16 Things You Didn't Know About Precautions For Adhesive Use

The adhesive is a fast setting adhesive capable of adhering to most body tissue and many other materials, such as surgical gloves and stainless steel. Inadvertent contact with any body tissue, and any surfaces or equipment that are not disposable or that cannot be readily cleaned with a solvent such as acetone should be avoided.

Polymerization of the adhesive may be accelerated by water or fluids containing alcohol. The adhesive should not be applied to wet wounds.

The adhesive should not be applied to the eye. If contact with the eye occurs, flush the eye copiously with saline or water. If residual adhesive remains, apply topical ophthalmic ointment to help loosen the bond and contact an ophthalmologist.

When closing facial wounds near the eye with the adhesive, position the patient so that any runoff of adhesive is away from the eye. The eye should be closed and protected with gauze. Prophylactic placement of petroleum jelly around the eye, to act as a mechanical barrier or dam, can be effective in preventing inadvertent flow of adhesive into the eye. The adhesive will not adhere to skin pre-coated with petroleum jelly. Therefore, avoid using petroleum jelly on any skin area where the adhesive is intended to adhere. Use of the adhesive near the eye has inadvertently caused some patients’ eyelids to be sealed shut. In some of these cases, general anesthesia and surgical removal has been required to open the eyelid.

The adhesive should not be introduced into the wound since this would interfere with wound healing or cause foreign body reaction. Avoid excessive pressure of the applicator tip against wound edges or surrounding skin. This can force the wound edges apart and allow adhesive into the wound. The adhesive should be applied with a light brushing motion of the dropper tip over easily approximated wound edges.

The adhesive should not be used in areas of high skin tension or across areas in which tension may increase, such as knuckles, elbows, or knees, unless the joint will be immobilized during the skin healing period or unless skin tension has been removed by application of another wound closure device (e.g., sutures or skin staples) prior to application of the adhesive.

As with all wounds, the adhesive treated wounds should be monitored for signs of infection. Wounds with signs of infection, such as erythema, edema, warmth, pain, and purulent exudate, should be evaluated and treated according to standard practice for infection. Patients should be instructed to contact the doctor if the such signs as well as wound reopen or the edges separation are found.

The adhesive should not be used on wound sites that will be subjected to repeated or prolonged moisture or friction.

The wounds should not be exposed to long periods of sunlight or tanning lamps during the healing period.

The adhesive should only be used after wounds have been thoroughly and adequately cleaned and debrided in accordance with standard surgical practice.

The adhesive polymerizes through an exothermic reaction in which a small amount of heat is released, and thus should not be applied to tissues that may be affected by such heat. The adhesive is to be applied in one continuous layer.

NOTE: Applying the adhesive in one continuous layer onto a dry wound will minimize the sensation of heat. Applying a second layer is not required or recommended.

If a second layer of the adhesive is applied or if large droplets of liquid are not spread thinly, the patient may experience an increased sensation of heat or discomfort.

NOTE: Excessive pressure of the dropper tip against the wound edges or surrounding skin can result in forcing the wound edges apart and allowing the adhesive into the wound.

The adhesive within the wound could delay wound healing and/or result in adverse cosmetic outcome.

The adhesive is packaged for single patient use. Discard remaining opened material after each wound closure procedure.

Do not resterilize the adhesive.

Do not place the adhesive in a procedure pack/tray that will be sterilized prior to use. Exposure of the adhesive to excessive heat (as in autoclaves or ethylene oxide sterilization) or radiation (such as gamma or electron beam) will increase its viscosity and may render the product unusable.