The Experts below are selected from a list of 234 Experts worldwide ranked by ideXlab platform
James Quinn - One of the best experts on this subject based on the ideXlab platform.
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closure of lacerations and incisions with Octylcyanoacrylate a multicenter randomized controlled trial
Surgery, 2002Co-Authors: Adam J. Singer, James Quinn, Robert E Clark, Judd E HollanderAbstract:Abstract Background. Most lacerations and surgical incisions are closed with sutures or staples. Octylcyanoacrylate tissue adhesive (OCA) was recently approved for use in the United States. We compared the cosmetic appearance of lacerations and incisions repaired with OCA versus standard wound closure methods (SWC). Methods. A multicenter randomized clinical trial including patients with simple lacerations or surgical incisions was conducted at 10 clinical sites. Patients were randomly assigned to treatment with OCA or SWC. Follow-up was performed at 1 week and at 3 months to determine infection rates and cosmetic outcome. Results. Eight hundred fourteen patients with 924 wounds (383 traumatic lacerations, 235 excisions of skin lesions or scar revisions, 208 minimally invasive surgeries, and 98 general surgical procedures) were enrolled. Groups were similar in baseline characteristics. Wound closure with OCA was faster than with SWC (2.9 vs 5.2 minutes, P
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a randomized clinical trial comparing butylcyanoacrylate with Octylcyanoacrylate in the management of selected pediatric facial lacerations
Academic Emergency Medicine, 1999Co-Authors: Martin H Osmond, James Quinn, Mario Jarmuske, Teresa Sutcliffe, Terry P KlassenAbstract:Objective: To compare two tissue adhesives, butylcyanoacrylate and Octylcyanoacrylate, in the treatment of small (<4 cm) superficial linear traumatic facial lacerations in children. Methods: This was a randomized, clinical trial with parallel design. 94 children <18 years of age seen in the ED of a tertiary care pediatric hospital with a facial laceration suitable for tissue adhesive closure underwent laceration closure using either butylcyanoacrylate or Octylcyanoacrylate. The primary outcome was the cosmetic result at three months rated from photographs by a plastic surgeon on a visual analog scale (VAS). Secondary outcomes included the time to perform the procedure, the perceived difficulty of the procedure, the pain perceived by the patient, and a wound evaluation score at ten to 14 days and three months. Results: Ninety-four patients were randomized with 47 in each group. The two groups were similar for baseline demographic and clinical characteristics. There was no difference in the three-month cosmesis VAS (median, 70.0 mm for n-butyl-2-cyanoacrylate vs 67.5 mm for octylcyanocrylate, p = 0.84). There was no difference between the groups for time to complete the procedure (p = 0.88), parent/patient-perceived pain of the procedure (p = 0.37), or physician-perceived difficulty of the procedure (p = 0.33). Similarly, there was no difference between the groups for the percentage of early (p = 0.58) or late (p = 0.71) optimal wound evaluation scores. Conclusions: In the closure of small linear pediatric facial lacerations, Octylcyanoacrylate is similar to butylcyanoacrylate in ease of use and early and late cosmetic outcomes. The superior physical properties of Octylcyanoacrylate appear to add little benefit to the management of these selected lacerations. Physician preference and differing costs may dictate use for these small selected lacerations.
