Dermabond Propen: Using High Viscosity Dermabond Topical Skin Adhesive

How does Dermabond Work?

Dermabond is composed of 2-octyl cyanoacrylate which is to be used as a topical skin adhesive. Unlike other formulations of cyanoacrylate which need to be injected onto the wound edges, use of cyanoacrylate in the form of Dermabond Propen allows it to be applied to the skin surface after keeping the wound edges approximated together. It is important that there should be no or very minimal tension on the wound edges to allow Dermabond to act as adhesive. High Viscosity Dermabond adhesive is six times thicker than the original Dermabond adhesive. The viscosity of the original Dermabond adhesive is slightly greater than water, while High Viscosity Dermabond adhesive has a syrup-like viscosity. 

Advantages Of Dermabond Propen And How Does It Compare To Sutures?

Dermabond skin adhesive when used to approximate edges of skin incisions, gives an extremely good cosmetic result. The only pre-requisite is that skin edges should not be under any tension; else they will separate away from each other during the application of Dermabond, allowing the liquid to enter deeper tissues. Using Dermabond Propen makes the application of Dermabond simpler than using the vial as the ability to hold the applicator like a pen makes it easy to apply the adhesive over the skin.

It is necessary that sutures be taken in the subdermal region of the wound to keep the skin edges close to each other and allow good sealing with Dermabond. Without these sutures the wound is likely to gape after application of Dermabond. When Ethilon or other suture materials are used to close skin incisions, the entry and exit points leave scars like alternating spots outside of the scar. Use of Dermabond does not have this problem and leaves a seamless scar in 10-14 days.

Tips On Using Surgical Supplies And Ethicon Dermabond Propen And Method Of Use:

Dermabond is supplied in a vial of 0.5 ml of violet coloured liquid. This vial is positioned inside the Dermabond Propen for use. Initially the skin is patted dry with a mop or gauze piece. Dermabond hardens up quicker when used on wet surfaces and in the presence of disinfectants like alcohol. The skin edges are apposed to each other with gloved fingers or forceps and the vial inside the pen is then broken by squeezing the soft rubber part. Dermabond has to be used immediately after breaking the vial since the liquid starts to harden. The Dermabond Propen is then used to spread 2 thin layers of the adhesive liquid over the apposed skin edges, leaving 30 seconds time in between the 2 applications. The skin edges are then held together for 60 seconds till the liquid polymerizes. Complete polymerization takes up to 5 minutes. If a dry dressing is to be placed above the Dermabond layer, it should be done after this period to avoid the dressing sticking to the wound.

More information on:  

DPP6 Dermabond Propen High Viscosity Sterile please visit: www.sosmedicalsuperstore.com

Buy now!! Call Toll free: 1800-3675735 and US Local: 305-8855855

What are Antibacterial Vicryl Sutures Made of and What are Their Absorbable Suture Properties

Synthetic absorbable sutures offer the strength needed for a wide range of applications, from abdominal and chest wound closure to ophthalmic and plastic surgery. Once such example is the Antibacterial Vicryl Suture, which is a synthetic, absorbable, sterile, surgical suture. It is a copolymer made from ninety percent glycolide and ten percent L-lactide. Coated Vicryl Plus Antibacterial Suture is coated with a mixture composed of equal parts of a copolymer of glycolide and lactide (polyglactin 370) and calcium stearate. Coated Vicryl Plus Antibacterial suture contains IRGACARE MP, which is one of the purest forms of the broad spectrum antibacterial agent triclosan.

Coated Vicryl Plus Antibacterial suture offers protection against bacterial colonization of the suture. In vivo studies demonstrate that Coated Vicryl Plus Antibacterial suture has a zone of inhibition that is effective against the disease causing organisms that most often cause surgical site infection  Staphylococcus aureus, methicillin resistant Staphylococcus aureus, Staphylococcus epidermidis, methicillin resistant staphylococcus epidermidis. In vivo studies demonstrate that Vicryl Plus Antibacterial suture has no adverse effect on normal wound healing. Coated Vicryl Plus Antibacterial suture performs and handles the same and has the same dependable construction as Coated Vicryl suture. In vivo testing by surgeons demonstrates the same excellence in performance and handling.

The suture is available in the market in two forms: When it is not dyed (naturally in a beige hue) and when it is dyed. The dyed form comes in violet color. Coated Vicryl  Plus suture is indicated for use in general soft tissue approximation and or ligation requiring medium support, except for ophthalmic, cardiovascular and neurological tissues. Frequent uses include general closure, bowel, orthopedic, and plastic surgery. Coated Vicryl Plus Antibacterial suture retains approximately seventy five percent of the original tensile strength at two weeks post implantation. At three weeks, approximately fifty percent of the original strength is retained. At four weeks, approximately twenty five percent of the original strength is retained. All of the original tensile strength is lost by five weeks post implantation. Absorption of Coated Vicryl Plus Antibacterial Suture is fundamentally complete between fifty six and seventy days.

Some of the major factors which can affect tensile strength loss and absorption rates are the type of suture, infection, and tissue sites. Plain gut generally absorbs more rapidly than chromic gut. Surgical gut is absorbed more rapidly in infected tissue than in non infected tissue. Surgical gut will absorb more rapidly in tissues where increased levels of enzymes are present, as in the secretions exhibited in the stomach, cervix and vagina. Physicians should consider the in vivo performance when selecting a suture for use in patients. . As with any foreign body, prolonged contact of any suture with salt solutions, such as those found in the urinary tracts may result in calculus formation.

