1
|
Topical hemostatic agents in neurosurgery, a comprehensive review: 15 years update. Neurosurg Rev 2021; 45:1217-1232. [PMID: 34734343 DOI: 10.1007/s10143-021-01684-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/26/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
Hemostasis in neurosurgery is of utmost importance. Bleeding management is one of the crucial steps of each neurosurgical procedure. Several strategies, namely thermal, mechanical, electric, and chemical, have been advocated to face blood loss within the surgical field. Over time, countless hemostatic agents and devices have been proposed. Furthermore, the ever-growing recent technological innovation has made available several novel and interesting tools. Pursuant to their impact on surgical practice, we perceived the imperative to update our previous disclosure paper. Therefore, we reviewed the literature and analyzed technical data sheets of each product in order to provide an updated and comprehensive overview in regard to chemical properties, mechanisms of action, use, complications, tricks, and pitfalls of topical hemostatic agents.
Collapse
|
2
|
Xu X, Liu H, Zhang Y, Xue E, Yu H, Hu Y. The use of 2-octyl cyanoacrylate as an adjuvant to wound closure in total knee arthroplasty. Arch Orthop Trauma Surg 2021; 141:663-668. [PMID: 33386442 DOI: 10.1007/s00402-020-03674-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 10/28/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The efficacy of the use of 2-octyl cyanoacrylate (OCA) as an adjuvant to wound closure in preventing wound complications after total knee arthroplasty (TKA) is rarely reported. This study was aimed to determine whether the use of OCA as a supplement to conventional wound closure reduces the incidence of wound complications following TKA. PATIENTS AND METHODS This retrospective study reviewed 1106 consecutive patients who underwent TKA for symptomatic end-stage osteoarthritis (OA) between 2012 and 2017. The first 562 patients who did not receive OCA were grouped into the Control group, and the subsequent 544 patients who received OCA as an adjuvant to wound closure were grouped into the OCA group. All patients were followed up for at least 2 years. The main outcome was the development of operative site complications, including aseptic and infectious complications. Aseptic wound complications were wound leakage, hematoma, wound dehiscence and delayed wound healing, and infectious complication was mainly referred to the superficial infection. RESULTS No significant difference with regard to hematoma was observed between groups (3.0% vs. 3.7%, P = 0.617, φ = - 0.02). The incidences were significantly higher in the Control group versus the OCA group in regard to wound leakage (9.4% vs. 2.0%, P = 0.000, φ = 0.16), wound dehiscence (5.7% vs. 1.3%, P = 0.000, φ = 0.12), delayed wound healing (4.4% vs. 1.5%, P = 0.004, φ = 0.09) and superficial infection (2.0% vs. 0.4%, P = 0.022, φ = 0.07). No serious adverse events (AEs) occurred. CONCLUSIONS The present study showed that the addition of OCA reduced the incidence of wound leakage, wound dehiscence, delayed wound healing and superficial infection after TKA compared to conventional wound closure. Based on the outcomes above, we decide to use OCA routinely for wound closure after TKA. LEVEL OF EVIDENCE III, retrospective, cohort study.