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tissue adhesive versus suture wound repair at 1 year randomized clinical trial correlating early 3 month and 1 year cosmetic outcome
Annals of Emergency Medicine, 1998Co-Authors: James Quinn, Jennifer Maw, George Wells, Terri Sutcliffe, Mario Jarmuske, Ian G Stiell, Peter JohnsAbstract:Abstract Study Objective: To compare the 1-year cosmetic outcome of wounds treated with Octylcyanoacrylate tissue adhesive and monofilament sutures and to correlate the early, 3-month, and 1-year cosmetic outcomes. Methods: We prospectively randomized 136 cases of traumatic laceration to repair with Octylcyanoacrylate tissue adhesive or 5-0 or smaller monofilament suture. A wound score was assigned by a research nurse, and validated by a second nurse blinded to the treatment, at 5 to 10 days after injury (early), 3 months, and 1 year. Standardized photographs were taken at 3 months and 1 year and shown to a cosmetic surgeon blinded to the method of closure, who rated the wounds on a validated cosmesis scale. Results: We were able to examine 77 lacerations at 1 year for follow-up. No differences were found in the demographic or clinical characteristics between groups. Likewise, at 1 year no difference was found in the optimal wound scores (73% versus 68%, P =.60) or in visual analog scale cosmesis scores (69 versus 69 mm, P =.95) for Octylcyanoacrylate and sutures, respectively. Agreement was poor between early and 3-month wound scores (κ=.34; 95% confidence interval [CI], .10 to .58) but a strong association existed between 3-month and 1-year wound scores (κ=.71; 95% CI, .52 to .90). We noted a moderate correlation between 3-month and 1-year results on the visual analog cosmesis scale (intraclass correlation, .48; 95% CI, .30 to .63). Conclusion: One year after wound repair, no difference is noted in the cosmetic outcomes of traumatic lacerations treated with Octylcyanoacrylate tissue adhesive and sutures. The assessment of wounds 3 months after injury and wound repair provides a good measure of long-term cosmetic outcome. [Quinn J, Wells G, Sutcliffe T, Jarmuske M, Maw J, Stiell I, Johns P: Tissue adhesive versus suture wound repair at 1 year: Randomized clinical trial correlating early, 3-month, and 1-year cosmetic outcome. Ann Emerg Med December 1998;32:645-649.]
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a new tissue adhesive for laceration repair in children
The Journal of Pediatrics, 1998Co-Authors: Thomas B Bruns, Bryan S Robinson, Ralph J Smith, Dale L Kile, Timothy P Davis, Kevin M Sullivan, James QuinnAbstract:To determine the effectiveness of a new tissue adhesive, 2-Octylcyanoacrylate (2-OCA), for laceration repair, 83 children presenting to T.C. Thompson Children's Hospital Emergency Department with lacerations meeting eligibility requirements between February and June 1996 were randomized to receive 2-OCA or nonabsorbable sutures/staples. The length of time for repair was recorded. The length of time for laceration repair was decreased (2.9 minutes 2-OCA vs 5.8 minutes suture/staple; p < 0.001), the parents' assessment of the pain felt by their children in the 2-OCA group was less, and the wounds closed with tissue adhesive had slightly lower cosmesis scores. 2-OCA is an acceptable alternative to conventional methods of wound repair with comparable cosmetic outcome.
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prospective randomized controlled trial of tissue adhesive 2 Octylcyanoacrylate vs standard wound closure techniques for laceration repair
Academic Emergency Medicine, 1998Co-Authors: Adam J. Singer, James Quinn, Judd E Hollander, Sharon M Valentine, Theo W Turque, Charles F MccuskeyAbstract:OBJECTIVE: To compare a new tissue adhesive, 2-Octylcyanoacrylate, with standard wound closure techniques for the repair of traumatic lacerations. METHODS: A prospective, randomized, controlled clinical trial enrolled consecutive patients > 1 year of age with non-bite, non-crush-induced lacerations who presented 3 months) was assessed by physicians using a previously validated categorical cosmetic scale and by patients using a 100-mm visual analog scale. RESULTS: There were 63 patients randomized to the Octylcyanoacrylate group and 61 patients treated with standard wound closure techniques. The 2 treatment groups were similar with respect to age, gender, race, medical history, and wound characteristics. At the 5-to-10-day follow-up, only 1 wound was infected and only 2 wounds required reclosure due to dehiscence. These 3 patients received treatment with Octylcyanoacrylate. At long-term follow-up, the cosmetic appearances were similar according to the patients (Octylcyanoacrylate, 83.8 +/- 19.4 mm vs standard techniques, 82.5 +/- 17.6 mm; p = 0.72) and the physicians (optimal cosmetic appearance, 77% vs 80%; p = 0.67). CONCLUSIONS: Wounds treated with Octylcyanoacrylate and standard wound closure techniques have similar cosmetic appearances 3 months later.
Adam J. Singer - One of the best experts on this subject based on the ideXlab platform.
