Ethicon Dermabond Mini Topical Skin Adhesive

Features of Dermabond

• 2-octyl cyanoacrylate high viscosity formulation for small incisions or lacerations
• Provides a microbial barrier with 99% protection in vitro for 72 hours against organisms commonly responsible for surgical site infections
• It is clinically shown to provide 7-day wound holding strength in just 3 minutes
• Proprietary Dermabond Topical Skin Adhesive formulation in an economically efficient size for small incisions—up to 4 cm in length
• Contains 0.36ml per single-use applicator
• Ideal for:
  - Small lacerations
  - Minimally invasive procedures

What to buy with Dermabond Mini Skin Adhesive

• 3M Steri-Strip Adhesive Skin Closure Strips
• Latex-Free Vinyl Exam Gloves
• Ethilon Suture with Needle

When to Use Dermabond Mini?

If deep dermal stitches are necessary, this item can be used to enhance structural support, but not in place of those stitches. This product is for topical use only.

• Lacerations
• Surgical Incisions
• Trauma Wounds

Contraindications:

• Do not use on any wound with evidence of active infection, gangrene, or wounds of decubitus etiology
• Do not use on mucosal surfaces or across mucocutaneous junctions (e.g., oral cavity, lips), or on the skin that may be regularly exposed to body fluids or with dense natural hair (e.g., scalp)
• Do not use on patients with a known hypersensitivity to cyanoacrylate, formaldehyde, or benzalkonium chloride

Storage Instructions:

• Recommended storage conditions: below 30°C, 86°F, away from moisture, direct heat, and direct light. Do not use it after the expiry date.

How to use Dermabond Mini Topical Skin Adhesive by Ethicon?

1. It requires thorough wound cleansing. Follow standard surgical practice for wound preparation before application of Dermabond Adhesive (i.e., anesthetize, irrigate, debride, obtain hemostasis, and close deep layers)
2. Pat the wound dry with dry, sterile gauze to ensure direct tissue contact for adherence to the skin. Moisture accelerates the high viscosity of Dermabond Adhesive polymerization and may affect wound closure results
3. To prevent the inadvertent flow of liquid to unintended areas of the body, the wound should be held in a horizontal position and should be applied from above the wound.
4. Should be used immediately after crushing the glass ampule since the liquid will flow freely from the tip for only a few minutes. Remove the applicator from the blister pouch. If using the pen applicator, refer to the instructions on the pouch for crushing the glass ampule and expressing the liquid adhesive. If using the plastic vial, hold the applicator with the thumb and a finger and away from the patient to prevent any unintentional placement into the wound or on the patient. While holding the applicator, and with the applicator tip pointed upward, apply pressure at the midpoint of the ampule to crush the inner glass ampule. Invert and gently squeeze the applicator just sufficiently to express to moisten the applicator tip
5. Approximate wound edges with gloved fingers or sterile forceps. Slowly apply multiple (at least two) thin layers to the surface of the approximated wound edges using a gentle brushing motion. Wait approximately 30 seconds between applications or layers. Maintain manual approximation of the wound edges for approximately 60 seconds after the final layer.
6. Do not apply liquid or ointment medications onto wounds closed because these substances can weaken the polymerized film, leading to dehiscence (skin edge separation)
7. Protective dry dressings such as gauze may be applied only after the film is completely solid/polymerized: not tacky to the touch (approximately five minutes after application). Allow the top layer to fully polymerize before applying a bandage. If a dressing, bandage, adhesive backing, or tape is applied before complete polymerization, the dressing can adhere to the film. The film can be disrupted from the skin when the dressing is removed, and dehiscence (skin edge separation) can occur
8. Patients should be instructed to not pick at the polymerized film. Picking at the film can disrupt its adhesion to the skin and cause dehiscence (skin edge separation). Picking at the film can be discouraged by an overlying dressing
9. Apply a dry protective dressing for children or other patients who may not be able to follow instructions for proper wound care
10. Patients treated should be provided the printed instruction sheet entitled, “How to Care for Your Wound After It’s Treated With High Viscosity Dermabond Adhesive”. This instruction sheet should be reviewed with each patient or guardian to ensure understanding of the proper care for the treatment site
11. Patients should be instructed that until the polymerized film has sloughed naturally (usually in 5-10 days), there should be only transient wetting of the treatment site. Patients may shower and bathe the site gently. The site should not be scrubbed, soaked, or exposed to prolonged wetness until after the film has sloughed naturally and the wound has healed closed. Patients should be instructed not to go swimming during this period
12. If removal is necessary for any reason, carefully apply petroleum jelly or acetone to the film to help loosen the bond. Peel off the film, do not pull the skin apart.

Precautions to take while using Dermabond Mini Topical Skin Adhesive

• Do not apply liquid or ointment medications or other substances to the wound after closure, as these substances can weaken the polymerized film and allow for dehiscence (skin edge separation). Prior to application, cleanse the application site thoroughly to remove any remaining blood, fluids, or topical medications/ anesthetics. Permeability by fluids is not known and has not been studied
• To prevent the inadvertent flow of liquid with high viscosity Dermabond Adhesive to unintended areas:
  (1) the wound should be held in a horizontal position, with high viscosity Dermabond Adhesive applied from above
  (2) high viscosity Dermabond Adhesive should be applied in multiple (at At least two), thin layers rather than in a few large droplets
• Hold the applicator away from yourself and the patient and break the ampule close to its center one time only. Do not crush the contents of the applicator tube repeatedly as further manipulation of the applicator may cause glass shard penetration of the outer tube. Glass shard penetration can result in inadvertent skin punctures, which may result in the transmission of bloodborne pathogens
• Dermabond Mini Skin Adhesive should be used immediately after crushing the glass ampule as the liquid adhesive will not flow freely from the applicator tip after a few minutes
• If unintended bonding of intact skin occurs, peel, but do not pull the skin apart. Petroleum jelly or acetone may help loosen the bond. Other agents such as water, saline, Betadine Antibiotics, Hibiclens (chlorhexidine gluconate), or soap, are not expected to immediately loosen the bond
• Safety and effectiveness on wounds of patients with peripheral vascular disease, insulin-dependent diabetes mellitus, blood clotting disorders, personal or family history of keloid formation or hypertrophy, or burst stellate lacerations, have not been studied
• The safety and effectiveness of wounds that have been treated and then exposed for prolonged periods to direct sunlight or tanning lamps have not been studied.

Ethicon Dermabond User Manual