Methods for Reducing SKin Irritation from Artificial Devices by use of Cyanoacrylate Adhesives
Methods for Reducing SKin Irritation from Artificial Devices by use of Cyanoacrylate Adhesives
US5653769
Company:
Folder:
Year:
Abstract:
A cyanoacrylate adhesive is applied onto surface skin areas prone to ulceration or irritation so as to inhibit irritation of the surface skin due to contact with an artificial device such as prosthetic devices, bandages, casts, etc.
Type of document:
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United States Patent [191
Barley, Jr. et al.
[54] METHODS FOR REDUCING SKIN
IRRITATION FROM ARTIFICIAL DEVICES
BY USE OF CYANOACRYLATE ADHESIVES
[75] Inventors: Leonard V. Barley, Jr., Colorado
Springs; Patrick J. Tighe, Littleton,
both of Colo.; Richard J. Gretf, Yorba
Linda, Calif.; Michael M. Byram,
Colorado Springs, C010.
[73] Assignee: MedLogic Global Corporation.
Colorado Springs, C010.
[21] Appl. No.: 542,034
[22] Filed: Oct. 12, 1995
Related U.S. Application Data
[63] Continuation of Ser. No. 200,953, Feb. 24, 1994, abandoned
[51] Int. Cl.5 ......................... .. A61F 2/54; A61K 31/785;
A61L 25/00
[52] U.S. C1. ......................... .. 623/66; 623/33; 424/7 8.02;
424/400
[58] Field of Search ............................ .. 424/78.05, 78.02;
623/66, 33
[56] References Cited
U.S. PATENT DOCUMENTS
8/1957 Galliene et al. .
9/1970 Rabinowitz.
3,591,676 7/1971 Hawkins et al. .
3,667,472 6/1972 Halpern .
3,699,076 10/1972 Thomsen et al. .................. .. 424/78.02
3,995,641 12/1976 Kronenthal et al. .
4,035,334 7/1977 Davydov et al. .
4,287,177 9/1981 Nakashima et al. .
4,444,933 4/1984 Columbus et al. ................... .. 524/292
4,650,826 3/1987 Waniczek et al. .
4,752,472 6/1988 Kligman ............................ .. 514/844
4,788,061 11/1988
4,958,748 9/1990 Otake .
5,254,132 10/1993 Bafley et al. ......................... .. 606/214
5,270,168 12/1993 '
5,306,490 4/1994
5,403,591 4/1995
5,480,935 1/1996
5,554,365 9/1996
5,580,565 12/1996
2,804,073
3,527,224
OTHER PUBLICATIONS
Akers, et al., ‘Treating Friction Blisters with
Alkyl-oc—Cyanoacrylates”, Arch. Dermatol., vol. 107, pp.
544-547, Apr. 1973.
Bhaskar,et al., “Healing of Skin Wounds with Butyl
Cyanoacrylate”, Journal of Dental Research, vol. 48, No. 2,
pp. 294-297, 1969.
Dalvi, et al., “Non-suture Closure of Wound Using
Cyanoacrylate”. Journal of Postgraduate Medicine, vol. 32,
No. 2, pp. 97-100, (1986).
Eiferman, et al., “Antibacterial Efiects of Cyanoacrylate
Glue”, Archives of Ophthalmology, vol. 101, pp. 958-960,
Jun. 1983.
USOO5653769A
[11] Patent Number: 5,653,769
[45] Date of Patent: Aug. 5, 1997
Ellis, et al., ‘The Ideal Tissue Adhesive in Facial Plastic and
Reconstructive Surgery”, The Journal of Otolaryngology.
vol. 19. No. 1. pp. 68-72, 1990.
Fung, et al.. “Use of Butyl-2-Cyanoacrylate in Rabbit
Auricular Cartilage”, Archives of Otolaryngology, vol. 111,
pp. 459-464, Jul. 1985.
Galil, et al., ‘The Healing of Hamster Sldn Ulcers Treated
with N-butyl-2-cyanoacrylate (Histoacryl blue)”, pp.