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Octylcyanoacrylate for the treatment of small superficial partial thickness burns a pilot study
Academic Emergency Medicine, 2005Co-Authors: Adam J. Singer, Harry S Soroff, John BrebbiaAbstract:Background: Octylcyanoacrylate (OCA) is a tissue adhesive used to close wounds and to treat minor abrasions. Objective: To explore the use of OCA in patients with superficial, partial-thickness burns. Methods: A prospective, noncomparative, pilot study was conducted in an emergency department (ED) and burn center. Consecutive patients with early (,6 hours), small (,5% total body surface area [TBSA]), superficial, partial-thickness burns were enrolled. Burns were cleaned and any nonadherent necrotic epidermis was removed. Tense blisters were aseptically aspirated. Burns were then covered with a liquid OCA that was applied with a sponge brush. Pain of cleansing and OCA application was recorded, and physicians assessed ease of application. Burns were evaluated every one to two days until complete epithelialization for the presence of infection and exudation, and the OCA was reapplied as necessary. Main outcomes measured were the need for additional topical therapy, pain and ease of application, patient comfort, and satisfaction. Results: Ten patients were enrolled. Mean patient age (6 standard deviation [SD]) was 23 (616) years, four were female, and nine were white. Burns were located on the hands (5), forearms (3), ankle (1), and back (1). Etiologies included contact (4), flame (4), and scald (2) burns. Mean (6SD) burn size was 71 (672) cm 2 . Blisters were present on admission in all patients and remained intact in five. Application of OCA was very easy in all patients; it immediately relieved pain in four patients and had no effect in three patients, while three patients complained of a brief increase in pain on OCA application. Exudation was present in four of ten patients within one to two days, all of whom had ruptured blisters at initial presentation. OCA was reapplied in two of these patients, and two patients were changed to silver sulfadiazine due to excessive exudation. The OCA was removed in one patient due to accumulation of exudate. There was no infection, and all burns were epithelialized within five to ten days. Conclusions: The results of this pilot study suggest that OCA may be useful for some, but not all, small, superficial, partial-thickness burns. Further studies may help clarify the indications and contraindications to proper usage of OCA in small, superficial burns. Key words: Octylcyanoacrylate; tissue adhesives; burns; wounds. ACADEMIC EMERGENCY MEDICINE 2005; 12:900‐904.
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A review of the literature on Octylcyanoacrylate tissue adhesive
American journal of surgery, 2004Co-Authors: Adam J. Singer, Henry C. ThodeAbstract:Abstract Background Octylcyanoacrylate is a medical grade topical tissue adhesive that has been approved for closing surgical incisions and traumatic lacerations. We reviewed animal and human studies that evaluated its use for a variety of surgical indications and specialties. We also performed a meta-analysis of all clinical trials using Octylcyanoacrylate. Data sources Animal and human studies published in peer-reviewed articles as well as published abstracts. A search of Medline was performed using the MESH terms: tissue adhesives, cyanoacrylates, and Octylcyanoacrylate. Conclusions The current review and metanalysis demonstrate that Octylcyanoacrylate can be used successfully in a wide variety of clinical and surgical settings for multiple types of wounds covering most of the surface of the human body. Prior knowledge of the limitations and technical aspects specific to wound closure with Octylcyanoacrylate as well as appropriate wound selection and preparation will help ensure optimal results.
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evaluation of a new high viscosity Octylcyanoacrylate tissue adhesive for laceration repair a randomized clinical trial
Academic Emergency Medicine, 2003Co-Authors: Adam J. Singer, Philip Giordano, Jeffrey L Fitch, Janet Gulla, Dennis Ryker, Stuart ChaleAbstract:OBJECTIVE Tissue adhesives have recently been approved for skin closure. Their low viscosity may result in inadvertent migration. The authors compared the tendency of the adhesive to migrate after laceration closure with a high- or low-viscosity Octylcyanoacrylate (OCA). METHODS This was a randomized, clinical trial set in university and community-based emergency departments. Participants included patients with simple traumatic lacerations. Patients were randomized to laceration closure with low- or high-viscosity OCA tissue adhesive. The outcome measured was immediate adhesive migration (interobserver agreement, kappa = 0.90). Data analysis was performed with proportions compared with chi-square and Fisher's exact tests. RESULTS Eighty-four patients were randomized to low- (n = 42) or high- (n = 42) viscosity OCA tissue adhesive. Groups were similar in baseline patient and wound characteristics. The high-viscosity OCA was less likely to migrate than the lower-viscosity agent (21% vs. 78%, p < 0.001; odds ratio = 0.3, 95% confidence interval = 0.1 to 0.5). The proportion of patients who noted a sensation of heat during OCA application was higher in the high-viscosity groups (44% vs. 26% respectively, p = 0.11); however, all such patients in both groups would use the device again. At 14 days, there were no wound infections in either group. There was one dehiscence in the high-viscosity group. CONCLUSIONS The high-viscosity OCA tissue adhesive was less likely to migrate than the lower-viscosity device. Wound dehiscence and infection rates were acceptably low in both treatment groups.
