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Are all tissue adhesives the
same?
There are different acrylate tissue adhesives which differ in
polymerization and firmness. EPIGLU is an Ethyl-2-Cyanoarcylate
which polymerizes very quickly and closes even wounds which
are under tension safely.
Are tissue adhesives more
expensive than traditional wound treatment with sutures?
The common opinion that tissue
adhesives are always more expensive than sutures is not valid
for EPIGLU. This Ethyl-2-Cyanoarcylate tissue adhesive
is available in 3g tubes and as Single Dose Dosette with 0.3
ml/cc. The 3g tubes are re-usable. Because each 3g tube is
sufficient for at least 20 wound treatments, the cost per
treatment is lower than for traditional wound treatment with
sutures. Also the Single Dose packages in Dosettes with 0.3 ml/cc
adhesive are still cheaper than the treatment with sutures. It
also should be considered that after a smaller or bigger
accident no anesthetic is necessary and there is no need for a
second appointment to remove the stitches.
How long does it take to treat
a wound traditionally or with adhesive?
Experiences prove that the
traditional wound treatment takes approx. 50 minutes (including
inspection of the wound, anesthesia, sewing, clearance of the
work equipment, sterilisation of the instruments and removing
the stitches), meanwhile the adhesion takes 10 minutes only.
Why do no infections occur to
the re-usability of EPIGLU from tubes?
EPIGLU is applied with
disposable dispensing pipettes or with the Single Dose
Dosettes which are thrown away after application. EPIGLU
is no culture medium for germs and even has an inhibitive
effect on existing germs. Sterile application sets for the
operation theatre are available. The EPIGLU solution is
sterile (Medical Device Services May 2008 / MedCert October
2008).
For how long EPIGLU is known on
the market and where is it used?
In December 1995, EPIGLU
has got the approval and it is used within Germany and many
other countries. Samples are shown on our homepage
www.meyerhaake.com Allergic reactions or other occurrences
were not observed so far. At the Tehran Burn Clinic skin
meshes had been adhered at the edges very successfully instead
of sewing them. The time of operation could be reduced about
50%, complications did not occur.
When EPIGLUŽ is applied is it
possible to abstain from subcutaneous sutures??
No, basically all acrylate tissue
adhesives are for the closures of skin surfaces only. If
because of the situation subcutaneous sutures are necessary,
nevertheless, the closure of the skin can be performed with
EPIGLU.
Is it possible to treat long
wounds which are under tension with EPIGLUŽ?
Yes, because EPIGLUŽ is an Ethyl-2-Cyanoacrylate.
These acrylates are more tear-proofed than other acrylate
compounds. To our knowledge we are the only company on the
world producing a tissue adhesive made of Ethyl-2-Cyanoacrylate.
Irrespective of the length, all cuts, lacerations and surgical
incisions can be closed with EPIGLUŽ if they do not bleed any
more, are not infected and not older than 6 hours. EPIGLUŽ is
particularly suitable for the treatment of wounds after
removal of skin lesions or excisions (basaliomas, nevi, senile
freckles, keratosis, xanthelasmas, warts and many other more).
EPIGLUŽ can also be applied onto the oral mucosa and the
external genitalia. Bites and abrasions should not be treated
with adhesives.
Why should EPIGLUŽ be applied
in several layers?
Because all tissue adhesives peel
off easier from the healthy skin which surrounds the wound it
is safer to apply 2 to 3 thin layers, each overlapping the
other, after the primary wound adhesion. With the pipettes or
the twisted off upper part of the Dosettes it is possible to
smooth out the adhesive thinly.
How fast does EPIGLUŽ
polymerize?
The first layer which was directly
applied onto the wound hardens in approx. 10 seconds. The
wound edges are now fixated already safely. Other layers
harden in 2 to 3 minutes.
What to do if after some hours
the patient has got an unpleasant ııthrobbingıı feeling?
It must be assumed that the wound
had been inflamed or that there had been foreign objects
before the adhesion. In this case, once it has set, EPIGLUŽ
can be peeled off.
Does EPIGLUŽ has to be removed
after the wound healing is completed?
No, with the formation of new skin
lamellae (after 5 to 10 days) EPIGLUŽ detaches itself from the
skin like scab.
Why do wounds heal faster after
adhesion?
Wounds closed with Ethyl-2-Cyanoacrylate
tissue adhesive are protected from infections. Also the wound
edges are closely laying side by side for the whole length of
the wound and, therefore, the healing process is accelerated.
Ugly scars are avoided and according to our experience keloids
develop rarely. Allergic reactions are not known.
Can EPIGLUŽ be used
additionally for already sutured wounds?
If a wound had been treated with
sutures already it is possible to apply EPIGLUŽ
additionally.This will help to stabilize the wound and to
protect it against infections.
Why does patients feel better
after a wound treatment with EPIGLUŽ?
The patients are much more
painless because there are no stitch channels and, therefore,
no tensile strength pain.
What should patients pay
attention to after the treatment with EPIGLUŽ?
The patient can immediately resume
the daily personal hygiene (washing/showering) and is able to
work or play again. Nevertheless, we recommend for children or
nervous patients to put a band-aid over the treated wound. So,
it can be avoided that the patient who is nearly pain-free
peels off the adhesive layers with or without intention..
How EPIGLUŽ has to be stored?
The longest shelf life of EPIGLUŽ
can be achieved if EPIGLUŽ is stored in a deep freezer. As
EPIGLUŽ is high-graded pure it does not freeze into a solid
block and can be used immediately after removal from the deep
freezer. Deep freezing is recommended especially for private
practices, where wound treatment does not occur so often. If
EPIGLUŽ is used several times a day, e. g. in emergency rooms
or operation theatres, it is not necessary to store the
adhesive in the deep freezer between the applications.
Which is the shelf life of
EPIGLUŽ?
If stored in a deep freezer EPIGLUŽ
has a shelf life of 36 months. If stored in a refrigerator or
at room temperature the shelf life decreases. Discontinue use
of EPIGLUŽ if the solution does not drip in a clear watery
consistency any longer. The material has then started to
polymerize and the adhesive can not be used any longer.
How does EPIGLUŽ polymerize?
Acrylates polymerize by absorption
of OH-ions. OHions are in the air. On a warm and humid summer
day the polymerization occurs faster than on a cold and dry
winter day. This is one reason why the first layer of the
adhesive is hardening much faster on the still humid wound. It
should not be forgotten that Ethyl-2-Cyanoacrylates as EPIGLUŽ
are polymerizing faster than other acrylates in general. |