Collapse
Affiliation(s)
- Xinxian Xu
- The Osteopathy Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haixiao Liu
- The Osteopathy Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Zhang
- The Osteopathy Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Enxing Xue
- The Osteopathy Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huachen Yu
- The Osteopathy Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuezheng Hu
- The Osteopathy Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
3
|
Fukumoto K, Miyajima A, Matsumoto K, Kobayashi H, Niwa N, Hongo H, Kurihara I, Kikuchi E, Oya M. Umbilical closure using 2-octyl cyanoacrylate in transumbilical laparoscopic adrenalectomy: A randomized controlled trial. Int J Urol 2020; 27:670-675. [PMID: 32483939 DOI: 10.1111/iju.14270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate postoperative pain and esthetic outcomes in patients undergoing transumbilical laparoscopic adrenalectomy with wound closure using 2-octyl cyanoacrylate. METHODS A total of 26 patients who underwent laparoscopic adrenalectomy with the transumbilical approach and agreed to participate in this study were included. Patients were randomly divided into two groups: the 2-octyl cyanoacrylate group (Glue group) or the non-use group (non-Glue group). A single surgeon (AM) carried out all procedures between 2014 and 2017. RESULTS There were no significant differences in the clinical background of the Glue and non-Glue groups. The number of patients with moderate or high levels of pain in the resting/moving period on postoperative days 1, 2 and 3 was 6/10 (46%/77%), 6/9 (46%/69%) and 3/5 (23%/38%) in the non-Glue group, and 5/7 (38%/54%), 2/7 (15%/54%) and 1/3 (8%/23%) in the Glue group. These differences were not significant. In the subgroup analysis of patients aged <50 years, the numbers were 4/6 (57%/86%), 5/7 (71%/100%) and 3/5 (43%/71%) in the non-Glue group, and 3/4 (33%/44%), 1/4 (11%/44%) and 0/1 (0%/11%) in the Glue group in the resting/moving period. On postoperative days 2 and 3, these differences were significant (P = 0.035 and 0.037 in the resting period, and P = 0.017 and 0.013 in the moving period). CONCLUSIONS 2-octyl cyanoacrylate can be used safely for laparoscopic adrenalectomy with the transumbilical approach, and might be useful for reducing postoperative pain in patients aged <50 years.
Collapse
Affiliation(s)
- Keishiro Fukumoto
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Akira Miyajima
- Department of Urology, Keio University School of Medicine, Tokyo, Japan.,Department of Urology, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Hiroaki Kobayashi
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Naoya Niwa
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Hongo
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Isao Kurihara
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Abstract
Introduction: Today is the era of “wireless” in technology and here comes era of “sutureless” in the field of surgery. Every surgeon wishes for better wound healing with better cosmesis without complications and early back to routine activities. All this is possible by use of adhesive for wound edges of circumcision is shown by us in this study. In addition, other aim was to study the efficacy, safety, functional outcome, and cosmesis of isoamyl cyanoacrylate when used as adhesive for wound edges of pediatric circumcisions. Materials and Methods: Group A comprised 162 pediatric patients who underwent sutureless circumcisions and Group B comprised a similar number, i.e., 162 pediatric patients who had undergone circumcision by conventional method using absorbable interrupted sutures. Comparative analysis of both the groups was done based on various parameters such as bleeding, infection, foreign body reaction, excessive swelling, and wound dehiscence. In addition, visual analog pain scoring was done after 6 h and after 12 h postoperative. Results: Complications were more commonly seen in sutured Group B versus sutureless circumcision-Group A. In addition, postoperative pain and need of analgesics were seen more commonly in sutured Group B patients. Wound healing and final cosmesis were far better in Group A patients. Conclusion: Our results show that isoamyl cyanoacrylate is comparatively safe, efficient, has better functional outcome and good cosmesis when used as adhesive for wound edges of pediatric circumcisions. Sutureless circumcision technique is better than conventional sutured circumcision.
Collapse
Affiliation(s)
- Amit Raut
- Department of Paediatric Surgery, Apollo Speciality Hospitals, Nashik, Maharashtra, India
| |
Collapse
|
5
|
Kwon JY, Yun HG, Park IY. n-Butyl-2-cyanoacrylate tissue adhesive (Histoacryl) vs. subcuticular sutures for skin closure of Pfannenstiel incisions following cesarean delivery. PLoS One 2018; 13:e0202074. [PMID: 30216337 PMCID: PMC6157826 DOI: 10.1371/journal.pone.0202074] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/29/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Tissue adhesives are now routinely used for skin closure in various surgeries. This study aimed to evaluate the safety and efficacy of n-butyl-2-cyanoacrylate (NBCA) tissue adhesive in cesarean delivery by comparing it with the safety and efficacy of subcuticular suture closure. METHODS AND FINDINGS A retrospective chart review was undertaken of all patients who underwent cesarean delivery via Pfannenstiel skin incision. During the study period, a total of 209 patients had NBCA (Histoacryl®) closure and 208 patients had suture closure. Wound complications and Vancouver scar scale (VSS) scores were compared between the 2 groups. RESULTS There were no significant differences between the two groups in indications for cesarean deliveries or number of previous cesarean deliveries. Incidences of wound disruption and infection were also similar between the two closure groups (p = 0.322 and 0.997, respectively). The rate of wound complications was 3.4% in the NBCA group and 5.3% in the suture group. All complications healed uneventfully with topical antibiotics or closure strips. VSS scores at 6-8 weeks after operation were not significantly different between the two groups (p = 0.858). These results were corroborated by propensity score-matching analysis. CONCLUSIONS NBCA may be a useful skin closure of Pfannenstiel skin incisions after cesarean delivery.