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a porcine epistaxis model hemostatic effects of Octylcyanoacrylate
Otolaryngology-Head and Neck Surgery, 2003Co-Authors: Adam J. Singer, Steve A. Mcclain, Arnold E KatzAbstract:OBJECTIVE: To develop a standardized porcine epistaxis model and evaluate the hemostatic effects of octyl-cyanoacrylate (OCA).STUDY DESIGN AND SETTING: Twenty-four standardized full-thickness wounds were created on the nasal septae of 7 pigs with a 4-mm surgical punch. Wounds were randomized to no treatment or topical OCA before and after full heparinization. The rate of hemostasis, time to hemostasis, and number of applicators of OCA required to achieve complete hemostasis were determined and groups were compared with t tests and X2 tests.RESULTS: Complete and sustained hemostasis was achieved in all wounds treated with OCA. The time to hemostasis was significantly shorter in the wounds treated with OCA vs those left to clot on their own (mean difference, 150 seconds; 95% CI, 92 to 209 seconds, P<0.001). None of the wounds required more than 3 applications of OCA.CONCLUSIONS: We describe a simple and reproducible animal epistaxis model and demonstrate that OCA is effective in achieving hemostasis in this...
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Evaluation of a new liquid occlusive dressing for excisional wounds
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 2003Co-Authors: Adam J. Singer, Maria Nable, Paul Cameau, Daniel D. Singer, Steve A. McclainAbstract:We evaluated a novel Octylcyanoacrylate-based liquid occlusive dressing for partial-thickness wounds. One hundred and fifteen standardized wounds were created with an electric dermatome set at a depth of 600 micro on the flanks of three pigs and randomly treated with liquid occlusive dressing, a hydrocolloid dressing, or gauze. In one pig, wounds were swabbed with Staphylococcus aureus. Biopsies were taken after 4, 5, 6, and 21 days. Hemostasis was obtained in all wounds treated with the liquid occlusive. The percent reepithelialization of wounds treated with the liquid occlusive and hydrocolloid dressings were significantly greater at days 4 and 5 than control wounds (78% and 82% vs. 40%, p < 0.001 and 99% and 100% vs. 72%, p < 0.001, respectively). None of the liquid occlusive-treated wounds challenged with bacteria became infected. Foreign body reactions were least common in wounds treated with the liquid occlusive (p < 0.001). Scar depth was less for liquid occlusive- and hydrocolloid-treated wounds than controls (285 micro and 303 micro vs. 490 micro, p < 0.001). We conclude that excisional wounds treated with the liquid occlusive dressing reepithelialize as quickly as hydrocolloid-treated wounds. The liquid occlusive dressing is an effective microbial barrier and hemostatic agent resulting in fewer foreign body reactions than hydrocolloid-treated wounds or controls.
Steve A. Mcclain - One of the best experts on this subject based on the ideXlab platform.
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a porcine epistaxis model hemostatic effects of Octylcyanoacrylate
Otolaryngology-Head and Neck Surgery, 2003Co-Authors: Adam J. Singer, Steve A. Mcclain, Arnold E KatzAbstract:OBJECTIVE: To develop a standardized porcine epistaxis model and evaluate the hemostatic effects of octyl-cyanoacrylate (OCA).STUDY DESIGN AND SETTING: Twenty-four standardized full-thickness wounds were created on the nasal septae of 7 pigs with a 4-mm surgical punch. Wounds were randomized to no treatment or topical OCA before and after full heparinization. The rate of hemostasis, time to hemostasis, and number of applicators of OCA required to achieve complete hemostasis were determined and groups were compared with t tests and X2 tests.RESULTS: Complete and sustained hemostasis was achieved in all wounds treated with OCA. The time to hemostasis was significantly shorter in the wounds treated with OCA vs those left to clot on their own (mean difference, 150 seconds; 95% CI, 92 to 209 seconds, P<0.001). None of the wounds required more than 3 applications of OCA.CONCLUSIONS: We describe a simple and reproducible animal epistaxis model and demonstrate that OCA is effective in achieving hemostasis in this...
