Dr Charles Meares1, Dr Aruna Wejiwardena1
1Royal North Shore Hospital, Sydney, Australia
Cyanoacrylates, more commonly known as Histoacryl™ and Dermabond™, have many applications in the setting of cutaneous repair and reconstruction. Today, cyanocrylates are widely used as fixation for skin grafts in the surgical management of burns. Cyanocrylates have been shown to be more reliable for graft success and less painful for burns patients (Samal et al. 2019). This poster will review the literature and history of its application in burns management.
Developed in 1949, cyanoacrylates were first documented for wound closure in 1959. This first generation of skin adhesives consisted of short-chain structures with breakdown products that had toxic tissue effects causing inflammatory reactions. Longer-chain derivatives were later synthesised which lacked this toxic risk profile (Singer et al. 2008). N-butyl-2-cyanoacrylate (Histacryl™), developed in 1978, was the first adhesive to have negligible tissue toxicity and good bonding strength, as well as acceptable wound cosmesis.
The first reported use of cyanoacrylate for skin graft fixation was in the Burns Unit at Birmingham, UK in 1976 by Prof Alan Roberts (Roberts 1976). It later came to prominence in its application in the large number of burns patients following the infamous Bradford fire in 1985 (Roberts 1988). Cyanoacrylates continue to be used for rapid, painless and efficient fixation of skin grafts in the setting of burns management.
Samal CC, Dash S, Agrawal K, Tandon R. Comparative evaluation of three methods of skin graft fixation for split thickness skin graft after release of post burn contracture of the neck. Burns. 2019 May;45(3):691-698.
Singer AJ, Quinn JV, Hollander JE. The cyanoacrylate topical skin adhesives. Am J Emerg Med. 2008 May;26(4):490-6.
Roberts AHN. A useful method of fixing split-skin grafts. Burns. 1976 October;3(1):20-23.
Roberts AC. The Development of Facial Prosthetics and Adhesives in Plastic and Reconstructive Surgery. University of Bradford PhD Thesis 1988, Bradford.
Charlie is a PRS Trainee currently at Royal North Shore Hospital