Collapse
Affiliation(s)
- Ji Young Kwon
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - Hang Goo Yun
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - In Yang Park
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
- * E-mail:
| |
Collapse
|
6
|
Davis SC, Harding A, Gil J, Parajon F, Valdes J, Solis M, Higa A. Effectiveness of a polyhexanide irrigation solution on methicillin-resistant Staphylococcus aureus biofilms in a porcine wound model. Int Wound J 2017; 14:937-944. [PMID: 28266133 DOI: 10.1111/iwj.12734] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/01/2017] [Accepted: 02/10/2017] [Indexed: 01/22/2023] Open
Abstract
Irrigation and removal of necrotic debris can be beneficial for proper healing. It is becoming increasingly evident that wounds colonized with biofilm forming bacteria, such as Staphylococcus aureus (SA), can be more difficult to eradicate. Here we report our findings of the effects of an irrigation solution containing propyl-betaine and polyhexanide (PHMB) on methicillin-resistant Staphylococcus aureus (MRSA) biofilms in a porcine wound model. Thirty-nine deep partial thickness wounds were created with six wounds assigned to one of six treatment groups: (i) PHMB, (ii) Ringer's solution, (iii) hypochlorous acid/sodium hypochlorite, (iv) sterile water, (v) octenidine dihydrochloride, and (vi) octenilin. Wounds were inoculated with MRSA and covered with a polyurethane dressing for 24 hours to allow biofilm formation. The dressings were then removed and the wounds were irrigated twice daily for 3 days with the appropriate solution. MRSA from four wounds were recovered from each treatment group at 3 days and 6 days hours after initial treatment. Irrigation of wounds with the PHMB solution resulted in 97·85% and 99·64% reductions of MRSA at the respective 3 days and 6 days assessment times when compared to the untreated group. Both of these reductions were statistically significant compared to all other treatment groups (P values <0·05).
Collapse
Affiliation(s)
- Stephen C Davis
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Andrew Harding
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Joel Gil
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Fernando Parajon
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jose Valdes
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Michael Solis
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Alex Higa
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| |
Collapse
|
7
|
Stoffel J, Bernatchez SF. Effect on Microbial Growth of a New Skin Protectant Formulation. Adv Wound Care (New Rochelle) 2017; 6:73-79. [PMID: 28289552 PMCID: PMC5346906 DOI: 10.1089/wound.2016.0706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/27/2016] [Indexed: 01/14/2023] Open
Abstract
Objective: Evaluate the effect of a new investigational skin protectant formulation on the growth of various microorganisms in vitro. Approach: An in vitro laboratory assay with various species of gram-positive bacteria, gram-negative bacteria, and yeast grown on agar plates was used to verify that a new investigational product used for the management of incontinence-associated dermatitis (IAD) does not support microbial growth. Results: The investigational product did not support the growth of all organisms tested for 48 h in these assays. The results demonstrate the barrier properties of this investigational formulation against bacteria and yeast that are relevant to incontinent patients. Innovation: IAD accompanied by skin damage is difficult to manage with currently available products. A new skin protectant that can be applied as a liquid and polymerizes into a breathable film in situ even in the presence of exudate (as shown previously) has been developed and tested to ensure that it does not support microbial growth. Conclusion: This work verifies that this new product does not support microbial growth in vitro using organisms relevant for the intended application.
