EPIGLU® – Adhesion Instead of SuturesP A C K A G I N G F O R M S

FOR PRIVATE PRACTICES, EMERGENCY ROOMSAND OUTPATIENT CARE:

EPIGLU® Tissue Adhesive in tubes (3g) with application aidsPackage: 1 tube with 3g of solution 24 pipettes, 24 individual snap-off trays for easy usefor 20 applications

Re-order Code: EPIGLU 01

If you still have any questions concerning EPIGLU® please contact us. It is a pleasure for us to answer them.

FOR DISPOSABLE USE IN PRIVATE PRACTICES,EMERGENCY ROOMS AND OUTPATIENT CARE:

EPIGLU® Single DoseAluminium sachets with 1 Dosette eachfilled with 0.3 ml/cc EPIGLU® tissue adhesivePackage with 10 Dosettes in aluminium sachets with 0.3 ml/cc EPIGLU® each

Re-order Code: EPIGLU S12

CYANO-EX: Remover for EPIGLU® and other acrylate adhesivesBottle with 20g CYANO-EX

Manufacturer: Distributor:

Meyer-Haake GmbH Phone g : +49 (0) 60 81 44 61-0Medical Innovations Telefaxc : +49 (0) 60 81 44 61-22Am Joseph 9 · 61273 Wehrheim E-Mail: export@meyer-haake.comDeutschland/Germany Internet: www.meyer-haake.com

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EPIGLU®

Single Dose

EPIGLU®

THE MOST BRILLIANT INVENTION SINCE BAND-AID

ADHESION INSTEAD OF SUTURES!NOWADAYS, WOUND TREATMENT IS NOT THE SAME AS IT WAS 100 YEARS AGO

Fresh deep lacerationat the lip.

After the manualadaptation of thewound edges thewound is fixatedwith a drop of EPIGLU®

and then covered witha thin, smoothed outlayer of the adhesive.

Already 11 days afterthe adhesion thewound is hardly visible.

Many emergency rooms, private

practices and hospitals just could

not imagine wound treatment

without adhesion and many

physicians would never go on

holiday without a supply of

wound adhesive for themselves

and their families.

When a laceration at the lip is

treated traditionally the result

often is not cosmetically satisfy-

ing. This differs much from the

quick and easy treatment with

EPIGLU®.

FAQs

concerning wound adhesives you

will find on the following pages.

EPIGLU® – Adhesion Instead of Sutures!CASE STUDIES

Removal of a nevus with wedge excisionand sutures. After 14 days the resultis not satisfying.

Removal of a nevus on the collateral sideof the same patient with radio surgery*and wound treatment with EPIGLU®.Excellent wound healing after 14 days.

Removal of a Nevus Treatment of an Aphthae

Acute painful aphthae prior to treatment. Aphthae during the healing process,at the 4th day after treatment.

Removal of a Nevus, left Forearm,Intracutaneous Sutures,Wound Closure with EPIGLU®

Wound treatment postoperative. Very satisfying result after 10 days.

Treatment of Injuries in Belize –an Aid Project which we are supporting

Removal of a Cysticand Very Deep Basalioma,Intracutaneous Sutures,Wound Closurewith EPIGLU®

After 10 days, the result is highlysatisfying even with older patients.

Removal of aSeborrhoic Keratosiswith a Sharp Spoon,Wound Treatmentwith EPIGLU® only

Wound closure instantly postoperative.The colourless adhesive does not bother.Despite a simultaneous treatment of both

feet the patient classified the pain asbearable as she could walk and drive her carinstantly after the treatment.

Treatment ofPlantar Wartswith Radio Surgery*(with ball electrode

and coagulation current only)

and PostoperativeTreatment with EPIGLU®

Lipoma

Removal of an egg-sized lipomain the neck with radio surgery*.

Subcutaneous sutures and closingof the skin surface with EPIGLU®

– situation postoperative.

Epidermal Nevus on Nevuscellnevus,Wound Closure and Suture Stabilization with EPIGLU®

Preoperative Postoperative

Treatment of injuries in the face,with EPIGLU® only.The lumberjack instantly went on working.

The gaping wound at the back of the headwas treated with EPIGLU®.After 6 weeks the flat and unobtrusivecured spot could not be pictured any more.

*The radio surgical treatments were performed with the radioSURG® 2200 of the company Meyer-Haake GmbH,Wehrheim, Germany.

T H E B E S T I N V E N T I O N S I N C E B A N D - A I DFAQs about

T I S S U E A D H E S I V E S

??Are all tissue adhesives the same?There are different acrylate tissue adhesives whichdiffer in polymerization and firmness. EPIGLU® is anEthyl-2-Cyanoarcylate which polymerizes very quicklyand closes even wounds which are under tension safely.

Are tissue adhesives more expensivethan traditional wound treatmentwith sutures?The common opinion that tissue adhesives are al-ways more expensive than sutures is not valid forEPIGLU®. This Ethyl-2-Cyanoarcylate tissue adhesiveis available in 3g tubes and as Single Dose Dosettewith 0.3 ml/cc. The 3g tubes are re-usable. Becauseeach 3g tube is sufficient for at least 20 wound treat-ments, the cost per treatment is lower than for tradi-tional wound treatment with sutures. Also the SingleDose packages in Dosettes with 0.3 ml/cc adhesiveare still cheaper than the treatment with sutures. Italso should be considered that after a smaller or big-ger accident no anesthetic is necessary and there is noneed for a second appointment to remove the stitches.