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Evaluation of a new liquid occlusive dressing for excisional wounds
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 2003Co-Authors: Adam J. Singer, Maria Nable, Paul Cameau, Daniel D. Singer, Steve A. McclainAbstract:We evaluated a novel Octylcyanoacrylate-based liquid occlusive dressing for partial-thickness wounds. One hundred and fifteen standardized wounds were created with an electric dermatome set at a depth of 600 micro on the flanks of three pigs and randomly treated with liquid occlusive dressing, a hydrocolloid dressing, or gauze. In one pig, wounds were swabbed with Staphylococcus aureus. Biopsies were taken after 4, 5, 6, and 21 days. Hemostasis was obtained in all wounds treated with the liquid occlusive. The percent reepithelialization of wounds treated with the liquid occlusive and hydrocolloid dressings were significantly greater at days 4 and 5 than control wounds (78% and 82% vs. 40%, p < 0.001 and 99% and 100% vs. 72%, p < 0.001, respectively). None of the liquid occlusive-treated wounds challenged with bacteria became infected. Foreign body reactions were least common in wounds treated with the liquid occlusive (p < 0.001). Scar depth was less for liquid occlusive- and hydrocolloid-treated wounds than controls (285 micro and 303 micro vs. 490 micro, p < 0.001). We conclude that excisional wounds treated with the liquid occlusive dressing reepithelialize as quickly as hydrocolloid-treated wounds. The liquid occlusive dressing is an effective microbial barrier and hemostatic agent resulting in fewer foreign body reactions than hydrocolloid-treated wounds or controls.
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the effects of Octylcyanoacrylate on scarring after burns
Academic Emergency Medicine, 2001Co-Authors: Adam J. Singer, Henry C. Thode, Steve A. McclainAbstract:OBJECTIVE To compare the effects of Octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane film (PU), and dry gauze (G) on scarring three months after partial-thickness burns. METHODS This was a prospective, blinded, controlled experimental trial using isoflurane-anesthetized swine. Standardized partial-thickness burns were inflicted by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of a young pig for 20 seconds. Four equal sets of ten burns each were randomly treated with OCA spray, SSD, PU, or G. Dressing changes were performed on days 1, 2, 3, and 4 after injury. Digital images of the burns were obtained immediately and three months later for masked computerized determination of scar surface area. Full-thickness biopsies were taken at three months for masked histopathological evaluation. The primary outcome was the percent reduction in residual wound area (RWA) calculated by subtracting the area of each individual burn from the area of the largest burn and dividing this value by the area of the largest burn (intraobserver correlation, r = 0.99). Secondary outcomes were the proportion of burns with the presence of scar tissue (abnormal collagen under polarized light; intraobserver agreement, kappa = 0.93) and the cosmetic appearance on a 100-mm visual analog scale marked "best scar" at the high end (inter-observer correlation, r = 0.82). Analysis of variance (ANOVA) and chi(2) tests were used for group comparisons as appropriate. This study had 80% power to detect a 33-percentage-point difference in RWA among groups (alpha = 0.05). RESULTS A total of 40 burns were inflicted on the pig. There was no difference in percent RWA across the groups (OCA = 25%, SSD = 40%, PU = 25%, G = 32%; p = 0.13). There was no difference in the proportion of wounds with scarring among the groups (OCA = 10%, SSD = 22%, PU = 2%, G = 30%; p = 0.89). There was also no difference in the cosmetic scores among the groups (OCA = 78 mm, SSD = 75 mm, PU = 74 mm, G = 74 mm; p = 0.96). CONCLUSIONS The effects of OCA spray, SSD, PU, and dry gauze on scarring three months after burns in pigs are similar.