Collapse
Affiliation(s)
- Joseph Stoffel
- 3M Critical & Chronic Care Solutions Division, St. Paul, Minnesota
| | | |
Collapse
|
8
|
Fernández-Gutiérrez M, Rodriguez-Mancheño M, Pérez-Köhler B, Pascual G, Bellón JM, Román JS. Structural Analysis and Application ofn-Alkyl Cyanoacrylate Surgical Adhesives to the Fixation of Meshes for Hernia Repair. Macromol Biosci 2016; 16:1803-1814. [DOI: 10.1002/mabi.201600246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 08/22/2016] [Indexed: 01/07/2023]
Affiliation(s)
- Mar Fernández-Gutiérrez
- Instituto de Ciencia y Tecnología de Polímeros; CSIC Juan de la Cierva 3 28006 Madrid Spain
- CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
| | - Marta Rodriguez-Mancheño
- Faculty of Medicine and Health Sciences; University of Alcalá; CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
| | - Bárbara Pérez-Köhler
- Faculty of Medicine and Health Sciences; University of Alcalá; CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
| | - Gemma Pascual
- CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
- Faculty of Medicine and Health Sciences; University of Alcalá; CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
| | - Juan Manuel Bellón
- CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
- Faculty of Medicine and Health Sciences; University of Alcalá; CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
| | - Julio San Román
- Instituto de Ciencia y Tecnología de Polímeros; CSIC Juan de la Cierva 3 28006 Madrid Spain
- CIBER-BBN Instituto de Salud Carlos III; 28029 Madrid Spain
| |
Collapse
|
9
|
Siddiqui M, Bidaye A, Baird E, Abu-Rajab R, Stark A, Jones B, Ingram R, Anthony I. Wound dressing following primary total hip arthroplasty: a prospective randomised controlled trial. J Wound Care 2016; 25:40, 42-5. [DOI: 10.12968/jowc.2016.25.1.40] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M. Siddiqui
- Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Glasgow, Scotland
| | - A. Bidaye
- Department of Orthopaedics, Royal Alexandra Hospital NHS Trust, Corsebar Road, Paisley, Scotland
| | - E. Baird
- Department of Orthopaedics, Royal Hospital for Sick Children, NHS Lothian, 9 Sciennes Road, Edinburgh
| | - R. Abu-Rajab
- Department of Orthopaedics, Royal Alexandra Hospital NHS Trust, Corsebar Road, Paisley, Scotland
| | - A. Stark
- Department of Orthopaedics, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland, G4 0SF
| | - B. Jones
- Department of Orthopaedics, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland, G4 0SF
| | - R. Ingram
- Department of Orthopaedics, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland, G4 0SF
| | - I. Anthony
- Department of Orthopaedics, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland, G4 0SF
| |
Collapse
|
10
|
Lin BW. A Novel, Simple Method for Achieving Hemostasis of Fingertip Dermal Avulsion Injuries. J Emerg Med 2015; 48:702-5. [DOI: 10.1016/j.jemermed.2014.12.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 07/03/2014] [Accepted: 12/22/2014] [Indexed: 10/23/2022]
|
11
|
|
12
|
Woo KY, Chakravarthy D. A laboratory comparison between two liquid skin barrier products. Int Wound J 2014; 11:561-6. [PMID: 25040947 DOI: 10.1111/iwj.12325] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/27/2014] [Accepted: 06/05/2014] [Indexed: 11/29/2022] Open
Abstract
Exposure of skin to friction and moisture is detrimental to skin health. The purpose of this experimental study was to investigate the ability of a cyanoacrylate polymer film to protect human skin against moisture and abrasion. A secondary purpose of this study was to compare this cyanoacrylate material to a traditional barrier film. Twelve healthy subjects participated in the wash-off resistance test to determine the percentage of dye that was left on the skin after repeated washing. Ten subjects participated in the abrasion test. Transepidermal water loss (TEWL) was measured before and after abrasion to determine the level of skin damage, as high water loss seen post-abrasion is indicative of skin damage post-abrasion. Skin treated with cyanoacrylate had significantly more dye remaining than sites treated with traditional film barrier or control sites. The change in TEWL was statistically lower for cyanoacrylate-treated areas.
