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Medical Professionals: Frequently Asked Questions

Learn more about our ground-breaking biomaterials technology, our innovative medical adhesive and tissue sealant devices, or our commitment to revolutionize healing in the following frequently asked questions (FAQs).

Topical Wound Closure FAQs
Internal Tissue Sealant and Surgical Adhesive Device FAQs

Topical Wound Closure FAQs

What are some of the advantages of a topical wound closure device?
DERMABOND Topical Skin Adhesive is used extensively by health professionals to replace topical sutures or staples in the fields of trauma, plastic and other surgeries, emergency medicine and pediatrics. The product is less painful to use than sutures and staples, provides cosmetic results equivalent to topical sutures, reduces procedure time and acts as a barrier to microbial penetration, protecting against the two most common bacteria that cause infection, staphylococcus and pseudomonas.

What devices employ this technology and how are they used?
Several of our products, including original DERMABOND, high-viscosity DERMABOND and the ProPen delivery devices employ the topical closure benefits. The advanced DERMABOND ProPen Applicator system was designed to provide physicians greater precision application and control of adhesive flow utilizing the new high-viscosity formulation of the market-leading DERMABOND adhesive. The ProPen is a single-use device designed with interchangeable tips, which allows for fine line delivery of adhesive for those wound closures requiring precise application. The XL version of ProPen differs in that it will deliver twice the express volume as the ProPen for closing long surgical incisions. All DERMABOND products are distributed by Ethicon, Inc., a Johnson & Johnson Company.

Can a topical adhesive device be used on a laceration if subcutaneous stitches are required?
Yes, DERMABOND adhesive may be used in conjunction with, but not in place of, deep dermal stitches.

If subcutaneous sutures are required, wouldn’t that eliminate the need for a topical wound closure device?
DERMABOND adhesive does not replace subcutaneous stitches, if they are required. DERMABOND adhesive can be used when there is minimal to no tension on the wound and it has easily approximated edges.

What are some reasons for using DERMABOND adhesive?
First, it is the only FDA-approved 2-octyl cyanoacrylate product of its kind for closing wounds. It provides a physical barrier to infection. It speeds closure and has been clinically proven to be faster than traditional closure methods. Finally, DERMABOND offers considerable benefits to the patient, including less pain, excellent cosmetic results, and no need for suture removal.

What types of wounds can be closed with a topical wound closure device?
In general, DERMABOND adhesive will close and seal wounds caused by lacerations, surgical incisions, minimally invasive surgery, and cosmetic surgery.

How strong is the seal created by a liquid adhesive?
DERMABOND adhesive has a three-dimensional strength creating a strong, yet nontoxic, flexible, transparent bond. In less than three minutes, DERMABOND topical skin adhesive provides the strength of tissue at seven days.

If it’s that strong, does it keep out germs?
Studies have shown that only DERMABOND adhesives act as microbial barriers. DERMABOND liquid adhesive was evaluated in individual assays to show that they were effective barriers against the penetration of certain types of bacteria. This in-vitro study showed that DERMABOND products acted as barriers to microbial penetration against Staphylococcus epidermis, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecium. These bacteria are the ones most commonly associated with skin infections.

How about germs that might already be in the wound?
DERMABOND® adhesive should never be applied to a wound that is infected or has not been thoroughly cleaned, irrigated, and debrided. A recent article reported finding lower bacteria counts under a cyanoacrylate-based bandage compared to a conventional bandage (Mertz, PM et al. Barrier and antibacterial properties of 2-octyl cyanoacrylate-derived wound treatment films. J Cutan Med Surg 7:1 1-6, Jan-Feb. 2003).

If the bandage is that strong, how does it come off?
DERMABOND adhesives do not come off readily with water, although prolonged soaking can remove them. The adhesive is meant to slough off naturally in five to ten days. The closure is not cumbersome or awkward for the patient. It does not limit normal activities. Since DERMABOND adhesive is transparent, it is not necessary to remove it to examine the wound.

What about cosmetic results?
Studies report that DERMABOND adhesive is clinically proven to have equivalent cosmetic outcomes versus other skin closure methods.

