1. DERMABOND® Topical Skin Adhesive
The Final Layer of Protection

2. DERMABOND® Adhesive is equivalent to other commercially available skin closure devices, studied effectively from small to long incisions up to 69cm.
DERMABOND
PLUS SUTURES
SUTURE
STAPLES
STRIPS
Closure Strength
Equivalent to 4.0
Variety
Strongest
Weak
Microbial barrier
Yes
Zone of inhibition No
Cosmesis
Excellent
May leave track marks
Inconsistent
Patient Comfort - showering
Can Shower Immediately
Not recommended for period of time
Not recommended
For period of time
Ease of Care
Simple
Complicated
Enduit to bacterial colonization
Removal
Sloughs off naturally
May need removal
Needs removal
Self removal

3. What is DERMABOND Topical Skin Adhesive?
Cyanoacrylates were developed in 1949
1970s - n-butyl-2-cyanoacrylate
Octyl-Cyanoacrylate (DERMABOND)
1st FDA approved Topical Skin Adhesive
Today – over 5 million patients a year are treated with DERMABOND Adhesive
DERMABOND Adhesive is a unique technology
2 Octyl cyanoacrylate has the longest carbon side chain for increased flexibility and, increased breaking strength versus butyl cyanoacrylate1
In vivo and In vitro studies demonstrate a proven microbial barrier against bacteria which may cause infection.
24 months shelf life, stores at room temperature
a violet, non tattooing dye for easy observation
Skin adhesives
Cyanoacrylates were first manufactured in The first adhesives were noted to have extreme inflammatory effects on tissues.
n-butyl-2-cyanoacrylate, which was developed in the 1970s, was the first adhesive to have negligible tissue toxicity and good bonding strength, as well as acceptable wound cosmesis.
DERMABOND Adhesive (2-Octyl-Cyanoacrylate), the latest in cyanoacrylate technology, has less toxicity and almost four times the strength of n-butyl-2-cyanoacrylate.
1. Quinn, JV Tissue Adhesives in Wound Care, BC Decker Attached are chapters from the book.
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4. Mechanism of action is a combination of monomer and plasticizers, that polymerizes to form a flexible/pliable adhesive film
Sets or cures within seconds following final layer
Reaches full mechanical strength in 1 min
If needed, can be wiped from skin within 10 seconds after application or with a petroleum based product after setting
Adhesive film sloughs or falls off wound within 7-10 days as skin re-epithelialize
Equivalent to 7 days wound healing strength in 3 minutes1
OCA: microns thick compared to other N- Butyls at : <50 microns thick
1. Singer and Hollander, Lacerations in Acute Wounds: An evidence-based guide, p DERMABOND adhesive package insert 3

5. DERMBOND Adhesive has proven strength over n-butyls and n-butyl blends due to it’s unique formulation. This strength is critical for topical wound closure and microbial barrier.
Wound Bursting Strength
Compliance Analysis

6. In vivo studies demonstrated DERMABOND Adhesive microbial barrier provides greater protection than sutures alone as well as n-butyls/ n-butyl blend adhesives.

7. DERMABOND® Adhesive has unique benefits that offer the potential to impact the cost of care.
*Health and Economic Outcomes after OB-GYN Surgery: A Comparison of Skin Closure Techniques
Susan G. Murrmann, MD1, Jeffrey S. Markowitz, DrPH2, Elane M. Gutterman, PhD2, Glenn Magee, MBA3
1 University of Tennessee, Department of Obstetrics & Gynecology, Memphis, TN 2 Health Data Analytics, Princeton Junction, NJ 3 Ethicon Inc., Somerville, NJ
Sutures
Staples
OCA
Sutures, Staples & OCA
Overall P Value
Significant pairwise comparisons1
Overall P-Value
Significant pairwise comparisons2
Hysterectomy Cohort
N= 21,201
N=23,441
N=880
N=489
Percent
Unadjusted Analysis
Adjusted Analysis 2
Infection as reflected by non-prophylactic antibiotic treatment
12.93%
17.51%
11.14%
23.72%
<0.0001
1a,3a,4a,5a,6a
1a,3a,5a,6a
Unadjusted Means
Total costs (dollars)
$5862
$6965
$5816
$9434
C-Section Cohort
N=102,797
N=50,097
N=2,391
N=272
12.83%
12.76%
9.50%
13.97%
2a,4a
$5572
$5594
$5010
$5949
2a,4a,6a
1a,2a,4a,6a
*Poster Presentation at 2008 Annual Clinical Meeting of The American College of Obstetricians and Gynecologists, New Orleans, LA, May 3-7, 2008

8. Physician, Hospital -centered Benefits
DERMABOND Adhesive for final skin closure provides benefits for surgeons, nurses, patients, and hospitals.
Physician, Hospital -centered Benefits
Proven microbial barrier for lasting protection
7 days of wound healing strength in 1 minutes for strong closure and peace of mind
No time spent removing staples or sutures
Reduces needle stick exposure
Increases patient satisfaction
Reduced Hospitalization Costs
Nurse, Patient -centered Benefits
Reduces number of suture set ups
Ease of Post Op wound checks
Reduces number of wound dressings
Shower immediately
Excellent Cosmesis
“Real World” benefits for use of DERMABOND Adhesive
Physician:
time savings in many situations
Reduce needle stick exposure
No followup needed to remove sutures
more reassurance
Increased patient satisfaction
more difficult patients (geri, pedi, bedbound)
building practice, marketing
Scott GR, Carson, CL, Borah, GL, DERMABOND skin closures for bilaterial reduction mammoplasties:
a review of 255 consecutive cases. Plast Reconst Surg.2007;120:
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9. Things to consider for successful outcomes
Standard wound management
Remove surgical prep solution
Ensure hemostasis
Precise application technique
Thin layers
Dry before bandage
No petroleum-based products over DERMABOND Adhesive
Post surgical ChloraPrep wipe downs ok as long as DERMABOND Adhesive has dried and the area is not vigorously scrubbed
Wound management
Relieve tension first!
Blot all blood
Well defined edges
Application Technique
Apply in a straight line
Consistent, linear bead of flow
2 or 3 THIN layers depending on product
Keep dome of applicator above surface, allowing meniscus of fluid to contact skin
Do not apply any petroleum based product over DERMABOND Adhesive® adhesive
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