Transcript File

DERMABOND® Topical Skin Adhesive
•The Final Layer of Protection
DERMABOND® Adhesive is equivalent to other commercially available skin
closure devices, studied effectively from small to long incisions up to 69cm.
DERMABOND
PLUS SUTURES
SUTURE
STAPLES
STRIPS
Closure Strength
Equivalent to 4.0
Variety
Variety
Strongest
Weak
Microbial barrier
Yes
Zone of inhibition
No
No
No
Cosmesis
Excellent
Excellent
Excellent
May leave track
marks
Inconsistent
Patient Comfort showering
Can Shower
Immediately
Not recommended
for period of time
Not recommended
for period of time
Not recommended
for period of time
Not recommended
For period of time
Ease of Care
Simple
Complicated
Complicated
Complicated
Complicated
Enduit to bacterial
colonization
No
No
Yes
Yes
Yes
Removal
Sloughs off
naturally
May need removal
May need removal
Needs removal
Self removal
What is DERMABOND Topical Skin Adhesive?
Cyanoacrylates were developed in 1949
• 1970s - n-butyl-2-cyanoacrylate
• 1999 - 2-Octyl-Cyanoacrylate (DERMABOND)

•
1st FDA approved Topical Skin Adhesive
Today – over 5 million patients a year are treated with
DERMABOND Adhesive
DERMABOND Adhesive is a unique technology
• 2 Octyl cyanoacrylate has the longest carbon side
chain for increased flexibility and, increased
breaking strength versus butyl cyanoacrylate1
• In vivo and In vitro studies demonstrate a proven
microbial barrier against bacteria which may cause
infection.
• 24 months shelf life, stores at room temperature
• a violet, non tattooing dye for easy observation
1. Quinn, JV Tissue Adhesives in Wound Care, BC Decker 1998. Attached are chapters from the book.
Mechanism of action is a combination of monomer and plasticizers,
that polymerizes to form a flexible/pliable adhesive film
• Sets or cures within 45-90 seconds
following final layer
• Reaches full mechanical strength in 1 min
• If needed, can be wiped from skin within
10 seconds after application or with a
petroleum based product after setting
• Adhesive film sloughs or falls off wound
within 7-10 days as skin re-epithelialize
OCA: 300-500 microns thick compared to
other N- Butyls at : <50 microns thick
• Equivalent to 7 days wound healing
strength in 3 minutes1
3
1. Singer and Hollander, Lacerations in Acute Wounds: An evidence-based
guide, p.85 2. DERMABOND adhesive package insert
DERMBOND Adhesive has proven strength over n-butyls and n-butyl blends
due to it’s unique formulation. This strength is critical for topical wound
closure and microbial barrier.
Wound Bursting Strength
Compliance Analysis
In vivo studies demonstrated DERMABOND Adhesive microbial barrier
provides greater protection than sutures alone as well as n-butyls/ n-butyl
blend adhesives.
DERMABOND® Adhesive has unique benefits that offer the potential
to impact the cost of care.
*Health and Economic Outcomes after OB-GYN Surgery: A Comparison of Skin Closure Techniques
Susan G. Murrmann, MD1, Jeffrey S. Markowitz, DrPH2, Elane M. Gutterman, PhD2, Glenn Magee, MBA3
1 University of Tennessee, Department of Obstetrics & Gynecology, Memphis, TN 2 Health Data Analytics, Princeton Junction, NJ 3 Ethicon Inc., Somerville, NJ
Hysterectomy Cohort
Sutures
Staples
OCA
Sutures,
Staples &
OCA
N= 21,201
N=23,441
N=880
N=489
Percent
Infection as reflected by
non-prophylactic
antibiotic treatment
12.93%
17.51%
11.14%
Overall
P Value
Significant
pairwise
comparisons1
Unadjusted Analysis
Overall
P-Value
Significant
pairwise
comparisons2
Adjusted Analysis 2
23.72%
<0.0001
1a,3a,4a,5a,6a
<0.000
1
1a,3a,5a,6a
<0.0001
1a,3a,4a,5a,6a
<0.000
1
1a,3a,5a,6a
Unadjusted Means
Total costs (dollars)
C-Section Cohort
$5862
$6965
$5816
$9434
N=102,797
N=50,097
N=2,391
N=272
Percent
Infection as reflected by
non-prophylactic
antibiotic treatment
12.83%
12.76%
9.50%
Unadjusted Analysis
Adjusted Analysis 2
13.97%
<0.0001
2a,4a
<0.000
1
2a,4a
$5949
<0.0001
2a,4a,6a
<0.000
1
1a,2a,4a,6a
Unadjusted Means
Total costs (dollars)
$5572
$5594
$5010
*Poster Presentation at 2008 Annual Clinical Meeting of The American College of Obstetricians and
Gynecologists, New Orleans, LA, May 3-7, 2008
DERMABOND Adhesive for final skin closure provides
benefits for surgeons, nurses, patients, and hospitals.
Physician, Hospital -centered Benefits
•
Proven microbial barrier for lasting protection
•
7 days of wound healing strength in 1 minutes
for strong closure and peace of mind
•
No time spent removing staples or sutures
•
Reduces needle stick exposure
•
Increases patient satisfaction
•
Reduced Hospitalization Costs
Nurse, Patient -centered Benefits
• Reduces number of suture set ups
• Ease of Post Op wound checks
• Reduces number of wound dressings
• Shower immediately
• Excellent Cosmesis
Scott GR, Carson, CL, Borah, GL, DERMABOND skin closures for bilaterial reduction mammoplasties:
a review of 255 consecutive cases. Plast Reconst Surg.2007;120:1460-1465.
Things to consider for successful outcomes
• Standard wound
management
 Remove surgical prep solution
 Ensure hemostasis
• Precise application
technique
 Thin layers
 Dry before bandage
 No petroleum-based products over
DERMABOND Adhesive
 Post surgical ChloraPrep wipe downs
ok as long as DERMABOND Adhesive
has dried and the area is not
vigorously scrubbed