601-607, 1984, Journal of Biomedical Materials Research,
vol. 18, pp. 601-607, 1984.
Harper, “Stabilization of Osteochondral Fragments Using
Limited Placement of Cyanoacrylate in Rabbits”, Clinical
Orthopaedics and Related Research, No. 231, pp. 272-276.
Jun. 1988.
Kamer, et al., “Histoacrylz Its Use in Aesthetic Facial Plastic
Surgery”, Archives of Otolaryngology Head and Neck Sur-
gery. vol. 115, pp. 193-197, Feb. 1989.
Kosko. “Upper Lid Blepharoplastyt Skin Closure Achieved
with Butyl-2-Cyanoacrylate”, Ophthalmic Surgery, vol.
12.. pp. 424-425, Jun. 1981.
Lehman. et al., “Toxicity of Alkyl 2—Cyanoacry1ate: Bacte-
rial Growth”, Archives of Surgery. vol. 93, pp. 447-450.
Sep. 1966.
Leonard, et al., “Synthesis and Degradation of
Po1y(a1ky1-ot-Cyano-acrylate)”, Journal of Applied Poly-
mer Science, vol. 10, pp. 259-272, 1966.
Makady, et al., “Efiect of tissue adhesives and suture pat-
terns on experimentally induced teat lacerations in lactating
dairy cattle”, JAVMA. Reports of Original Studies, vol. 198.
No. 11, pp. 1932-1934, Jun. 1991.
Matsumoto, “Bacteriology and Wound Healing”, Chapter 3
in Tissue Adhesives in Surgery, pp. 106-113, 1972.
Matsumoto, “Clinical Considerations and Applications of
Bucrylate Tissue Adhesive”, Tissue Adhesives in Surgery,
Chap. 1, Sec. 111, pp. 226-237, 1972.
Matsumoto, “Reactions of the Organism to Aciylate-Adhe-
sives”, Tissue Adhesives in Surgery, pp. 436-444, 1972.
Matsumoto, et al., ‘Tissue Adhesive and Wound Healing”,
Archives of Surgery, vol. 98, pp. 266-271, Mar. 1969.
Mizrahi, et al., “Use of Tissue Adhesives in the Repair of
Lacerations in Children”, Journal of Pediatric Surgery, vol.
23, No. 4, pp. 312-313, Apr. 1988.
Morton, et al., ‘The Use of Histoacryl Tissue Adhesive for
the Primary Closure of Scalp Wounds”, Archives of Emer-
gency Medicine, vol. 5, pp. 110-112, 1988.
Ousterhout, et al., “Cutaneous Absorption of
n-Alkyl-oz-Cyanoacrylate”, Joumal of Biomedical Materi-
als Research, vol. 2, pp. 157-163, 1968.
Pepper, “Kinetics and Mechanism of Zwitterionic Polymer-
ization of Alkyl Cyanoacrylate”, Polymer Journal, vol. 12,
No. 9., pp. 629-637, 1980.
(List continued on next page.)
Primary Examiner—Peter E Kulkosky
Attomey, Agent, or Firm-Burns, Doane, Swecker &
Mathis,L.L.P.
[57] ABSTRACT
A cyanoacrylate adhesive is applied onto surface skin areas
prone to ulceration or irritation so as to inhibit irritation of
the surface skin due to contact with an artificial device such
as prosthetic devices, bandages, casts, etc.
15 Claims, No Drawings
5,653,769
Page 2
OTHER PUBLICATIONS
Pepper, et al.. “Kinetics of Polymerization of Alkyl
Cyanoacrylate by Tertiary Amines and Phosphines”, Mak-
romol. Chem., vol. 184. pp. 395-410, 1983.
Ronis. et al., “Review of Gyanoaciylate Tissue Glues with
Emphasis of Their Otorhinolaryngological Applications”,
Laryngoscope, vol. 94, pp. 210-213, Feb. 1984.
Saches, “Enbucrylate as Cartilage Adhesive in Augmenta-
tion Rhinoplasty”, Archives of Otolaryngology, vol. 111, pp.
389-393, Jun. 1985.
