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TOPICAL SKIN ADHESIVES
DERMABOND Topical Skin Adhesive Product 1
Product 2
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DERMABOND TOPICAL SKIN ADHESIVE - INTRODUCTION
DERMABOND Adhesive is a strong and highly
flexible topical skin adhesive with a chemical
composition that gives it flexibility and
strength superior to those of competitors
products.1
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DERMABOND TOPICAL SKIN ADHESIVE - INTRODUCTION
DERMABOND Adhesive may be used in place of
sutures or staples to close wounds in conjunction
with deep dermal stitches (you will learn more
about this later in the tutorial). It may be
used to close wounds of any length (DERMABOND
Adhesive has been clinically shown to be
effectively close skin on wounds of up to 69 cm),
with excellent cosmetic outcomes.
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DERMABOND TOPICAL SKIN ADHESIVE - INTRODUCTION
When DERMABOND Adhesive is used in addition to
skin sutures or staples it functions as a
microbial barrier to protect wounds from bacteria
that can cause infection.
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DERMABOND TOPICAL SKIN ADHESIVE - FEATURES AND
BENEFITS

• DERMABOND Adhesive is a highly viscous, sterile,
  nonabsorbable, single-use liquid made from the
  polymer 2-octyl cyanoacrylate (you will learn
  more about why this is important in Tutorial 2).
  It is dyed with DC Violet 2 for easier
  visualization during application.2

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DERMABOND TOPICAL SKIN ADHESIVE - FEATURES AND
BENEFITS

• DERMABOND Adhesive
• 7 days of wound-healing strength in 3 minutes4
• Faster and as strong as 4-0 suture5,6
• Acts as a microbial barrier and as its own
  dressing7,8
• Has been clinically proven to close skin
  effectively in both short and long incisions
  (up to 69 cm)9
• Can save the surgeon significant amounts of time
  in some procedures5

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DERMABOND TOPICAL SKIN ADHESIVE - FEATURES AND
BENEFITS

• DERMABOND Adhesive
• Is water-resistant enough for a patient to
  shower a few minutes after application10
• Holds securely to the wound and sloughs off as
  the skin re-epithelializes at around 5 to 10
  days2
• Does not require a return visit for removal
• Can be stored at room temperature for up to 24
  months11

Throughout the tutorial, we will learn more about
the many features and benefits of DERMABOND
Adhesive.
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DERMABOND TOPICAL SKIN ADHESIVE - PRODUCTS

• DERMABOND Adhesive is supplied in the following
  3 packaging options
• DHV12 DERMABOND Adhesive High Viscosity, in
  0.5 mLampoule form
• DPP6 DERMABOND Adhesive ProPen, containing 0.5
  mL
• DPPXL6 DERMABOND Adhesive ProPen XL,
  containing 0.75 mL

We will be learning more about each of these
later in this tutorial. First, lets take a
look at how DERMABOND Adhesive is applied to a
wound using the DERMABOND Adhesive ProPen XL.
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DERMABOND TOPICAL SKIN ADHESIVE - PRODUCTS
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DERMABOND TOPICAL SKIN ADHESIVE - PREPARING A
WOUND

• When applying DERMABOND Adhesive to a wound, the
  wound should be clean and dry, and adequate
  hemostasis should be achieved.2
• In the following frames, we will look at how
  DERMABOND Adhesive is used in conjunction with
  sutures to close deeper wounds that extend below
  the skin.

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DERMABOND TOPICAL SKIN ADHESIVE - PREPARING A
WOUND
In such a case, the surgeon should first
utilize deep dermal sutures in the wound to
relieve the tension, using absorbable suture such
as MONOCRYL Plus Antibacterial (poliglecaprone
25) Suture or Coated VICRYL Plus Antibacterial
(polyglactin 910) Suture. Deep suturing may
include subcutaneous and deep dermal closure (as
shown here), or it may be a combination
subcutaneous/deep dermal closure.
subcuticular
subcutaneous

• Trademark

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DERMABOND TOPICAL SKIN ADHESIVE PREPARING
LONG WOUNDS
In some cases, a wound may be too long to be
easily approximated in one section. If this is
the case, after applying deep dermal sutures the
surgeon should divide the wound temporarily into
segments using adhesive strips, forceps, or
fingers.
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DERMABOND TOPICAL SKIN ADHESIVE THE PATIENT
EXPERIENCE

• Once in place, DERMABOND Adhesive provides an
  extremely flexible microbial barrier that helps
  prevents some of the most common
  infection-causing bacteria from entering a
  wound.1,12

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DERMABOND TOPICAL SKIN ADHESIVE THE PATIENT
EXPERIENCE

• The common bacteria that DERMABOND Adhesive has
  been shown in vitro to serve as a barrier to7
• Staphylococcus epidermidis
• Staphylococcus aureus
• Escherichia coli
• Pseudomonas aeruginosa
• Enterococcus faecium

