Adhesive strength of ethyl-2-cyanoacrylate tissue adhesive: How strong is it?

Purpose: We evaluated the adhesive strength of ethyl-2-cyanoacrylate and compared the findings with those of traditional monofilament synthetic sutures. We also investigated the factors that could affect the effectiveness of cyanoacrylate bonding by skin surface modifications at the adhesion site. Methods: Using a porcine skin model, we measured the maximum load for ethyl-2-cyanoacrylate adhesive under various application conditions. Results: When the application width was 5 mm, no differences were found in the maximum force load for one layer or two layers of ethyl-2-cyanoacrylate adhesive (3.3 ± 1.7 and 4.8 ± 1.5 N, p = 0.176). When the application width was extended to 10 mm, the maximum force load for one layer was 8.2 ± 0.6 N, which was significantly higher than for 5 mm (p <0.002). The force fell to within the loads generated by 6-0 to 5-0 ETHILON™ monofilament non-absorbable synthetic sutures. Roughening of the application surface had little effect on adhesion; however, smoothing resulted in a decrease in overall adhesive strength. Conclusions: The width of the application of ethyl-2-cyanoacrylate adhesive over the skin defect was important for achieving good and stable adhesive strength. Increasing the number of layers of adhesive through repeated applications of the cyanoacrylate did not increase overall adhesive strength. Skin surface modifications other than regular cleaning should be avoided.