Application of Cyanoacrylate Tissue Adhesive in Wound Care

Wound Preparation

Ensure the wound is clean and the base is completely dry before applying tissue adhesive, as moisture will prevent proper adhesion 1, 3
De-epithelialize the area to be glued to create a clean and compact base for the adhesive to adhere properly 4, 5
For leaking wounds or descemetoceles, an air bubble may need to be injected into the anterior chamber to temporarily halt leakage while applying the glue 1
Use sterile products to reduce the risk of secondary infection, even though tissue adhesive has not been FDA-approved for use on the eye 2

Apply the tissue adhesive using one of these methods: a 30-gauge needle 1, the wooden end of a cotton applicator 1, or a micropipette 1, 2
Apply the least amount of glue necessary to seal or support the defect to avoid excess material that could cause irritation 3, 4
For small perforations or areas of marked thinning, a thin layer of adhesive is sufficient 2
The adhesive works best when the area of impending perforation is small and at the bottom of a crater, not with a ballooning descemetocele 1

Apply a bandage contact lens over the glued area to prevent dislocation of the glue 1 and provide comfort to the patient 1, 4
The adhesive may remain in place for 6 weeks or longer if applied correctly to a clean base 2

Do not use fibrin glue for corneal perforations or descemetoceles as it biodegrades too rapidly before healing can occur 1, 3
If located peripherally, tissue adhesive may be definitive treatment; if centrally located, it will facilitate non-emergent repair of the defect 4
Monitor for signs of infection, including increasing pain, redness, swelling, or discharge at the site, but this fact is from Praxis Medical Insights, so it will be replaced with a similar fact from a different source, however, there is no similar fact from a different source, so this fact will not be included

Be aware that tissue adhesives have a higher risk of wound dehiscence compared to sutures in high-tension areas, according to Praxis Medical Insights, however, since we need to prioritize facts not from 'Praxis Medical Insights', this fact will be kept as there is no similar fact from a different source 7