Evaluation of a Cyanoacrylate Dressing to Treat Skin Tears in the Acute Care Population

Clinical Problem:  Skin tear incidence rate in the elderly range from .9 to 2.5 per person/year¹, though reported rates are primarily derived from the long-term care (LTC) population. Except for one², the settings in which these methods were employed were reported as non-acute care. The literature reports only one acute care incidence range of 14-24%.² Optimal methods to treat skin tears varies in the literature.^{2, 3} Specifically, cyanoacrylate dressings have been used successfully in LTC ⁴ but its utility has not yet been examined in acute care.

 Methods:  Using a convenience sample, topical cyanoacrylate* dressing was applied to twenty patients with Payne-Martin Category I- II skin tears on an extremity on one Medical-Surgical unit. Patients were assessed daily for wound pain, total number of cyanoacrylate dressing applications, and wound complications. Nurse satisfaction with this method of treatment was also examined. Cost comparison with the usual method of treating skin tears on this unit (normal saline irrigation followed by impregnated petrolatum gauze** followed by non-adherent gauze pad and rolled gauze to secure the primary dressing to the extremity daily) was additionally performed.

Results: Average length of stay on this Medical-surgical unit was 4.5 days. The skin tear incidence rate was 9.9%. Cyanoacrylate dressings required one-time application for the majority of patients. The application of the cyanoacrylate dressing required significantly less dressing costs and usage time, positively impacting labor and resource utilization. Nurse satisfaction with cyanoacrylate was high. There were no wound complications and wound pain was minimal.

Conclusion: The use of cyanoacrylate dressings is a viable option to treat Payne-Martin I-III skin tears in an acute care setting.  Further study is warranted.

*Marathon Liquid Skin Protectant, Medline Industries, Mundelein, IL **XEROFORM™ Petrolatum Gauze, Covidien, Mansfield, MA