Objective-To assess the strength of the glue and microbial contamination over 28 days from opening a vial of tissue adhesive in the accident and emergency setting, and to quantify cost savings of repeated use of the vials. Method-(1) Strips of reinforced nylon and a specially constructed piece of apparatus designed to measure the force at which the glue gave way were used to measure the strength of the tissue adhesive at various times after the glue was opened to assess if the glue strength deteriorated over time. (2) Microbial contamination of the glue was assessed. Results-There was no deterioration in the glue strength over time. There was no evidence of microbial contamination of the glue. Conclusion-Cyanoacrylate tissue adhesive can safely be reused for a period of 28 days after opening with no risk of degradation of glue strength or contamination with micro-organisms. In our department this represents a potential saving of £5400 per year. (J Accid Emerg Med 2000;17:341-343) Keywords: biological tissue adhesive Tissue adhesives have many advantages over other methods of minor wound closure including ease and speed of application, 1 relatively painless application and dressings are not required.2 3 They are used frequently and successfully in many accident and emergency (A&E) departments.The tissue adhesive used in our department is Indermil. This is presented in a 5 g vial. The manufacturers recommend this for single use only. We estimated that the amount of glue used on a 2 cm wound was less than 0.05 g and hence the 5 g vial would suYce for up to 100 such wounds. We therefore sought to determine the feasibility of the repeated use of a vial of tissue adhesive in regard to its strength and contamination by micro-organisms. MethodsThe glue we tested was Indermil taken from a 5 g vial.Initially a simple calibration test was performed to test the consistency of the apparatus, using 18 similar sized strips of A4 oYce quality paper. The strips of paper were placed into the testing apparatus in the same way as the nylon strips and then force was applied. The range of forces at which the paper ripped was 83.4 to 107.9 Newtons (mean 95.8; standard deviation 6.3). The coeYcient of variation for the calibration experiment was 6.6%, indicating that the test apparatus was consistent and reliable.A pilot study was then carried out using 30 strips of reinforced nylon. The forces at which the glue gave way ranged from 11.6 to 86.0 Newtons (mean 46.2; standard deviation 20.2) with a coeYcient of variation of 43.8%. Comparison of this value with that obtained from the calibration experiment indicates that the variation in the performance of the glue was considerably greater than the variation in the performance of the apparatus. STRENGTH ASSESSMENTThe model used to assess glue strength was reinforced nylon. Although this is not what the glue is designed for, it was suitable for our experiment because the material was such that it did not tear in the force gauge before the glue bond gave way-that is, material str...
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