Octylcyanoacrylate for the Treatment of Partial‐thickness Burns in Swine: A Randomized, Controlled Experiment

Abstract

Abstract. Objective: To compare re-epithelialization rates of superficial partial-thickness burns treated with octylcyanoacrylate (OCA), silver sulfadiazine (SSD), and dry gauze (controls) in swine. Methods: This was a prospective, longitudinal, blinded, controlled, experimental trial using anesthetized swine. Sixty-three standardized burns were created by applying an aluminum bar preheated to 80 o C for 20 seconds to the flanks of four young pigs. Three equal sets of 21 burns were randomly treated with OCA spray, SSD, or dry gauze (controls). Full-thickness biopsies were taken after 30 minutes and at seven and 14 days for blinded histopathologic evaluation by two dermatopathologists using hematoxylin and eosin staining. The percent of wound re-epithelialization was measured at days 7 and 14, calculated by dividing the length of the regenerated epidermis by the measured width of the biopsy. Analysis of variance (ANOVA) and repeated-measures ANOVA controlling for the individual pig were used for comparisons among groups. This study had 80% power to demonstrate a large between-group difference in percent re-epithelization (alpha = 0.05). Results: There were 63 burns and 126 biopsies. Ten biopsies were excluded for technical reasons. At seven days, there was a significant between-group difference in percent re-epithelialization. Percent re-epithelialization was greatest in the OCA group (65.0%), followed by the SSD group (37.6%), and lowest in the control group (8.8%). At 14 days, all wounds demonstrated near complete re-epithelialization and there was no significant difference in the percent of re-epithelialization among the groups. There was only one wound infection in the OCA group. Conclusions: Under these study conditions, treatment of partial-thickness burns with OCA spray resulted in a higher percent of re-epithelialization at seven but not 14 days when compared with both SSD and control, with no significant increase in infection rates. Future studies should evaluate the use of OCA for the treatment of burns in humans.

The Effects of Octylcyanoacrylate on Scarring after Burns

“…Prior studies regarding the role of OCA for the treatment of thermal injuries suggest that partialthickness burns treated with OCA do as well as those treated with standard treatments such as SSD or PU. 12,25 For example, a study comparing the rates of infection and reepithelialization of noncontaminated burns in swine found more rapid reepithelialization in burns treated with OCA in comparison with SSD with similar infection rates. 12 Similarly, a porcine study comparing partial-thickness burns treated with OCA or PU found similar rates of reepithelialization and infection during the first two weeks after injury.…”

“…12,25 For example, a study comparing the rates of infection and reepithelialization of noncontaminated burns in swine found more rapid reepithelialization in burns treated with OCA in comparison with SSD with similar infection rates. 12 Similarly, a porcine study comparing partial-thickness burns treated with OCA or PU found similar rates of reepithelialization and infection during the first two weeks after injury. 25 Another study evaluated the rates of infection and reepithelialization of partial-thickness burns in a contaminated porcine model.…”

“…[7][8][9][10][11] Several recent studies suggest that OCA may also be beneficial in the treatment of superficial wounds resulting from thermal and mechanical injuries. [12][13][14] However, these studies, which have focused on early reepithelialization and infection rates, have been limited to the first two weeks after injury. Thus, it is unclear what effects OCA might have on longerterm outcomes such as scarring and residual wound area, which may be far more important than the short-term outcomes studied thus far.…”

“…17 These burns usually become reepithelialized within one to two weeks. 12,13 Four equal sets of five burns were inflicted on each of the two sides of the pig in a mirror fashion for a total of 40 burns. Groups of ten burns each were randomly treated with OCA spray (Closure Medical Corporation, Raleigh, NC), silver sulfadiazine (SSD, Par Pharmaceuticals Inc., Spring Valley, NY), polyurethane film (Tegaderm, 3M Health Care, St. Paul, MN), or dry nonadherent gauze (Telfa, Kendall Company, Mansfield, MA).…”

Octylcyanoacrylate for the Treatment of Small, Superficial, Partial-thickness Burns: A Pilot Study

“…Several studies evaluating an OCA-based liquid dressing for porcine partial-thickness burns demonstrated similar or improved healing when compared with other standard burn therapies. [10][11][12] Quinn et al found that superficial abrasions in guinea pigs treated with an OCA spray healed as well as those treated with Biobrane. 13 Singer et al reported similar results after treating deep, partial-thickness excisional wounds with OCA in a porcine model.…”