A comparative study of the surgically relevant mechanical characteristics of the topical skin adhesives

Objectives Topical skin adhesives (TSAs) offer a noninvasive alternative to sutures. The growing trend is to use them in addition to sutures and staples to add strength and provide a microbial barrier. The authors compared the mechanical characteristics of recently approved TSAs that are most likely to be of surgical relevance in the emergency department. Methods Linear incisions were made on anesthetized swine and the wounds were approximated with one of six commercially available TSAs. Three-dimensional bursting strength was measured with a BTC-2000TM device. Tensile failure force was measured ex vivo using TSA-approximated porcine skin strips with a tensionometer. Resistance to cyclic loading was measured by subjecting approximated skin strips to repetitive cycles of rotational torque and linear tension. Viscosity was measured with a viscometer and setting times were measured by periodically dabbing the adhesive applied to skin strips with a cotton swab to determine whether it was dry. Results Dermabond Advanced TSA provided significantly (p < 0.00001) greater acute in vivo wound bursting strength and ex vivo tensile force, greater mean number of normal tensile loading cycles to failure (while under continuous torsional cycling), and longest time to failure, and the mean setting time was the shortest. Conclusions Of all the TSAs tested in this study, Dermabond Advanced was the strongest and most flexible, set in the shortest time, and was a fairly viscous adhesive, all of which are clinically desirable characteristics.