Toriumi, et a1., “Histotoxicity of Cyanoacrylate Tissue
Adhesives: A Comparative Study”, Archives of Otolaryn-
gology Head and Neck Surgery, vol. 116, pp. 546-550, Jun.
1990.
Tseng, et al., “Modification of Synthesis and Investigation of
Properties for 2-cyanoacrylate”, Biomaterials, vol. 11, pp.
73-79. Jan. 1990.
Vinters, et al.. ‘The Histotoxicity of Cyanoacry1ate:A Selec-
tive Review”. Neuroradiology. vol. 27, pp. 279-291, 1985.
Watson, “Use of Qranoacrylate Tissue Adhesive for Closing
Facial Lacerations in Children”, British Medical Journal,
vol. 299, p. 1014. Oct. 1989.
Chem. Abstract, CAO79—027521 (O5).
5,653,769
1
METHODS FOR REDUCING SKIN
IRRITATION FROM ARTIFICIAL DEVICES
BY USE OF CYANOACRYLATE ADHESIVES
This application is a continuation of application Ser. No.
08/200,953, filed Feb. 24, 1994, now abandoned.
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention is directed to methods for inhibiting sur-
face skin irritation arising from friction between the skin
surface and artificial devices such as tapes, prosthetic
devices, casts. and the like by application of a layer of
cyanoacrylate polymer to the skin area which is prone to
such irritation. The cyanoacrylate adhesive to be used can be
stored in dispensers for single or repeated/intermittent use
and can be applied to the skin by spraying. painting, etc. of
the adhesive.
2. State of the Art
Cyanoacrylate adhesives have been suggested for a vari-
ety of adhesive purposes including glues and surgical adhe-
sives. In particular, cyanoacrylate adhesives of formula I:
o I
ll
CH2=? —COR
CN
wherein R is an alkyl or other suitable substituents are
disclosed in U.S. Pat. Nos. 3,527,224; 3,591,676; 3,667,472;
3.995.641; 4,035,334; and 4,650,826. Typically. when used
as adhesives for living tissues, the R substituent is alkyl of
from 2 to 6 carbon atoms and most often is butyl (e.g.,
n-butyl).
The suggested medical uses for cyanoacrylate adhesives
include surgical environments wherein the cyanoacrylate
adhesives are utilized, e.g., as an alternative to sutures or as
a hemostat.
In contrast to such prior art uses of cyanoacrylate
adhesives, this invention is directed to methods for inhibit-
ing surface skin irritation arising from friction between the
skin surface and artificial devices in contact with the skin
surface. Such artificial devices in contact with the skin
surface are those devices which are attached or next to the
human body and which can cause irritation to the sldn
surface (e.g., irritation due to friction arising from the
constant or repeated rubbing of a device with the skin or
irritation due to removal of tape from the skin surface due to
the adhesive employed). Included within such artificial
devices are prosthetic devices, casts, tapes, tubings,
cannulae, bandages (e.g., BAND-AID® brand bandages),
and the like.
With artificial devices such as prosthetic devices, casts
and the like, once skin irritation arises it is diflicult to treat
primarily because such devices are not usually removed for
the purpose of treating sldn irritation unless the irritation
becomes severe or results in an infection. With bandages,
irritation due to the bandage adhesive and irritation and/or
skin tears due to bandage removal causes discomfort and, in
some cases, the individual may forego application of the
bandage and the benefits ascribed thereto in order to prevent
ensuing discomfort upon its removal. Accordingly, the
health care industry has focused on measures to prevent the
formation of skin irritation when such devices are used
SUMMARY OF THE INVENTION
This invention is drawn to methods for inhibiting surface
skin irritation arising from artificial devices attached or next
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to human sldn by application of a layer of cyanoacrylate
polymer to the sldn area which is prone to such irritation.