Collapse
Affiliation(s)
- Kevin Y Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | | |
Collapse
|
13
|
Elrazek AEMAA, Yoko N, Hiroki M, Afify M, Asar M, Ismael B, Salah M. Endoscopic management of Dieulafoy’s lesion using Isoamyl-2-cyanoacrylate. World J Gastrointest Endosc 2013; 5:417-419. [PMID: 23951399 PMCID: PMC3742709 DOI: 10.4253/wjge.v5.i8.417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 07/01/2013] [Indexed: 02/05/2023] Open
Abstract
Dieulafoy’s lesion (DL) is a rare but important cause of obscure gastrointestinal bleeding that may be overlooked during diagnostic endoscopy. Mortality rates are similar to those of other causes for gastrointestinal bleeding. Diagnosis by upper endoscopy is the modality of choice during acute bleeding. In the absence of active bleeding, the lesion resembles a raised nipple or visible vessel. There are no guidelines regarding effective selective therapy for DL, when diagnosed, endoscopist experience is the major determinant of the treatment strategy. Following our strategy, an expert endoscopist with a skilled assistant should have a high rate of successful DL diagnosis when an obscured gastrointestinal lesion is suspected. Cyanoacryltes compounds have been used successfully in management of Gastric varices and DLs. To our knowledge, there have been no previous reports regarding use of isoamyl-2-cyanoacrylate (AMCRYLATE®; Concord Drugs Ltd., Hyderabad, India) as an effective therapy for gastric DL without serious complications. In our case study, Isoamyl-2-cyanoacrylate (AMCRYLATE®) was effective and safe for treating DL. Surgical wedge resection of the lesion should be considered as a therapeutic option if endoscopic therapy fails.
Collapse
|
14
|
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]
|
15
|
Efficacy of integuseal for surgical skin preparation in children and adolescents undergoing scoliosis correction. Spine (Phila Pa 1976) 2012; 37:E1331-5. [PMID: 22814302 DOI: 10.1097/brs.0b013e3182687d6c] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective randomized trial. OBJECTIVE To explore the use of a microbial sealant applied before the surgical incision to reduce surgical site infection in patients with scoliosis. SUMMARY OF BACKGROUND DATA The incidence of superficial or deep infections is reported in 2 groups of patients treated for neuromuscular or adolescent idiopathic scoliosis. Statistical analysis aimed to compare the effect of the use of a cyanoacrylate microbial sealant on infection rate. METHODS From June 2010 to June 2011, 56 patients were prospectively enrolled in the study. Using a random number table, patients were assigned either to receive or not a sterile, film-forming cyanoacrylate liquid application (Integuseal). Epidemiological data and infection occurrence were compared in both groups. RESULTS Statistical analysis comparing patients with neuromuscular scoliosis and adolescent idiopathic scoliosis showed that patients with neuromuscular scoliosis had more fused levels, increased intraoperative bleeding, and longer intraoperative time. Six patients had early postoperative infections of the posterior approach, which included 3 deep and 3 superficial infections. Five infections occurred in patients treated with Integuseal. Outcome was favorable in 6 cases after local wound debridement and antibiotics. Nonparametric statistical tests (Fisher exact test) showed no significant correlation (P = 0.096) between early postoperative infection occurrence and the use of Integuseal. CONCLUSION Although microbial sealant may be a useful addition to a multimodal approach to minimize surgical site infection, there is currently insufficient evidence as to whether the use of microbial sealants reduces the risk of surgical site infection in patients undergoing scoliosis surgery.
Collapse
|
16
|
Abstract
Barrier wound therapy is commonplace in the health care environment and functions to limit bacterial colonization and infection in both acute wounds and recalcitrant chronic wounds. This article reviews the nature of acute and chronic wounds and their available adjunctive barrier therapies.