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Octylcyanoacrylate versus polyurethane for treatment of burns in swine a randomized trial
Burns, 2000Co-Authors: Adam J. Singer, Henry C. Thode, Mazhar Mohammad, Steve A. McclainAbstract:Abstract In order to determine whether the enhanced reepithelialization of second-degree burns treated with Octylcyanoacrylate (OCA) was due to its occlusive nature we compared reepithelialization (REP) and infection rates of second degree burns treated with OCA and polyurethane film (Tegaderm) in swine. Forty-four standardized partial thickness burns were created by applying an aluminum bar preheated to 80°C to the backs of pigs for 20 s and randomly treated with OCA or Tegaderm. Full thickness biopsies were taken at 7, 10 and 14 days for blinded histopathological evaluation of rates of infection and reepithelialization. T -tests and χ 2 tests were used for group comparisons. There were no between group difference in the rates of reepithelialization and infection. All wounds were reepithelialized by day 14 and there were no infections in either group. We conclude that treatment of partial thickness burns with OCA spray or Tegaderm results in similar rates of reepithelialization and infection, suggesting that the beneficial effects of OCA on reepithelialization are due to its occlusive nature.
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Octylcyanoacrylate for the treatment of contaminated partial thickness burns in swine a randomized controlled experiment
Academic Emergency Medicine, 2000Co-Authors: Adam J. Singer, Henry C. Thode, Mazhar Mohammad, G T Tortora, Steve A. McclainAbstract:Objective: To compare infection and reepithelialization rates of contaminated second-degree burns treated with Octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane (PU) film, and dry gauze (control; C) in swine. Methods: Eighty standardized burns were created by applying an aluminum bar preheated to 80°C to the backs and flanks of young pigs for 20 seconds. All burns were immediately contaminated with 0.1 mL of Staphylococcus aureus 105/mL and randomly treated with OCA spray, SSD, PU, or dry gauze (C). Full-thickness biopsies were taken at 3, 7, and 14 days for blinded histopathologic evaluation using hematoxylin and eosin (HE p = 0.40 (Kruskal-Wallis test). At day 7, infection rates were 35% (OCA), 85% (SSD), 70% (PU), and 65% (C); p = 0.01. Median bacterial counts at day 3 were 6,500 (OCA), 20,000 (SSD), 1,000,000 (PU), and 650,000 (C); p = 0.29. The proportion of completely reepithelialized wounds at day 14 were 75% (OCA), 90% (SSD), 85% (PU), and 90% (C); p = 0.50. Conclusions: Treatment of contaminated partial-thickness burns with OCA spray resulted in fewer infections at one week than with the other three treatments.
Henry C. Thode - One of the best experts on this subject based on the ideXlab platform.
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A review of the literature on Octylcyanoacrylate tissue adhesive
American journal of surgery, 2004Co-Authors: Adam J. Singer, Henry C. ThodeAbstract:Abstract Background Octylcyanoacrylate is a medical grade topical tissue adhesive that has been approved for closing surgical incisions and traumatic lacerations. We reviewed animal and human studies that evaluated its use for a variety of surgical indications and specialties. We also performed a meta-analysis of all clinical trials using Octylcyanoacrylate. Data sources Animal and human studies published in peer-reviewed articles as well as published abstracts. A search of Medline was performed using the MESH terms: tissue adhesives, cyanoacrylates, and Octylcyanoacrylate. Conclusions The current review and metanalysis demonstrate that Octylcyanoacrylate can be used successfully in a wide variety of clinical and surgical settings for multiple types of wounds covering most of the surface of the human body. Prior knowledge of the limitations and technical aspects specific to wound closure with Octylcyanoacrylate as well as appropriate wound selection and preparation will help ensure optimal results.
