the potential in promoting wound healing and inhibiting the keloid formation.
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Affiliation(s)
- Hong Tao Pang
- The Division of Life Science and Technology, College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, P.R. China
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Singer AJ, McClain SA, Hacht G, Batchkina G, Simon M. Semapimod Reduces the Depth of Injury Resulting in Enhanced Re-epithelialization of Partial-Thickness Burns in Swine. J Burn Care Res 2006; 27:40-9. [PMID: 16566536 DOI: 10.1097/01.bcr.0000194276.36691.fb] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Studies suggest that tumor necrosis factor alpha (TNF-alpha) plays a role in burn pathogenesis. We conducted a randomized controlled experiment in swine to determine whether a novel macrophage inhibitor, semapimod (formerly known as CNI-1493), would blunt the local production of TNF-alpha, interleukin (IL)-1, and IL-6 in burns leading to less injury extension and faster re-epithelialization. After creating second-degree burns, animals received one or two intravenous boluses of semapimod 1 mg/kg or normal saline, and all burns were treated with silver sulfadiazine. The depth of follicular necrosis and thrombosis was reduced by either one or two doses of semapimod (P=.04 and .02, respectively). However, no differences were noted between groups in cytokine levels. Depth of scarring was similar in all groups. We conclude that Semapimod reduces the depth of follicular necrosis and thrombosis after second-degree burns in swine, indirectly resulting in more rapid re-epithelialization. However, this affect does not appear to be mediated by reduced local TNF-alpha, IL-1, or IL-6 protein levels.
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Affiliation(s)
- Adam J Singer
- Department of Emergency Medicine, Stony Brook University, Stony Brook, New York 11794-8350, USA
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Abstract
Cyanoacrylates (CAs) were not widely adopted for medical use until recently because of lingering concerns regarding the initial tissue toxicities of the short-chain CAs. The medium-chain CAs, primarily butyl-cyanoacrylate, have been widely used in Europe and Canada for several decades and have gone a long way in dispelling any lingering concerns about tissue toxicity. The newer, longer chain CA, octyl-2-cyanoacrylate (2-OCA), now has been approved for multiple uses in the United States and has achieved widespread acceptance by the medical and lay communities. The current authors believe that this is probably only the beginning of the use of 2-OCA and other CAs in cutaneous medicine. This article discusses the use of CAs in their original cutaneous use as glues for the repair of lacerations and incisions and in their more recent use as dressings for the treatment of abrasions and wounds.
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Affiliation(s)
- William H Eaglstein
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL 33136, USA
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Singer AJ, Thode HC. A review of the literature on octylcyanoacrylate tissue adhesive. Am J Surg 2004; 187:238-48. [PMID: 14769312 DOI: 10.1016/j.amjsurg.2003.11.017] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2003] [Revised: 06/01/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Octylcyanoacrylate is a medical grade topical tissue adhesive that has been approved for closing surgical incisions and traumatic lacerations. We reviewed animal and human studies that evaluated its use for a variety of surgical indications and specialties. We also performed a meta-analysis of all clinical trials using octylcyanoacrylate. DATA SOURCES Animal and human studies published in peer-reviewed articles as well as published abstracts. A search of Medline was performed using the MESH terms: tissue adhesives, cyanoacrylates, and octylcyanoacrylate. CONCLUSIONS The current review and metanalysis demonstrate that octylcyanoacrylate can be used successfully in a wide variety of clinical and surgical settings for multiple types of wounds covering most of the surface of the human body. Prior knowledge of the limitations and technical aspects specific to wound closure with octylcyanoacrylate as well as appropriate wound selection and preparation will help ensure optimal results.
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Affiliation(s)
- Adam J Singer
- Department of Emergency Medicine, Stony Brook Health Sciences Center, L3-058, Stony Brook University, Stony Brook, NY 11794-8350, USA.