Collapse
Affiliation(s)
- Luke G Gutwein
- Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Florida, Post Office Box 100286, 1600 Southwest Archer Road, Gainesville, FL 32610, USA
| | | | | | | |
Collapse
|
17
|
Pechter PM, Gil J, Valdes J, Tomic-Canic M, Pastar I, Stojadinovic O, Kirsner RS, Davis SC. Keratin dressings speed epithelialization of deep partial-thickness wounds. Wound Repair Regen 2012; 20:236-42. [DOI: 10.1111/j.1524-475x.2012.00768.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 12/19/2011] [Indexed: 12/20/2022]
Affiliation(s)
- Patricia M. Pechter
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Joel Gil
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Jose Valdes
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Marjana Tomic-Canic
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Irena Pastar
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Olivera Stojadinovic
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Robert S. Kirsner
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| | - Stephen C. Davis
- Department of Dermatology; University of Miami Miller School of Medicine; Miami; FL; USA
| |
Collapse
|
18
|
Tiwari P, Tiwari A, Kumar S, Patil R, Goel A, Sharma P, Kundu AK. Sutureless circumcision - An Indian experience. Indian J Urol 2012; 27:475-8. [PMID: 22279312 PMCID: PMC3263214 DOI: 10.4103/0970-1591.91435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Context: Traditionally, circumcision wounds are closed by absorbable sutures. However, certain alternative methods are also being utilized to overcome the shortcomings of the conventionally used method for circumcision wound closuring. In the current study, the use of tissue glue ((iso amyl 2-cyanoacrylate) has been compared with traditional suturing for the approximation of circumcision wounds. In our study, both the methods were found to be comparable with significantly less time consumed in glue group. Aims: The purpose of the present study has been to compare directly cyanoacrylate as a better alternative to conventional suture material in terms of cosmetic result, time consumed and incidence of infection (comparative study). Materials and Methods: The results of all the patients seen in outpatient department for circumcision were included in this study. The study was conducted from Aug 2009 to May 2010. The tissue glue (iso amyl 2-cyanoacrylate) was compared to sutures as a method of wound approximation in circumcision. Results: Tissue glue group has been observed to have less wound inflammation, bleeding or hematoma rate and was cosmetically superior as compared to suture group; however, none of these findings could reach statistically significant level. The mean time taken for circumcision was 14.2 min (SD 2.42), when tissue glue was used for wound approximation. However, it was 24.4 min (SD 5.06) in case of the use of sutures. This difference was found as highly significant (P value < 0.001). However, regarding postoperative pain no significant reduction was observed when glue was used. Conclusions: This study showed that the use of tissue glue in comparison to sutures is having the following advantages: Cosmetically superior Less time consuming
All other parameters measured were nearly the same and statically insignificant.
Collapse
Affiliation(s)
- Punit Tiwari
- Department of Urology, SSKM Hospital, Institute of Post-Graduate Education and Research, Kolkata, WB, India
| | | | | | | | | | | | | |
Collapse
|
19
|
Scuderi N, Dessy LA, Buccheri EM, Marchetti F, Mazzocchi M, Chiummariello S, Klinger F, Onesti MG, Klinger M, Alfano C. Phase 2 cross-over multicenter trial on the efficacy and safety of topical cyanoacrylates compared with topical silicone gel in the prevention of pathologic scars. Aesthetic Plast Surg 2011; 35:373-81. [PMID: 21079955 DOI: 10.1007/s00266-010-9621-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 10/14/2010] [Indexed: 01/08/2023]
Abstract
BACKGROUND Many clinical studies on scar therapy are reported in the literature, but only silicone gel sheeting and corticosteroid injections are supported by accurate prospective controlled studies. This prospective multicenter cross-over phase 2 study tested the effectiveness of a topical cyanoacrylate compared with silicone gel in improving postsurgical scars METHODS Patients presenting with symmetric breast scars after augmentation or reduction mammaplasty were enrolled in the study. From the same day as stitch removal, the cyanoacrylate was applied on one side every 3 to 5 days and the silicone gel on the other side twice a day for 3 months. Assessments of patients and external observers using a visual analog scale were recorded at scheduled visits during 1 year, and scars were photographed. Objective evaluations included measurements of scar width, length, and elevation. The statistical significance of objective parameter modifications was analyzed using the Wilcoxon test RESULTS Positive effects of both tested products were observed during the scar maturation process, and final scars of good quality were achieved without any major adverse effect. The topical cyanoacrylate proved to be more efficacious in preventing scar widening, and this result was statistically significant CONCLUSIONS The tested topical cyanoacrylate had a positive effect on the scar maturation process at least comparable with that of topical silicone gel.
