I don’t know about you but I find stuff like this absolutely fascinating. Also critical – it’s the type of knowledge you think you’ll never need until you really need it, and then you’ll wish you knew it.
Cyanoacrylate (CA) glues are commonly used in medical and household repairs. Their chemical compositions have been refined over half a century, making some more suitable than others for creative applications. In remote settings where advanced medical care is not accessible, readily available CAs of differing chemical composition may possess an important therapeutic function. Within this paper we critically examine the published therapeutic risks and benefits of both pharmaceutical and hardware grade CAs when applied in acute care situations. Topics discussed include wound closure as well as the treatment of burns, abrasions, and blisters. Also considered are their chemical properties, toxicities, and potential off-label uses.
From the hardened alpinist to the jungle explorer, most backcountry travelers have heard of or experimented themselves with instant adhesive to mend wounds when isolated from definitive medical care. Since their discovery in 1947, cyanoacrylates (CAs) have been used in numerous applications deviating from their intended purpose as a clear resin for gun sights.1, 2 By 1959, the fast curing and strong adhesive properties had found their way into the medical field when Coover et al3 reported on their applicability to wound closure. Methyl 2-cyanoacrylate (MCA) and to a greater extent, ethyl-2-cyanoacrylate (ECA), are commercially marketed today as hardware-grade instant adhesives.4 Early examination of these compounds revealed histotoxic properties, and their use by many medical practitioners was subsequently discontinued. Nevertheless, these off-the-shelf adhesives continue to be used by some healthcare providers for wound repair, hemostasis, and various surgical applications.5, 6, 7 Longer chain CAs with properties more conducive to medical use have since been developed. Of these, there are currently only a few US Food and Drug Administration (FDA)-approved CAs: 2-octyl cyanoacrylate (OCA, Dermabond) and various formulations of n-butyl-2-cyanoacrylates (BCA), some with dye to visualize the application (Indermil, TRUFILL, Histoacryl, and Histoacryl Blue). Given the barriers, including cost, availability, and the prescription requirement for medical-grade adhesives, the use of hardware store CAs in underdeveloped settings may be an acceptable therapeutic alternative despite their relative toxicities and differing physical properties. In this paper we describe these differences and explore the therapeutic utility of commercial and medical-grade CA glues in resource-poor and remote locations.