In what types of facilities are liquid adhesives used?
DERMABOND skin adhesive, sometimes called “purple glue” because of its distinctive hue, has become a staple in emergency rooms and clinics all over America. Physicians in many different types of practices have used DERMABOND products for years. For simple skin lacerations and cuts, a modified formulation is available called BAND-AID® Brand Liquid Bandage. Two-octyl cyanoacrylate technology has also created Nexaband® products for veterinary use and SOOTHE-N-SEAL® for oral application (canker sores, ulcerations, and cuts). In the future, we at Closure Medical expect that liquid adhesives will find increasing applications.

Are topical wound closure devices really cost effective?
DERMABOND® topical skin adhesive saves valuable clinical time and can eliminate the need for a second follow-up visit (to remove the stitches). Consider the elimination of the injection of local anesthetic into the wound, waiting for the numbing effect, time to close the wound with sutures, and placing a dressing over the wound. This represents a great savings in terms of time, supply costs, and improved patient and surgeon satisfaction. Taken globally, liquid adhesives represent a great savings in terms of time, money, and convenience for the physician, patient, and healthcare system.

How are topical wound closure devices stored and packaged?
Products manufactured by Closure Medical require no special handling, separate applicators, or refrigeration, making them easy to store in hospitals and clinics. Closure Medical has developed outstanding delivery devices to assure that its medical adhesives can be quickly activated and precisely applied, even under the most rigorous clinical setting.

Haven’t we had the technology to make this kind of powerful glue for years already?
Yes and no. While chemists have known about super-strong adhesives for decades, products used on the human body must be completely biocompatible and a product used in the body must be completely biocompatible and biodegradable. Most strong adhesives are toxic to the human body. Closure Medical met the daunting challenge of developing safe and reliable medical adhesives for human use through many years of rigorous research.

Internal Tissue Sealant and Surgical Adhesive Device FAQs

Don’t medical adhesives for internal use already exist?
Yes, there are a few commercially available products, but none with similar performance as Closure Medical’s technology.

What makes Closure’s tissue sealant devices different?
Our new vascular sealant (in clinical trials since fourth quarter of 2003) is completely synthetic thereby eliminating the infectious and immunologic risks associated with blood derived products and considerably stronger with greater bonding to a wider variety of tissues and graft materials than existing products. It’s also easier to store, prepare, and apply with precision in only very small amounts, all highly desirable qualities for this type of product.

Why is a synthetic product better?
Biologically derived tissue sealants – whether from human or non-human sources - pose infectious and immunologic risks, which many physicians prefer to avoid, if at all possible while still being able to achieve desired sealing or adhesive results. A fully synthetic sealant or adhesive eliminates concerns about these risks.

How much of this vascular sealant does a surgeon typically need?
Usually only a couple of drops. Our new vascular sealant is dispensed a drop at a time, because that is all many procedures will require. Additionally, our product’s tremendous strength allows less product to provide greater strength than other sealants used in much larger volumes. This is important, because many physicians believe that when it comes to using an internal product, less is more.

Doesn’t the vascular sealant need to be applied in several layers?
No. A few drops dispensed evenly across the desired area should provide complete coverage. Once the area to be sealed is covered, repeated applications are not necessary.

Does this vascular sealant offer good hemostasis?
Reliable mechanical hemostasis is one of the benefits of our vascular sealant, although it is not intended to stop active bleeding.

How long does it take a vascular sealant product to set?
Allowing for individual variations based on the procedure, the patient, the conditions, and other factors, no more than two minutes. The product sets very quickly.

What procedures are suitable for tissue sealants?
We are only on the brink of speculating about all of the potential medical procedures that could benefit from tissue sealants and surgical adhesives. Our new vascular sealant is intended for vascular surgical procedures. Our scientists are currently evaluating clinical applications focused on pulmonary, orthopedics, neuro, GI, oncology, gynecologic, and general surgery as potential beneficiaries of this technology.

What is the future of tissue sealants and surgical adhesive devices?
Our ground-breaking new technologies have opened a new door in surgical applications of biomaterials. A wealth of new and exciting tissue sealants and surgical adhesive devices will be available in the future to help solve currently unmet clinical needs. These innovative devices will offer powerful clinical benefits and revolutionize healing for patients around the world.


Real People. Real Healing.