NOTE: THE OUTER SURFACE OF THE APPLICATOR SHOULD BE COLD
STERILIZED BEFORE USING, ESPECIALLY IF BEING USED IN A
STERILE FIELD.
» Indications
In Canada GluStitch® is indicated for the closure of uncomplicated skin lacerations
where there is little or no tissue loss. Cyanoacrylate tissue adhesive is also
a viable adjunct to traditional therapies in the treatment of "polar hands" and
fissured skin.1 GluStitch® should be used under the direction of a physician.
TOPICAL USE ONLY. APPOSE WOUND EDGES AND APPLY ALONG THE SURFACE.
» Description
GluStitch® is the n-butyl ester of the cyanoacrylate series. This compound
which exists in monomeric form in the plastic containers, polymerizes extremely
rapidly
in the presence of anions, especially of hydroxyl ions [in the presence of water].
» Method
Unit of Use Kit: Prepare the wound for closure by disinfecting, removing foreign
bodies, and examining to rule out underlying damage. The area should be dried,
and hemostasis achieved. Hold the applicator in a vertical position, and tap
the tip lightly to move glue away from the tip. Clip off the top and gradually
lower the tip to move the adhesive into position. Take care not to apply pressure
while doing so to avoid inadvertent expelling of the adhesive.
Skin edges should be accurately apposed and slightly everted. A very thin film
of glue should be applied over the closely approximated skin edges by squeezing
the applicator and producing microdroplets. The skin edges should be kept apposed
for at least 30 seconds to allow maximum polymerization. Additional coats may
be applied to increase the tensile strength. The polymerization time is only
10 seconds therefore caution must be used to adapt the surfaces exactly. Areas
under tension should be reinforced using splints or tapestrips.
Care must be taken that no instruments, cloths, swabs,
or gloves come in contact with the adhesive as they will
adhere to the surface being glued. Instruments which have
been contaminated with adhesive should be cleaned with
dimethyl formamide or acetone. If too much adhesive has
been inadvertently applied, it can be removed in the first
few seconds using a dry swab. Misalignment can be corrected
by picking off the glue with forceps and starting again.
Vaseline or petrolatum may be of use to remove adhesive
from unwanted areas.
|
» Opening
Multiuse (regular): Squeeze the sides of the cap on the smooth surfaces and twist.
The cap has a pin embedded in the top to ensure viability.
» Minikit: Holding the vial upright, remove the protective
cap and pierce the top with the T-pin provided. If the removal
of the pin becomes difficult, remove the plug at the opposite
end with a dry paper towel and withdraw using a pipette.
Replace when complete.
Once opened, drop the required amount of adhesive into one of the wells in the
tray provided. Using one of the pipettes provided, draw up and apply the adhesive
to the surface being treated.2
» Closing and Storage
Minikit: Once opened, the vial should be resealed using the T-pin provided. Ensure
that the pin is clean and dry. Do not allow the pin to dwell in the adhesive
as it may precipitate polymerization. Store upright in the freezer or refrigerator.
Multiuse (regular): Ensure that the tip and cap are clean and dry by removing
excess adhesive with a dry paper towel. Replace the cap and store in freezer
or refrigerator.
» Important Recommendations
Ideally, GluStitch® should be stored below 5° C. or 40° F. Refrigeration is
important to keep the product viable. Whenever the adhesive is used, care must
be taken
that none splashes onto the cornea of the eye or into the conjunctival sac, where
it would cause adhesions. When treating lacerations near the eye, the periorbital
area should be protected using gauze or eye shields.
Hemostasis is important since excess blood may cause an intense exothermic reaction
[pain!], and may prevent proper tissue adhesion.
Polymerization of GluStitch® produces heat. This is insignificant as long as
the adhesive is applied in a very thin film.
|
|
» Multiuse Kits:
Only adhesive of a thin, liquid consistency should be used. The condition of
the adhesive should be assessed before opening the vials.
» Contraindications
GluStitch® is intended for external use only. GluStitch® must not come into
contact
with the conjunctival sac since conglutination may occur.
» Supplied:
MiniKit: one x 1 mL. cyanoacrylate, 20 pipettes, multiwell administration tray,
T-sealing pin.
» Multiuse Kit: (regular): one x 5 mL. cyanoacrylate, 50 pipettes, multiwell administration
tray.
» Unit of Use Kit: twelve x 0.2 mL. cyanoacrylate
All kits are available in clear or with violet surgical coloring.
|
| 1. Polar Hands: Spontaneous
skin fissures closed with cyanoacrylate [Histoacryl Blue] tissue
adhesive in Antarctica. Jeffrey M. Ayton, Polar Medicine, Australian
Antarctic Division, Kingston, Tasmania, Australia, Arct Med
Res 1993; 52: 127-130. |
2. N-2-Butylcyanoacrylate:
Risk of Bacterial Contamination with an Appraisal of its Antimicrobial
Effects, James V. Quinn et al., J. Emerg. Med 1995: 13. No.
4. Pp 581-585. |
site 