Collapse
|
20
|
Prospective randomised study to evaluate the use of DERMABOND ProPen (2-octylcyanoacrylate) in the closure of abdominal wounds versus closure with skin staples in patients undergoing elective colectomy. Int J Colorectal Dis 2010; 25:899-905. [PMID: 20352261 DOI: 10.1007/s00384-010-0929-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2010] [Indexed: 02/04/2023]
Abstract
BACKGROUND Topical 2-octylcyanoacrylate tissue (OCA) adhesive has been used as an alternative to close wounds with a comparable cosmetic outcome. The use of 2-OCA in the closure of abdominal laparotomy wounds has not been thoroughly evaluated. Our aim was to compare 2-OCA with conventional skin stapling devices in colorectal surgery. METHODS A prospective randomised study was conducted in which 74 consecutive patients above the age of 21 undergoing open elective colectomies for benign or malignant indications were allocated to skin closure with 2-OCA or skin staples. Cosmetic outcome as assessed with the Hollander Cosmesis Scale with a single assessor, complication rates, and patient satisfaction were recorded at discharge (4-10POD) 2 weeks after discharge and then at 3 months. RESULTS Of the 74 patients, 38 were randomised to skin staples and 36 to 2-OCA. There was no significant difference in cosmetic outcomes between the two groups as assessed with a visual analogue scale or the Hollander Cosmesis Scale but showed a trend to better cosmetic outcomes in the 2-OCA group. Patient satisfaction scores were higher but did not reach statistical significance. The time taken to close a wound with 2-OCA was significantly longer than with skin staples. There was no statistical difference in rates of wound infection. CONCLUSION 2-OCA is a safe and effective means of skin closure in patients undergoing elective colectomies with a good and at least equivalent outcome to traditional methods of closure.
Collapse
|
21
|
Rocos B, Blom AW, Bowker K. Cyanoacrylate dressings: are they microbiologically impermeable? J Hosp Infect 2010; 75:144-5. [PMID: 20417580 DOI: 10.1016/j.jhin.2010.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Accepted: 01/09/2010] [Indexed: 10/19/2022]
|
22
|
Tissue Adhesives as Active Implants. ACTIVE IMPLANTS AND SCAFFOLDS FOR TISSUE REGENERATION 2010. [DOI: 10.1007/8415_2010_48] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
23
|
Wick JY, Zanni GR. Skin Tears: Prevention and Treatment. ACTA ACUST UNITED AC 2009; 23:508-10, 512-4, 517-8. [DOI: 10.4140/tcp.n.2008.508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
24
|
Singer AJ, Quinn JV, Hollander JE. The cyanoacrylate topical skin adhesives. Am J Emerg Med 2008; 26:490-6. [PMID: 18410821 DOI: 10.1016/j.ajem.2007.05.015] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2007] [Accepted: 05/11/2007] [Indexed: 12/15/2022] Open
Abstract
Each year there are over 7 million lacerations requiring wound closure in the emergency department. Traditionally, most lacerations have been closed with sutures. Topical cyanoacrylate skin adhesives offer many advantages over traditional wound closure devices. Recently, the Food and Drug Administration (FDA) has reclassified the topical skin adhesives. As a result, new topical skin adhesives are expected to enter the market in the near future. This article will review the structure and function of cyanoacrylates as well as their advantages, indications, and usage.