The layer of cyanoacrylate polymer is formed from appli-
cation of cyanoacrylate adhesive to the skin surface and
polymerization of the adhesive wherein application is
typically, but not necessarily, conducted prior to develop-
ment of sldn irritation. The methods involve applying
cyanoacrylate adhesive, particularly n-butyl cyanoacrylate
adhesive, onto skin surface areas which will be in Contact
with the artificial device and which are prone to surface skin
irritation so as to form a flexible, waterproof polymer layer
over such skin areas. In turn. this polymer layer increases the
skin integrity whfle reducing skin irritation to the underlying
skin by forming a physical barrier layer interposed between
the artificial device and the skin surface area.
Accordingly, in one of its method aspects, this invention
is directed to a method for inhibiting irritation from an
artificial device which contacts the human skin surface
which method comprises:
applying to skin surface area(s) which will be in contact
with the artificial device and which will be prone to
surface skin irritation, a sufficient amount of a
cyanoacrylate adhesive so as to cover said area(s);
polymerizing the cyanoacrylate adhesive so as to form a
flexible, waterproof, adhesive polymer coating which
adheres to the area(s) where the adhesive was applied;
and
attaching the artificial device such that at least a portion
of the skin surface area(s) abutting said device has said
adhesive polymer coating interposed between,
wherein the cyanoacrylate, in monomeric form. is repre-
sented by formula I:
0 1
II
CH2 =C|I —COR
CN
where R is selected from the group consisting of:
alkyl of 2 to 10 carbon atoms,
alkenyl of 2 to 10 carbon atoms,
cycloalkyl groups of from 5 to 8 carbon atoms, phenyl,
2-ethoxyethyl,
3-methoxybutyl,
and a substituent of the formula:
R‘ 0
I II
—p—c—oR"
R.
wherein each R‘ is independently selected from the
group consisting of:
hydrogen and methyl, and
R" is selected from the group consisting of:
alkyl of from 1 to 6 carbon atoms,
alkenyl of from 2 to 6 carbon atoms,
alkynyl of from 2 to 6 carbon atoms,
cycloalkyl of from 3 to 8 carbon atoms,
aralkyl selected from the group consisting of benzyl,
methylbenzyl and phenylethyl,
phenyl, and
phenyl substituted with 1 to 3 substituents selected
from the group consisting of hydroxy, chloro,
bromo, nitro, alkyl of 1 to 4 carbon atoms, and
alkoxy of from 1 to 4 carbon atoms.
Preferably R is alkyl of from 2 to 10 carbon atoms and
more preferably alkyl of from 2 to 8 carbon atoms. Even
5,653,769
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more preferably, R is butyl, pentyl or octyl and most
preferably, R is n-butyl.
In a preferred embodiment, the cyanoacrylate is applied
so as to provide from at least about 0.02 milliliter (ml), more
preferably from about 0.02 to about 0.2 ml, and still more
preferably from about 0.02 to about 0. 1 ml, of cyanoacrylate
adhesive per square centimeter of skin which is to be
covered.
In another preferred embodiment, the cyanoacrylate adhe-
sive to be applied to the skin has a viscosity of from 2 to
about 1500 centipoise at 20° C. More preferably, the
cyanoacrylate in the cyanoacrylate adhesive is almost
entirely in monomeric form and the adhesive has a viscosity
of from about 20 to about 100 centipoise at 20° C.
As used herein, the following terms have the following
meanings:
The term “cyanoacrylate adhesive” refers to adhesive
formulations comprising cyanoacrylate monomers of for-
mula I:
o I
II
CH;=? —COR
CN
where R is selected from the group consisting of alkyl of 2
to 10 carbon atoms, alkenyl of 2 to 10 carbon atoms,
cycloalkyl groups of from 5 to 8 carbon atoms, phenyl,
2-ethoxyethyl, 3-methoxybutyl, and a substituent of the
formula:
R‘O
I ll
—c|: —c—-on"
R.
where each R‘ is independently selected from the group
consisting of hydrogen and methyl and R" is selected from
the group consisting of alkyl of from 1 to 6 carbon atoms;
alkenyl of from 2 to 6 carbon atoms; alkynyl of from 2 to 6
carbon atoms; cycloalkyl of from 3 to 8 carbon atoms;
aralkyl selected from the group consisting of benzyl, meth-
ylbenzyl and phenylethyl; phenyl; and phenyl substituted
with 1 to 3 substituents selected from the group consisting
of hydroxy, chloro, bromo, nitro, alkyl of 1 to 4 carbon
atoms, and alkoxy of from 1 to 4 carbon atoms.