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Singer AJ, Nable M, Cameau P, Singer DD, McClain SA. Evaluation of a new liquid occlusive dressing for excisional wounds. Wound Repair Regen 2003; 11:181-7. [PMID: 12753599 DOI: 10.1046/j.1524-475x.2003.11306.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We evaluated a novel octylcyanoacrylate-based liquid occlusive dressing for partial-thickness wounds. One hundred and fifteen standardized wounds were created with an electric dermatome set at a depth of 600 micro on the flanks of three pigs and randomly treated with liquid occlusive dressing, a hydrocolloid dressing, or gauze. In one pig, wounds were swabbed with Staphylococcus aureus. Biopsies were taken after 4, 5, 6, and 21 days. Hemostasis was obtained in all wounds treated with the liquid occlusive. The percent reepithelialization of wounds treated with the liquid occlusive and hydrocolloid dressings were significantly greater at days 4 and 5 than control wounds (78% and 82% vs. 40%, p < 0.001 and 99% and 100% vs. 72%, p < 0.001, respectively). None of the liquid occlusive-treated wounds challenged with bacteria became infected. Foreign body reactions were least common in wounds treated with the liquid occlusive (p < 0.001). Scar depth was less for liquid occlusive- and hydrocolloid-treated wounds than controls (285 micro and 303 micro vs. 490 micro, p < 0.001). We conclude that excisional wounds treated with the liquid occlusive dressing reepithelialize as quickly as hydrocolloid-treated wounds. The liquid occlusive dressing is an effective microbial barrier and hemostatic agent resulting in fewer foreign body reactions than hydrocolloid-treated wounds or controls.
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Affiliation(s)
- Adam J Singer
- Department of Emergency Medicine, Stony Brook University, Stony Brook, New York 11794, USA.
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Abstract
Tissue adhesives are common adjuncts in surgical practice. Fibrin sealants are the most prevalent adhesives today. Recently, new adhesives have been approved for use in the United States, including cyanoacrylates, albumin-based compounds, collagen-based compounds, glutaraldehyde glues, and hydrogels. This review summarizes all the available tissue adhesives, focusing on their current and prospective indications in the clinical forum.
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Affiliation(s)
- T B Reece
- Department of Surgery, Division of Thoracic and Cardiovascular Surgery, The University of Virginia Health Sciences Center, Box 801359, Charlottesville, VA 22908, USA.
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Abstract
OBJECTIVE To compare the effects of octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane film (PU), and dry gauze (G) on scarring three months after partial-thickness burns. METHODS This was a prospective, blinded, controlled experimental trial using isoflurane-anesthetized swine. Standardized partial-thickness burns were inflicted by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of a young pig for 20 seconds. Four equal sets of ten burns each were randomly treated with OCA spray, SSD, PU, or G. Dressing changes were performed on days 1, 2, 3, and 4 after injury. Digital images of the burns were obtained immediately and three months later for masked computerized determination of scar surface area. Full-thickness biopsies were taken at three months for masked histopathological evaluation. The primary outcome was the percent reduction in residual wound area (RWA) calculated by subtracting the area of each individual burn from the area of the largest burn and dividing this value by the area of the largest burn (intraobserver correlation, r = 0.99). Secondary outcomes were the proportion of burns with the presence of scar tissue (abnormal collagen under polarized light; intraobserver agreement, kappa = 0.93) and the cosmetic appearance on a 100-mm visual analog scale marked "best scar" at the high end (inter-observer correlation, r = 0.82). Analysis of variance (ANOVA) and chi(2) tests were used for group comparisons as appropriate. This study had 80% power to detect a 33-percentage-point difference in RWA among groups (alpha = 0.05). RESULTS A total of 40 burns were inflicted on the pig. There was no difference in percent RWA across the groups (OCA = 25%, SSD = 40%, PU = 25%, G = 32%; p = 0.13). There was no difference in the proportion of wounds with scarring among the groups (OCA = 10%, SSD = 22%, PU = 2%, G = 30%; p = 0.89). There was also no difference in the cosmetic scores among the groups (OCA = 78 mm, SSD = 75 mm, PU = 74 mm, G = 74 mm; p = 0.96). CONCLUSIONS The effects of OCA spray, SSD, PU, and dry gauze on scarring three months after burns in pigs are similar.
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Affiliation(s)
- A Singer
- Department of Emergency Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA.
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