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
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
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
What are some reasons for using
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.
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
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
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
Reliable mechanical hemostasis is one of the benefits of our
vascular sealant, although it is not intended to stop active
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