Preferably, R is an alkyl group of from 2 to 10 carbon
atoms including ethyl, n-propyl, iso-propyl, n-butyl, iso-
butyl, sec-butyl, n-pentyl, iso-pentyl, n-hexyl, iso-hexyl,
2-ethylhexyl, n-heptyl, octyl, nonyl, and decyl. More
preferably, R is butyl, pentyl or octyl and most preferably, R
is n-butyl.
These cyanoacrylate adhesives are known in the art and
are described in, for example, U.S. Pat. Nos. 3,527,224;
3,591,676; 3,667,472; 3,995,641; 4,035,334; and 4,650,826
the disclosures of each are incorporated herein by reference
in their entirety.
A preferred cyanoacrylate adhesive for use in the inven-
tion is n-butyl-2-cyanoacrylate.
The cyanoacrylate adhesives described herein rapidly
polymerize in the presence of water vapor or tissue protein,
and the n-butyl-cyanoacrylate is capable of bonding human
skin tissue without causing histoxicity or cytotoxicity.
DETAILED DESCRIPTION OF TIDE
PREFERRED EMBODIMENTS
This invention relates to cyanoacrylate adhesives which
are useful for inhibiting surface skin irritation arising from
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artificial devices in contact with at least a portion of the
human skin surface by application of a layer of cyanoacry-
late polymer to that portion of the skin area prone to such
irritation. The cyanoacrylate adhesive which is applied to
surface skin areas prone to such irritation can be monomeric
or par1ial1y polymeric. In general, partially polymerized
cyanoacrylate adhesives are liquid polymers having a higher
viscosity than that of the corresponding monomer and,
therefore, are better suited for those applications which are
intended to be specific for a particular skin area. In other
words, less viscous materials are more likely to “run” (i.e.,
flow) into areas where application, is not intended.
The cyanoacrylate adhesives used herein preferably have
a viscosity of from 2 to about 1500 centipoise and more
preferably from greater than 20 to about 100 centipoise at
20° C. It is contemplated, however, that pastes and gels
having viscosities of up to 50,000 centipoise at 20° C. can
also be employed and will make for easier skin application.
The specific viscosity of the fonnulation depends, in part,
on the amount and degree of partially polymerized
cyanoacrylate adhesive employed as well as additives which
are employed in the formulation to enhance or decrease
viscosity. Such factors are readily ascertainable by the
skilled artisan. For example, methods for preparing partially
polymerized cyanoacrylate adhesives are disclosed, for
example, by Rabinowitz, U.S. Pat. No. 3,527,224 which is
incorporated herein by reference in its entirety. Additives
which can be incorporated into the formulation to enhance
its viscosity include polymers such as polymethyl methacry-
late (PMMA) and polymerized cyanoacrylate adhesives as
disclosed in U.S. Pat. Nos. 3,654,239 and 4,038,345 both of
which are incorporated herein by reference in their entirety.
Monomeric forms of cyanoacrylate adhesives are often
preferred where application is to be made to a large surface
area. This preference results from the fact that those forms
are less viscous and, accordingly, will permit more facile
large surface area application. Mixtures of monomeric forms
of cyanoacrylate adhesive and partially polymerized forms
of cyanoacrylate adhesive can also be used to prepare a
formulation having intermediate viscosities.
For purposes of this invention, monomeric or partially
polymerized n-butyl-2-cyanoacrylate is a particularly pre-
ferred adhesive and is capable of effectively bonding human
skin tissue without causing histoxicity or cytotoxicity.
Upon contact with skin moisture and tissue protein, the
cyanoacrylate adhesives will polymerize or, in the case of
partially polymerized cyanoacrylate adhesives, will further
polymerize, at ambient conditions (skin temperature) over
about 10 to 60 seconds to provide a solid layer which forms
over and strongly adheres to the surface of the skin. The
resulting adhesive polymer layer or coating is flexible and
waterproof thereby forming a protective layer which
increases underlying skin integrity and reduces irritation to
the surface skin area arising from the artificial device.