Collapse
Affiliation(s)
- Adam J Singer
- Department of Emergency Medicine, University Hospital, Stony Brook, NY 11794-7400, USA.
| | | | | |
Collapse
|
25
|
Martineau L, Davis SC, Peng HT, Hung A. Controlling methicillin resistant Staphyloccocus aureus and Pseudomonas aeruginosa wound infections with a novel biomaterial. J INVEST SURG 2007; 20:217-27. [PMID: 17710602 DOI: 10.1080/10717540701481275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Wound infections, especially those associated with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, offer considerable challenges for clinicians. Our laboratory has recently developed novel composite biomaterials (DRDC) for wound dressing applications, and demonstrated their in vitro bactericidal efficacy. In the present study, we assessed the proliferation of planktonic and sessile Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus in porcine full-thickness wounds covered for up to 48 h with either saline- or mafenide acetate-loaded DRDC puffs and meshes. All biomaterials were applied 4 h following bacterial inoculation of the wounds with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, to allow colonization of the tissues and initiation of biofilm formation. The drug-loaded biomaterials eradicated both the planktonic and biofilm bacteria in the wounds within 24 h (p <. 05), irrespective of the bacterial strain or architecture of the dressing. While the wound bioburdens increased in the ensuing 24 h, they remained approximately 2 log(10) colony-forming units (CFU) below (p <. 05) their respective baseline values. Similarly, less than 4 log(10) CFU was recovered in the drug-loaded DRDC biomaterials throughout the study. These data show that the DRDC puffs and meshes are effective in delivering certain medications, such as antimicrobial agents, to the wound bed, suggesting considerable value of this material for treating wounds, especially those with irregular shapes, contours, and depths.
Collapse
Affiliation(s)
- Lucie Martineau
- Defence Research & Development Canada, Valcartier, Québec, Quebec, Canada.
| | | | | | | |
Collapse
|
26
|
Cascarini L, Kumar A. Case of the month: Honey I glued the kids: tissue adhesives are not the same as "superglue". Emerg Med J 2007; 24:228-9. [PMID: 17351240 PMCID: PMC2660042 DOI: 10.1136/emj.2006.036392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A case of a father who treated his child's facial laceration with the home supply of "superglue" having been previously misinformed that superglue is used to treat lacerations is presented. The differences between tissue adhesive and superglue are described and suggest that emergency staff should be careful to avoid using the term "superglue" when using tissue adhesives.
Collapse
Affiliation(s)
- Luke Cascarini
- Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK
| | | |
Collapse
|
27
|
Milne CT, Corbett LQ. A New Option in the Treatment of Skin Tears for the Institutionalized Resident: Formulated 2-Octylcyanoacrylate Topical Bandage. Geriatr Nurs 2005; 26:321-5. [PMID: 16213985 DOI: 10.1016/j.gerinurse.2005.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Skin tears are a common phenomenon in elderly institutionalized adults (EIAs). Incidence ranges from 0.92 to 2.5 per person/year. Little supportive literature exists regarding optimal treatment with many regimens reported. A convenience sample of 20 patients with Payne-Martin Category II and III skin tears of less than 8 hours' duration were prospectively evaluated with the use of a formulated 2-octylcyanoacrylate topical bandage. Patients were followed weekly until the tear healed. Complete healing occurred with 1 application of 2-OTB in 90% (18/20) of study subjects; 5% (n = 1) reported transient mild pain (less than 15 seconds), and 90% (n = 19) reported no pain. There were no incidents of cellulitis or infection. Shower and bathing routines were not interrupted. Cost averaged less than $1 per application. Clinician time averaged 1.5 minutes per application. Clinicians reported high satisfaction because repeated dressing changes were eliminated.
Collapse
|
28
|
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.
Collapse
Affiliation(s)
- William H Eaglstein
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL 33136, USA
| | | |
Collapse
|