Antibacterial Vicryl suture is only being made by Ethicon Inc. at this time. All Ethicon product codes related to Antibacterial  Vicryls begin with the prefix VCP.

Prolene Suture and Overall Polypropylene Suture Characteristics, Knot Tying Tips, and Surgical Uses

Polypropylene is a compound that has an isostatic crystalline stereoisomer form. It is a hydrocarbon polymer that allows very less saturation. This is manufactured by a patented process which enhances pliability and handling. Thus, polypropylene monofilament sutures cannot be degraded or weakened by the action of tissue enzymes. They cause a negligible amount of tissue reaction and hold knots better than most other synthetic monofilament materials. One suture that is made of such a compound is Prolene suture.  It is made by Ethicon Inc., which is part of the Johnson and Johnson Company.

Prolene sutures are widely used in general, cardiovascular, plastic, and orthopedic surgery. Prolene sutures do not stick on to tissue and are therefore effective as a pullout suture. Prolene sutures are relatively biologically inert in comparison to other sutures, and offer strength, reliability and versatility that have been proven time and time again during surgeries. Prolene sutures are recommended for use where minimal suture reaction is desired. This can be in cases such as contaminated and infected wounds to minimize the sinus that can form later. Prolene sutures are also recommended for suture extrusion, i.e. forced out or squeezed through small openings. However, the few disadvantages include fragility, high plasticity, high expense, and difficulty of use compared to standard nylon sutures.

Certain patients may be sensitive to the compound that PROLENE suture is made up of, and might exhibit an immunological reaction resulting in inflammation, tissue granulation or fibrosis, wound suppuration and bleeding, as well as sinus formation.

The surgeon's or friction knot is recommended for tying Prolene polypropylene suture. The surgeon’s knot also may be performed using a one hand technique. The surgeon should avoid unnecessary tension when running down knots, to reduce the occurrence of surface fraying and weakening of the strand. Prolene sutures are available in the market in two forms. The undyed version is available in clear, and the dyed one comes in blue for better visibility.

Prolene has also become the mainstay of vascular anastomosis and had facilitated significant advances in cardiac and vascular surgery. It is used on both small vessels such as coronary artery bypasses and large vessels such as the aorta. It is used in obstetrical practice, during cesarean sections to suture the rectus sheath of the abdominal wall because it is non absorbable in nature and provides the sheath the due strength it deserves (rectus sheath is made up of various tendon extensions and muscle fibers and keeps up the strength of the abdominal wall, if it becomes weak the abdominal contents start producing symptoms of hernia) it stays there forever and is also often seen during repeat cesarean section as that of the previous section.

Polypropylene suture is also made by many different manufacturers as Look and Sharpoint, which have a much better overall cost than the brand name. Although Prolene suture is made by Ethicon, there are other suture makers that also manufacture it. In the case of Syneture (Covidien) their polypropylene suture product is called Surgipro. 

Please visit: SOS Medical for more information on these Sutures .

Properties of PDS II Absorbable Ethicon Suture and some of Its Surgical Use

Absorbable sutures are used to give support to wound edges temporarily, until they have healed enough to endure the regular stresses of the external environment. These sutures are prepared either from the collagen of healthy mammals or from synthetic polymers. Synthetic absorbable sutures are hydrolyzed. This is a process by which water slowly and eventually goes through the suture filaments. This leads to the breakdown of the suture's polymer chain. Hydrolysis results in a smaller degree of tissue reaction following implantation in comparison to the enzymatic action of natural absorbable materials. One example of a synthetic absorbable suture is the PDS II monofilament suture made by Ethicon, and which is deemed to be a wonderful addition to the suture market.  

PDS II is a monofilament that has resulted in a significant advance in suturing options. A monofilament suture is made of a single strand. It stops microorganisms from growing and living in the wound area, and it ties down smoothly. A suture can lose tensile strength rapidly and yet be absorbed slowly. It can maintain adequate tensile strength through wound healing, followed by rapid absorption. In any case, the strand is eventually completely dissolved, leaving no detectable traces in tissue. PDS II sutures are made up of the polyester polydioxanone. There are many advantages of using the PDS II suture. It combines the features of soft, pliable, monofilament construction with absorbability and extended wound support for up to six weeks. It causes only a slight tissue reaction. This material is widely acceptable and preferred for many types of soft tissue approximation, including pediatric cardiovascular, orthopedic, microsurgery and neural tissue, gynecologic, ophthalmic, plastic, digestive, and colonic surgeries.

Like other synthetic absorbable suture, PDS II sutures are absorbed in vivo through hydrolysis. Its tensile strength remains around seventy percent two weeks after the implantation, fifty percent at four weeks after implantation, and twenty five percent at six weeks after implantation. Absorption is negligible until about the 90th day after the operation and is for all intents and purposes complete within six months. The safety and effectiveness of PDS II sutures in microsurgery, neural tissue, and adult cardiovascular tissue have not been established. They may also be impregnated or coated with agents that improve their handling properties, and colored with a dye to increase visibility in tissue. PDS II sutures are available in clear or with a violet dye to increase visibility during a surgery.

PDS Plus Suture has an antibacterial agent added to it. This gives an additional advantage over the regular PDS II. It is indicated for use in soft tissue approximation, including use in pediatric cardiovascular tissue where growth is expected to take place and ophthalmic surgery. However, contact with cornea and sclera is a noted exception. PDS Plus Suture is not indicated in adult cardiovascular tissue, microsurgery, and neural tissue. These sutures are chiefly useful where the combination of an absorbable suture and wound support is indicated for a long period of time.  Up to six weeks is more often than not desirable.