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Octylcyanoacrylate for the Treatment of Partial-thickness Burns in Swine: A Randomized, Controlled Experiment
Authors:Adam J. Singer MD  Luis Berrutti MD  Henry C. Thode Jr.  PhD Steve A. McClain MD
Affiliation:Department of Emergency Medicine, State University of New York at Stony Brook, USA. asinger@epo.som.synysb.edu
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 degrees 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.
Keywords:burns    skin    partial thickness    re-epithelialization    healing    tissue adhesives    silver sulfadiazine    octylcyanoacrylate
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