Octylcyanoacrylate for the treatment of small, superficial, partial-thickness burns: a pilot study

Octylcyanoacrylate (OCA) is a tissue adhesive used to close wounds and to treat minor abrasions. To explore the use of OCA in patients with superficial, partial-thickness burns. A prospective, noncomparative, pilot study was conducted in an emergency department (ED) and burn center. Consecutive patients with early (< 6 hours), small (< 5% total body surface area [TBSA]), superficial, partial-thickness burns were enrolled. Burns were cleaned and any nonadherent necrotic epidermis was removed. Tense blisters were aseptically aspirated. Burns were then covered with a liquid OCA that was applied with a sponge brush. Pain of cleansing and OCA application was recorded, and physicians assessed ease of application. Burns were evaluated every one to two days until complete epithelialization for the presence of infection and exudation, and the OCA was reapplied as necessary. Main outcomes measured were the need for additional topical therapy, pain and ease of application, patient comfort, and satisfaction. Ten patients were enrolled. Mean patient age (+/- standard deviation [SD]) was 23 (+/- 16) years, four were female, and nine were white. Burns were located on the hands (5), forearms (3), ankle (1), and back (1). Etiologies included contact (4), flame (4), and scald (2) burns. Mean (+/- SD) burn size was 71 (+/- 72) cm(2). Blisters were present on admission in all patients and remained intact in five. Application of OCA was very easy in all patients; it immediately relieved pain in four patients and had no effect in three patients, while three patients complained of a brief increase in pain on OCA application. Exudation was present in four of ten patients within one to two days, all of whom had ruptured blisters at initial presentation. OCA was reapplied in two of these patients, and two patients were changed to silver sulfadiazine due to excessive exudation. The OCA was removed in one patient due to accumulation of exudate. There was no infection, and all burns were epithelialized within five to ten days. The results of this pilot study suggest that OCA may be useful for some, but not all, small, superficial, partial-thickness burns. Further studies may help clarify the indications and contraindications to proper usage of OCA in small, superficial burns.