The surface skin areas prone to irritation due to contact
with an artificial device are readily identified by conven-
tional methods. The cyanoacrylate adhesive is applied to
such irritation skin prone areas to provide an efi°ectively
thick coating over the human skin tissue. The cyanoacrylate
adhesive forms a polymeric layer which provides an adhe-
sive coating over the surface skin area prone to irritation
which, when set, is waterproof and satisfactorily flexible and
adherent to the tissue without premature peeling or cracking.
Preferably, the adhesive coating has a thickness of less than
about 0.5 millimeter (mm), and more preferably the coating
has a thickness of less than about 0.3 mm. In a particularly
5,653,769
5
preferred embodiment, the thiclmess of the adhesive coating
is from about 0.1 millimeter to about 0.5 millimeter and even
more preferably from about 0.1 millimeter to about 0.3
millimeter.
Adhesive coatings of such thicknesses form a physical
barrier layer interposed between the artificial device and the
human skin surface which coatings provide protection
against artificial devices which cause surface skin irritation
due to friction such as prosthetic devices and casts.
Additionally, these coatings also provide protection against
surface skin irritation due to the removal of artificial devices
having an adhesive layer which maintains the location of the
artificial device on the human skin surface. In the former
case, irritation is reduced because the artificial device no
longer contacts the skin surface and fiiction forces are either
eliminated or reduced. In the latter case. irritation is reduced
because the adhesive employed to maintain the location of
the artificial device on the human skin sinface no longer
contacts the skin but rather contacts the polymeric coating.
Moreover, since this coating naturally sloughs off the skin
about 2-3 days after application. there is no need to effect
removal of the coating from the skin surface. However, if
early removal of this polymeric coating is desired, such can
be achieved by use of solvents such as acetone.
The adhesive coating can be formed by applying at least
about 0.02 ml of cyanoacrylate adhesive per square centi-
meter of skin. more preferably from about 0.02 to about 0.2
ml, and still more preferably from about 0.02 to about 0.1
ml, of cyanoacrylate adhesive per square centimeter of skin
and yet more preferably from about 0.02 to about 0.05 ml of
cyanoacrylate adhesive per square centimeter of skin.
FORMULATIONS
The cyanoacrylate adhesive formulations employed
herein generally comprise monomeric and/or partially poly-
merized compounds of formula I described above and are
sometimes referred to herein as simply cyanoacrylate adhe-
sives. These formulations are liquid in nature and. upon
contact with surface skin proteins and moisture, will poly-
merize to provide a solid film or layer over the skin surface.
The formulations may additionally contain one or more
optional additives such as colorants, plasticizers, perfumes,
anti-diffusion agents, modifying agents and stabilizers. In
practice, each of these optional additives should be both
miscible and compatible with the cyanoacrylate adhesive.
Compatible additives are those that do not prevent the use of
the cyanoacrylate adhesives in the manner described herein.
In general, colorants are added so that the polymerized
film will contain a discrete and discernable color. Perfumes
are added to provide a pleasant smell to the formulation.
Stabilizers, such as sulfur dioxide, are added to minimize in
situ polymerization in containers during storage.
Plasticizers, such as dioctylphthalate or tri(p-cresyl)
phosphate, are added in order to enhance the flexibility of
the resulting polymer layer. Each of these additives is
conventional. For example, suitable stabilizers are disclosed
in U.S. Pat. No. 4,650,826 and suitable plasticizers are
disclosed in U.S. Pat. Nos. 2,784,127 and 4,444,933 the
disclosures of all of these patents being incorporated herein
by reference in their entirety.
The amount of each of these optional additives employed
in the cyanoacrylate adhesive is an amount necessary to
achieve the desired effect.
The formulation is generally stored in an applicator for
use in a single dose application or for use in repeated
applications. Single dose applicators include those having
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breakable or removable seals that prevent moisture, includ-
ing atmospheric moisture. from contacting the formulation
and causing in situ polymerization.