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the effects of Octylcyanoacrylate on scarring after burns
Academic Emergency Medicine, 2001Co-Authors: Adam J. Singer, Henry C. Thode, Steve A. McclainAbstract:OBJECTIVE To compare the effects of Octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane film (PU), and dry gauze (G) on scarring three months after partial-thickness burns. METHODS This was a prospective, blinded, controlled experimental trial using isoflurane-anesthetized swine. Standardized partial-thickness burns were inflicted by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of a young pig for 20 seconds. Four equal sets of ten burns each were randomly treated with OCA spray, SSD, PU, or G. Dressing changes were performed on days 1, 2, 3, and 4 after injury. Digital images of the burns were obtained immediately and three months later for masked computerized determination of scar surface area. Full-thickness biopsies were taken at three months for masked histopathological evaluation. The primary outcome was the percent reduction in residual wound area (RWA) calculated by subtracting the area of each individual burn from the area of the largest burn and dividing this value by the area of the largest burn (intraobserver correlation, r = 0.99). Secondary outcomes were the proportion of burns with the presence of scar tissue (abnormal collagen under polarized light; intraobserver agreement, kappa = 0.93) and the cosmetic appearance on a 100-mm visual analog scale marked "best scar" at the high end (inter-observer correlation, r = 0.82). Analysis of variance (ANOVA) and chi(2) tests were used for group comparisons as appropriate. This study had 80% power to detect a 33-percentage-point difference in RWA among groups (alpha = 0.05). RESULTS A total of 40 burns were inflicted on the pig. There was no difference in percent RWA across the groups (OCA = 25%, SSD = 40%, PU = 25%, G = 32%; p = 0.13). There was no difference in the proportion of wounds with scarring among the groups (OCA = 10%, SSD = 22%, PU = 2%, G = 30%; p = 0.89). There was also no difference in the cosmetic scores among the groups (OCA = 78 mm, SSD = 75 mm, PU = 74 mm, G = 74 mm; p = 0.96). CONCLUSIONS The effects of OCA spray, SSD, PU, and dry gauze on scarring three months after burns in pigs are similar.
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Octylcyanoacrylate versus polyurethane for treatment of burns in swine a randomized trial
Burns, 2000Co-Authors: Adam J. Singer, Henry C. Thode, Mazhar Mohammad, Steve A. McclainAbstract:Abstract In order to determine whether the enhanced reepithelialization of second-degree burns treated with Octylcyanoacrylate (OCA) was due to its occlusive nature we compared reepithelialization (REP) and infection rates of second degree burns treated with OCA and polyurethane film (Tegaderm) in swine. Forty-four standardized partial thickness burns were created by applying an aluminum bar preheated to 80°C to the backs of pigs for 20 s and randomly treated with OCA or Tegaderm. Full thickness biopsies were taken at 7, 10 and 14 days for blinded histopathological evaluation of rates of infection and reepithelialization. T -tests and χ 2 tests were used for group comparisons. There were no between group difference in the rates of reepithelialization and infection. All wounds were reepithelialized by day 14 and there were no infections in either group. We conclude that treatment of partial thickness burns with OCA spray or Tegaderm results in similar rates of reepithelialization and infection, suggesting that the beneficial effects of OCA on reepithelialization are due to its occlusive nature.
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Octylcyanoacrylate for the treatment of contaminated partial thickness burns in swine a randomized controlled experiment
Academic Emergency Medicine, 2000Co-Authors: Adam J. Singer, Henry C. Thode, Mazhar Mohammad, G T Tortora, Steve A. McclainAbstract:Objective: To compare infection and reepithelialization rates of contaminated second-degree burns treated with Octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane (PU) film, and dry gauze (control; C) in swine. Methods: Eighty standardized burns were created by applying an aluminum bar preheated to 80°C to the backs and flanks of young pigs for 20 seconds. All burns were immediately contaminated with 0.1 mL of Staphylococcus aureus 105/mL and randomly treated with OCA spray, SSD, PU, or dry gauze (C). Full-thickness biopsies were taken at 3, 7, and 14 days for blinded histopathologic evaluation using hematoxylin and eosin (HE p = 0.40 (Kruskal-Wallis test). At day 7, infection rates were 35% (OCA), 85% (SSD), 70% (PU), and 65% (C); p = 0.01. Median bacterial counts at day 3 were 6,500 (OCA), 20,000 (SSD), 1,000,000 (PU), and 650,000 (C); p = 0.29. The proportion of completely reepithelialized wounds at day 14 were 75% (OCA), 90% (SSD), 85% (PU), and 90% (C); p = 0.50. Conclusions: Treatment of contaminated partial-thickness burns with OCA spray resulted in fewer infections at one week than with the other three treatments.