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DERMABOND TOPICAL SKIN ADHESIVE THE PATIENT
EXPERIENCE

• A wound to which DERMABOND Adhesive has been
  applied needs no other dressing and the patient,
  if mobile, can shower immediately after
  application.7
• DERMABOND Adhesive remains on the skin until
  after healing has occurred. Ultimately, it will
  slough off as a result of natural
  epithelialization.2

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CYANOACRYLATES

• For tissue adhesives, the increase in the length
  of the carbon chain means an increase in certain
  important physical characteristics of the
  monomer.
• DERMABOND Topical Skin Adhesive is a 2-octyl
  cyanoacrylate with an 8-carbon chain

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DIFFERENCES IN CYANOACRYLATES

• unlike its competitors, which are
  N-butyl-2-octyl cyanoacrylates and have a
  4-carbon chain.

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DIFFERENCES IN CYANOACRYLATES

• The increased length of the carbon chain gives
  DERMABOND Topical Skin Adhesive many advantages,
  such as strength, flexibility and microbial
  barrier performance.

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DIFFERENCES IN CYANOACRYLATES

• The 2-octyl cyanocrylate that is used in
  DERMABOND Adhesive provides a 3-dimensional
  strength (ie, flexibility that is 3 to 4 times
  stronger than that of N-butyl-2
  cyanoacrylate).1,12 Demonstrated in vivo

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PLASTICIZERS

• In addition to using different base formulas,
  manufacturers can vary the physical
  characteristics of cyanoacrylates by adding
  components, such as plasticizers and
  elasticizers.
• The plasticizers used in DERMABOND Adhesive
  produce a stronger, more pliable
  tissue-compatible end product that flexes with
  the skin and remains in place for longer.
  DERMABOND Adhesive provides more dependable
  closure than butyl-based skin closure products,
  which become brittle and weak.1,12, 13
  Demonstrated in vivo.

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REFERENCES

• 1 Data on file. Ethicon, Inc.
• 2 DERMABOND Adhesive Package Insert.
• 3 INDERMIL Tissue Adhesive (package insert).
  Norwalk, CT United States Surgical/Syneture
  2002.
• 4 Quinn J, Wells G, Sutcliffe T, et al. A
  randomized trial comparing octylcyanoacrylate
  tissue adhesive and sutures in the management
  of lacerations. JAMA. 19972771527-1530.
• 5 Toriumi DM, OGrady K, Desai D, Bagal A. Use
  of octyl-2 cyanocrylate for skin closure in
  facial plastic surgery. Plast Reconst Surg.
  1998 1022209-2219.
• 6 Shapiro AJ, Dinsmore RC, North JH. Tensile
  strength of would closure with cyanoacrylate
  glue. Am Surg. 2001671113-1115.
• 7 Bhende S, Rothenberger S, Spangler DJ, Dito M.
  In vitro assessment of microbial barrier
  properties of Dermabond Topical Skin Adhesive.
  Surg Infect. 20023251-257.
• 8 Kannon GA, Garrett AB. Moist wound healing
  with occlusive dressings a clinical review.
  Dermatol Surg. 199521583-590.
• 9 Blondeel MD. Closure of long surgical
  incisions with a new formulation of
  2-octylcyanoacrylate tissue adhesive versus
  commercially available methods. AmJ Surg.
  2004186307-313.

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REFERENCES

• 10 Rubio PA. Use of semiocclusive, transparent
  film dressings for surgical wound protection
  experience in 3637 cases. Int Surg.
  19917253-254.
• 11 Laura McCrum, Final Report Marketing Claims
  Support Wound Length Coverage for High
  Viscosity DERMABOND Products.
• 12 Singer AJ, Zimmerman T,Rooney J, Cameau P,
  Rudomen G, McClain SA. Comparison of wound-
  bursting strengths and surface characteristics of
  FDA-approved tissue adhesive for skin closure.
  J Adhes Sci Technol. 20041819-27.
• 13 Perry L.C. An evaluation of acute incisional
  strength with tramaseal surgical tissue adhesive
  wound closure. Findings by Dimensional
  Analysis Systems, Inc. Leonia, NJ. 1995.
• 14 Hall, LT, MD, Bailes, JE, MD. Using DERMABOND
  for wound closure in lumbar and cervical
  neurosurgical procedures. Abstract taken from
  Neurosurgery. 56(1) Operative Neurosurgery
  Suppliment 1147-150. Viewed January 2005.
  http//www.neurosurgery- online.com/pt/re/neuro
  surg/abstract.00006123-200501001-00018.htm.
  Accessed 4/10/2007.

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CR Approved 5.13.09