Using a Novel Cyanoacrylate Skin Protectant to Reduce Periwound Tissue Breakdown with Venous Leg Ulcers Under Compression and with Prolonged Use Offloading Devices

The purpose of this study was to evaluate the effect of applying a novel cyanoacrylate skin protectant to reduce periwound MASD in chronic venous leg ulcers under an extended wear compression dressing. Ointments, sprays, solvent-based, and silicones have all been used to prevent moisture-associated skin damage (MASD). Periwound dermatitis is common in lower extremity wounds and especially in venous leg ulcers treated with compression. Fluid management is difficult and often secondary dressings fail to hold all the fluid generated between dressing changes. Creams and ointment preparations are often messy, plug up absorptive dressings, and must be removed at each dressing change.

Cyanoacrylate skin protectors have been available for several years and have specific qualities that make them preferable as a skin protectant. Cyanoacrylates are liquids that form a high-strength film to skin at risk for MASD, preventing damage to the skin from exposure to moisture. They have historically been used as biological glues and tissue adhesives but also have applications as a skin protectant.

Recent studies have shown that, in addition to protecting the skin from wound fluid degeneration, they also prevent biomechanical damage to the skin, reduce the incidence of infection, and increase healing. Problems with moist skin and the need to use multiple packets or vials to cover the size of the skin at risk made using them difficult and reduced cost effectiveness in the past. In these five cases, a new novel cyanoacrylate applied with a wand applicator was used for periwound protection with excellent clinical results. Periwound dermatitis was minimized, and we found that it could even be applied to moist skin. The wand applicator made it easy to apply, and the amount of the protectant per applicator was enough to cover even large wounds.