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Octylcyanoacrylate for the treatment of partial thickness burns in swine a randomized controlled experiment
Academic Emergency Medicine, 1999Co-Authors: Adam J. Singer, Henry C. Thode, Luis Berrutti, Steve A. McclainAbstract:Objective To compare re-epithelialization rates of superficial partial-thickness burns treated with Octylcyanoacrylate (OCA), silver sulfadiazine (SSD), and dry gauze (controls) in swine. Methods This was a prospective, longitudinal, blinded, controlled, experimental trial using anesthetized swine. Sixty-three standardized burns were created by applying an aluminum bar preheated to 80 degrees C for 20 seconds to the flanks of four young pigs. Three equal sets of 21 burns were randomly treated with OCA spray, SSD, or dry gauze (controls). Full-thickness biopsies were taken after 30 minutes and at seven and 14 days for blinded histopathologic evaluation by two dermatopathologists using hematoxylin and eosin staining. The percent of wound re-epithelialization was measured at days 7 and 14, calculated by dividing the length of the regenerated epidermis by the measured width of the biopsy. Analysis of variance (ANOVA) and repeated-measures ANOVA controlling for the individual pig were used for comparisons among groups. This study had 80% power to demonstrate a large between-group difference in percent re-epithelization (alpha = 0.05). Results There were 63 burns and 126 biopsies. Ten biopsies were excluded for technical reasons. At seven days, there was a significant between-group difference in percent re-epithelialization. Percent re-epithelialization was greatest in the OCA group (65.0%), followed by the SSD group (37.6%), and lowest in the control group (8.8%). At 14 days, all wounds demonstrated near complete re-epithelialization and there was no significant difference in the percent of re-epithelialization among the groups. There was only one wound infection in the OCA group. Conclusions Under these study conditions, treatment of partial-thickness burns with OCA spray resulted in a higher percent of re-epithelialization at seven but not 14 days when compared with both SSD and control, with no significant increase in infection rates. Future studies should evaluate the use of OCA for the treatment of burns in humans.
Judd E Hollander - One of the best experts on this subject based on the ideXlab platform.
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closure of lacerations and incisions with Octylcyanoacrylate a multicenter randomized controlled trial
Surgery, 2002Co-Authors: Adam J. Singer, James Quinn, Robert E Clark, Judd E HollanderAbstract:Abstract Background. Most lacerations and surgical incisions are closed with sutures or staples. Octylcyanoacrylate tissue adhesive (OCA) was recently approved for use in the United States. We compared the cosmetic appearance of lacerations and incisions repaired with OCA versus standard wound closure methods (SWC). Methods. A multicenter randomized clinical trial including patients with simple lacerations or surgical incisions was conducted at 10 clinical sites. Patients were randomly assigned to treatment with OCA or SWC. Follow-up was performed at 1 week and at 3 months to determine infection rates and cosmetic outcome. Results. Eight hundred fourteen patients with 924 wounds (383 traumatic lacerations, 235 excisions of skin lesions or scar revisions, 208 minimally invasive surgeries, and 98 general surgical procedures) were enrolled. Groups were similar in baseline characteristics. Wound closure with OCA was faster than with SWC (2.9 vs 5.2 minutes, P
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prospective randomized controlled trial of tissue adhesive 2 Octylcyanoacrylate vs standard wound closure techniques for laceration repair
Academic Emergency Medicine, 1998Co-Authors: Adam J. Singer, James Quinn, Judd E Hollander, Sharon M Valentine, Theo W Turque, Charles F MccuskeyAbstract:OBJECTIVE: To compare a new tissue adhesive, 2-Octylcyanoacrylate, with standard wound closure techniques for the repair of traumatic lacerations. METHODS: A prospective, randomized, controlled clinical trial enrolled consecutive patients > 1 year of age with non-bite, non-crush-induced lacerations who presented 3 months) was assessed by physicians using a previously validated categorical cosmetic scale and by patients using a 100-mm visual analog scale. RESULTS: There were 63 patients randomized to the Octylcyanoacrylate group and 61 patients treated with standard wound closure techniques. The 2 treatment groups were similar with respect to age, gender, race, medical history, and wound characteristics. At the 5-to-10-day follow-up, only 1 wound was infected and only 2 wounds required reclosure due to dehiscence. These 3 patients received treatment with Octylcyanoacrylate. At long-term follow-up, the cosmetic appearances were similar according to the patients (Octylcyanoacrylate, 83.8 +/- 19.4 mm vs standard techniques, 82.5 +/- 17.6 mm; p = 0.72) and the physicians (optimal cosmetic appearance, 77% vs 80%; p = 0.67). CONCLUSIONS: Wounds treated with Octylcyanoacrylate and standard wound closure techniques have similar cosmetic appearances 3 months later.
