Ethicon Dermabond Advanced Topical Skin Adhesive

How to Use Dermabond Topical Skin Adhesive?

• The application of Dermabond Advanced Adhesive requires thorough wound cleansing. Follow standard surgical practice for wound preparation before application of Dermabond Advanced Adhesive (i.e., anesthetize, irrigate, debride, ensure hemostasis, and close deep layers making sure that the wound edges can be easily approximated).
• Pat the wound dry with dry, sterile gauze to ensure direct contact of the Dermabond Advanced Adhesive to the skin. Moisture accelerates Dermabond Advanced Adhesive’s polymerization and may affect wound closure results. 
• To prevent inadvertent flow of liquid Dermabond Advanced Adhesive to unintended areas of the body, the wound should be maintained in a horizontal position and the Dermabond Advanced Adhesive should be applied from above the wound. 
• Dermabond Advanced Adhesive should be used immediately after crushing the ampoule, since the liquid Dermabond Advanced Adhesive will flow freely from the tip for only a few minutes. 
• Refer to the instructions on the package for crushing the ampoule and expressing the liquid adhesive. Remove the applicator from the blister package. Hold the applicator with the thumb and a finger away from the patient to prevent any unintentional placement of the liquid Dermabond Advanced Adhesive into the wound or on the patient. With the applicator tip pointing downward, apply pressure at the midpoint of the bulb to crush the ampoule. Gently squeeze the applicator sufficiently to moisten the internal filter with the liquid adhesive. Stop squeezing and allow the liquid Dermabond Advanced Adhesive to draw back into the applicator. 
• Approximate the wound edges with gloved fingers or sterile forceps. Slowly apply the liquid Dermabond Advanced Adhesive in one continuous layer to the surface of the approximated wound edges using a gentle brushing motion. Maintain manual approximation of the wound edges for approximately 60 seconds after the application. The width of the layer can be increased or decreased by adjusting the amount of pressure applied to the bulb during application. NOTE: Dermabond Advanced Adhesive polymerizes through an exothermic reaction in which a small amount of heat is released. Dermabond Advanced Adhesive is to be applied in one continuous layer. Applying Dermabond Advanced 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 Dermabond Advanced Adhesive is applied or if large droplets of liquid are not spread thinly, the patient may experience an increased sensation of heat or discomfort. Avoid excessive pressure of the applicator tip against the wound edges or surrounding skin to avoid forcing the wound edges apart and allowing Dermabond Advanced Adhesive into the wound. Full apposition strength is expected to be achieved within minutes after the adhesive is applied. Full polymerization is expected when the Dermabond Advanced Adhesive layer is no longer sticky.
• Do not apply liquid or ointment medications onto wounds closed with Dermabond Advanced Adhesive because these substances can weaken the polymerized film, leading to dehiscence (skin edge separation). 
• Protective dry dressings such as gauze may be applied only after Dermabond Advanced Adhesive film is completely polymerized: not tacky to the touch after a few minutes. Allow the Dermabond Advanced Adhesive to fully polymerize before applying a bandage.
• Patients should be instructed to not pick at the polymerized film of Dermabond Advanced Adhesive. Picking at the film can disrupt its adhesion to the skin and cause dehiscence (skin edge separation). 
• Patients should be instructed that until the polymerized film of Dermabond Advanced Adhesive has sloughed naturally (usually in 5–10 days), there should be only transient wetting of the treatment site. Patients

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