How long does it take to treat a woundtraditionally or with adhesive?Experiences prove that the traditional wound treat-ment takes approx. 50 minutes (including inspectionof the wound, anesthesia, sewing, clearance of thework equipment, sterilisation of the instruments andremoving the stitches), meanwhile the adhesion takes10 minutes only.

Why do no infections occur to there-usability of EPIGLU® from tubes?EPIGLU® is applied with disposable dispensing pi-pettes or with the Single Dose Dosettes which arethrown away after application. EPIGLU® is no culturemedium for germs and even has an inhibitive effecton existing germs. Sterile application sets for theoperation theatre are available.

For how long EPIGLU® is knownon the market and where is it used?In December 1995, EPIGLU® has got the approval andit is used within Germany and many other countries.Samples are shown on our homepage www.meyer-haake.com. Allergic reactions or other occurrenceswere not observed so far. At the Tehran Burn Clinicskin meshes had been adhered at the edges verysuccessfully instead of sewing them. The time ofoperation could be reduced about 50%, complicationsdid not occur.

When EPIGLU® is applied is it possibleto abstain from subcutaneous sutures?No, basically all acrylate tissue adhesives are for theclosures of skin surfaces only. If because of the situa-tion subcutaneous sutures are necessary, neverthe-less, the closure of the skin can be performed withEPIGLU®.

Is it possible to treat long woundswhich are under tension with EPIGLU®?Yes, because EPIGLU® is an Ethyl-2-Cyanoacrylate.These acrylates are more tear-proofed than otheracrylate compounds. To our knowledge we are theonly company on the world producing a tissue adhe-sive made of Ethyl-2-Cyanoacrylate.Irrespective of the length, all cuts, lacerations and sur-gical incisions can be closed with EPIGLU® if they donot bleed any more, are not infected and not olderthan 6 hours. EPIGLU® is particularly suitable for thetreatment of wounds after removal of skin lesions orexcisions (basaliomas, nevi, senile freckles, keratosis,xanthelasmas, warts and many other more). EPIGLU®

can also be applied onto the oral mucosa and theexternal genitalia. Bites and abrasions should not betreated with adhesives.

Why should EPIGLU® be appliedin several layers?Because all tissue adhesives peel off easier from thehealthy skin which surrounds the wound it is safer toapply 2 to 3 thin layers, each overlapping the other,after the primary wound adhesion. With the pipettesor the twisted off upper part of the Dosettes it is pos-sible to smooth out the adhesive thinly.

How fast does EPIGLU® polymerize?The first layer which was directly applied onto thewound hardens in approx. 10 seconds. The woundedges are now fixated already safely. Other layersharden in 2 to 3 minutes.

What to do if after some hours the patienthas got an unpleasant ııthrobbingıı feeling?It must be assumed that the wound had been in-flamed or that there had been foreign objects beforethe adhesion. In this case, once it has set, EPIGLU®

can be peeled off.

Does EPIGLU® has to be removedafter the wound healing is completed?No, with the formation of new skin lamellae (after 5to 10 days) EPIGLU® detaches itself from the skin likescab.

Why do wounds heal faster after adhesion?Wounds closed with Ethyl-2-Cyanoacrylate tissueadhesive are protected from infections. Also thewound edges are closely laying side by side for thewhole length of the wound and, therefore, the heal-ing process is accelerated. Ugly scars are avoided andaccording to our experience keloids develop rarely.Allergic reactions are not known.

Can EPIGLU® be used additionallyfor already sutured wounds?If a wound had been treated with sutures already it ispossible to apply EPIGLU® additionally.This will help tostabilize the wound and to protect it against infections.

Why does patients feel betterafter a wound treatment with EPIGLU®?The patients are much more painless because there areno stitch channels and, therefore, no tensile strengthpain.

What should patients pay attention toafter the treatment with EPIGLU®?The patient can immediately resume the daily personalhygiene (washing/showering) and is able to work orplay again. Nevertheless, we recommend for childrenor nervous patients to put a band-aid over the treat-ed wound. So, it can be avoided that the patient whois nearly pain-free peels off the adhesive layers withor without intention.

How EPIGLU® has to be stored?The longest shelf life of EPIGLU® can be achieved ifEPIGLU® is stored in a deep freezer. As EPIGLU® ishigh-graded pure it does not freeze into a solid blockand can be used immediately after removal from thedeep freezer. Deep freezing is recommended especial-ly for private practices, where wound treatment doesnot occur so often. If EPIGLU® is used several times aday, e. g. in emergency rooms or operation theatres,it is not necessary to store the adhesive in the deepfreezer between the applications.

Which is the shelf life of EPIGLU®?If stored in a deep freezer EPIGLU® has a shelf life of36 months. If stored in a refrigerator or at room tem-perature the shelf life decreases. Discontinue use ofEPIGLU® if the solution does not drip in a clear wa-tery consistency any longer. The material has thenstarted to polymerize and the adhesive can not beused any longer.

How does EPIGLU® polymerize?Acrylates polymerize by absorption of OH-ions. OH-ions are in the air. On a warm and humid summerday the polymerization occurs faster than on a coldand dry winter day. This is one reason why the firstlayer of the adhesive is hardening much faster onthe still humid wound. It should not be forgottenthat Ethyl-2-Cyanoacrylates as EPIGLU® are polyme-rizing faster than other acrylates in general.