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 EPIGLU® 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 EPIGLU®?
Yes, because EPIGLU® 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 EPIGLU® if they do not bleed any more, are not infected and not older than 6 hours. EPIGLU® 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). EPIGLU® can also be applied onto the oral mucosa and the external genitalia. Bites and abrasions should not be treated with adhesives.
Why should EPIGLU® 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 EPIGLU® 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, EPIGLU® can be peeled off.
Does EPIGLU® has to be removed after the wound healing is completed?
No, with the formation of new skin lamellae (after 5 to 10 days) EPIGLU® 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 EPIGLU® be used additionally for already sutured wounds?
If a wound had been treated with sutures already it is possible to apply EPIGLU® additionally.This will help to stabilize the wound and to protect it against infections.
Why does patients feel better after a wound treatment with EPIGLU®?
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 EPIGLU®?
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 EPIGLU® has to be stored?
The longest shelf life of EPIGLU® can be achieved if EPIGLU® is stored in a deep freezer. As EPIGLU® 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 EPIGLU® 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 EPIGLU®?
If stored in a deep freezer EPIGLU® has a shelf life of 36 months. If stored in a refrigerator or at room temperature the shelf life decreases. Discontinue use of EPIGLU® 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 EPIGLU® 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 EPIGLU® are polymerizing faster than other acrylates in general.