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Surgical Techniques: Subcision, Grafting, Excision, and Punch Techniques
Published in Antonella Tosti, Maria Pia De Padova, Gabriella Fabbrocini, Kenneth R. Beer, Acne Scars, 2018
Rohit Kakar, Farhaad Riyaz, Megan Pirigyi, Murad Alam
To perform punch elevation, a punch instrument is chosen that exactly matches the diameter of the scar base (Figure 12.4). The punch is inserted down to the level of subcutaneous fat so that the tissue may be manipulated [48]. Next, forceps are used to gently elevate the scar base until it sits slightly higher than the surrounding surface, and the tissue is held in place for 1 or 2 minutes until a coagulum forms beneath it [48] (Figure 12.4). The plug is then secured in place using sutures, Dermabond (2-octyl cyanoacrylate, Ethicon, Inc., Somerville, NJ, USA), or Steri-Strips [19]. The area is covered with a topical antibiotic and dressed with gauze, and the patient is instructed to gently wash the area and reapply a topical antibiotic twice a day [1].
The neurosurgical operating room
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Erika Freiberg, Sara Kadlec, Sharad Rajpal
Once the surgical wound has been closed, a dressing is typically applied. Dressings provide a more appealing look for the patient’s wound and may possibly provide protection from microbes. Some theorize that a dressing may actually increase the risk of infection. Applying an antibiotic ointment rather than a dressing has been shown to result in similar rates of infection. Typical dressing options include gauze, tissue adhesives, and silver-impregnated bandages. Octyl cyanoacrylate is a common tissue adhesive and provides a barrier against both Gram-positive and Gram-negative nonmotile organisms for at least 3 days. Use of silver-impregnated bandages has been shown to reduce infections after lumbar fusions (Walcott et al., 2012). Discuss dressing options and preferences with your surgeon.
Pharmacology for venous and lymphatic diseases
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
The cyanoacrylate molecule has a two-carbon ethylene group, a B-carbon which has two hydrogens attached which contribute to its electric activity, and an A-carbon which has a cyano-group and an ester function called a carbonyl (Figure 5.5a). Various hydrocarbons perform the carbonyl function and provide its name, such as n-butyl cyanoacr ylate, ethyl2-cyanoacrylate, methyl 2-cyanoacrylate and 2-octyl cyanoacrylate.
Assessment of the Retinal Toxicity and Sealing Strength of Tissue Adhesives
Published in Current Eye Research, 2022
Anna Sharabura, John Chancellor, M. Zia Siddiqui, David Henry, Ahmed B. Sallam
We found that cyanoacrylates exhibited high strength (0.217–0.247 N) and high RPE toxicity 0.242–43.25 mm at 24 hours). While this class of adhesives would seal a retinal break, cyanoacrylates would not be recommended because of their high RPE toxicity.19 Their ocular toxicity could also be inferred from previous studies reporting propensity to cause stromal neovascularization, giant papillary conjunctivitis, secondary glaucoma, and synechiae.20 Because of its well-documented bacteriostatic action, cyanoacrylates like Histoacryl Topical Skin Adhesive (TissueSeal), Nexacryl (Tri-Point Medical), Isodent (SpofaDental), and Dermabond (Ethicon) are used for corneal perforation or progressive thinning leading to perforation.23 Octyl-cyanoacrylate is less toxic than histoacyl.25 Alternatives to cyanoacrylates include Tisseel Fibrin Sealant (Baxter) or Evicel Fibrin Sealant (Ethicon), which are FDA-approved for corneal application. ReSure (polyethlene glycol hydrogel) was nontoxic to the RPE cells, but it exhibited minimal strength, in addition to lasting only 2–3 days and requiring a dry surface for application.
Skin hypersensitivity following application of tissue adhesive (2-octyl cyanoacrylate)
Published in Baylor University Medical Center Proceedings, 2021
Raymond P. Shupak, Sid Blackmore, Roderick Y. Kim
Skin adhesives are frequently used for wound closure. Advantages include added strength to wound closure, microbial barrier protection, and patient comfort, convenience, and cosmesis.1–3 One common skin adhesive available for use is 2-octyl cyanoacrylate (DermabondTM). Dermabond is indicated for closely approximated surgical skin wounds and cleansed traumatic lacerations.4 It is contraindicated in areas of infection and in mucosal surfaces/junctions of skin and mucosa, as well as in patients with a hypersensitivity to cyanoacrylate, formaldehyde, or benzalkonium.4 Typically, skin adhesives are generally very well tolerated; however, there have been rare reports of adverse reactions. Infection, hypersensitivity reactions, wound dehiscence, pruritus, and skin blistering are potential adverse side effects of its use. Skin reactions can present immediately or in a delayed fashion.5 This report describes two incidents of allergic hypersensitivity reaction to skin adhesive following topical application in head and neck surgery.
The Adjunctive Effect of DuraSeal® vs. 2-Octyl-Cyanoacrylate on Delayed Repair of Gastric Perforation: An Experimental Study
Published in Journal of Investigative Surgery, 2022
Fatih Akgunduz, Alper Sozutek, Oktay Irkorucu, Abit Yaman
In fact, adhesive materials such as fibrin glue and acrylate derivatives are currently used as a primary or adjunctive treatment of many surgical complications including embolization, bleeding, GI fistula and perforation [10,12–18]. Because of its clinically proven efficacy and strength, cyanoacrylate is commonly preferred than fibrin glue in clinical practice. It works by polymerizing reaction; it creates a forcible bond between the tissues followed by applying to a moist area [19]. Since 2-Octyl-Cyanoacrylate is the most strength one, we preferred to compare it in this study.