For repeated and intermittent usage, minimal exposure to
atmospheric moisture is required. This can be achieved by
devices having very narrow outlets and low dead-
space. One applicator for such repeated intermittent use is
described in U.S. Pat. No. 4,958,748 which is incorporated
herein by reference in its entirety.
Another applicator comprises a conventional spray appli-
cator wherein the cyanoacrylate adhesive is sprayed onto the
surface skin area prone to irritation due to friction with an
artificial device. The spray rate of the applicator can be
controlled so that application of a metered quantity of
adhesive per unit area of skin surface over a set period of
time is controlled.
Still another applicator comprises a brush or solid paddle
applicator wherein the cyanoacrylate adhesive is “painted”
onto the surface skin area prone to irritation due to friction
with an artificial device.
A preferred applicator for repeated and intermittent usage
is an applicator suitable for the non-sterile storage and
metered dispersement of a cyanoacrylate adhesive after
opening of the applicator wherein the applicator is charac-
terized as having a resealable opening of no more than about
0.008 square inches (0.0516 square centimeters) so as to
permit the metered dispersement of the adhesive from the
applicator and which is capable of multiple administrations
of the adhesive and is further characterized as having
resealing means such as a cap which either tightly mates
with the applicator or which screws onto the applicator.
Preferably, the opening of the applicator is about 0.0016
to about 0.003 square inches (about 0.0103 to about 0.0194
square centimeters).
In another preferred embodiment, the walls of the appli-
cator are made of a pliable material, so that upon application
of pressure onto the walls, the walls depress sufliciently to
force the adhesive contained in the applicator through the
opening. Preferably, the applicator is manufactured with its
opening covered by a metal foil or other similar construction
which closes this opening until the device is ready for use.
The opening is then reinstated by use of a pin or similar
device which punctures the covering.
In applicators suitable for repeated intermittent uses, the
cyanoacrylate adhesive is stored at ambient conditions and
is selected to be bacteriostatic. See, for example, Rabinowitz
et al., U.S. Pat No. 3,527,224. When the selected adhesive
is bacteriostatic, prolonged storage at ambient conditions
can be achieved without regard to the sterility of the for-
mulation.
ME'I‘HODOLOGY
The above-described formulations are applied to surface
skin areas in contact with artificial devices attached to the
human body which devices can cause irritation to the surface
skin area(s) in contact therewith. Application is conducted
under conditions suitable for polymerizing the adhesive so
as to form a protective coating and can be conducted either
prior to or after irritation develops. While preferably appli-
cation is conducted prior to development of irritation, appli-
cation after development of irritation will prevent further
irritation and can enhance recovery of the irritated skin. In
general, sufficient amounts of cyanoacrylate adhesive are
employed to cover (i.e., coat) the entire surface skin area
subjected to such irritation. The coating is preferably
extended by at least about 1 centimeter and preferably by at
least about 5 centimeters beyond the surface skin area prone
to irritation.
5,653,769
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The adhesive polymer coating should be maintained in a
unbroken manner over the entire skin area prone to such
surface skin irritation. This can be assured by careful appli-
cation of the adhesive onto the skin. Additionally, the use of
a plasticizer will facilitate the maintenance of the polymer
coating in an unbroken manner. However, in a preferred
embodiment. after the initial layer of adhesive has cured to
provide for an adhesive polymer coating, a second, prefer-
ably thinner, layer is applied over the adhesive polymer
coating. Additional amounts of cyanoacrylate adhesive can
be applied as needed to maintain an unbroken coating
covering over the irritation prone surface skin areas. For
example, in the case of prosthetic devices, application of the
cyanoacrylate adhesive to form the protective coating is
typically made to the skin surface area which contacts the
prosthetic device. In the case of bandages, application is
made to that part of the skin surface where the adhesive of
the bandage would otherwise contact the skin surface.
Suflicient cyanoacrylate adhesive is preferably employed
to form a coating of from about 0.1 mm to less than about
0.5 mm thick. Such coatings can be formed by applying at
least about 0.02 ml of cyanoacrylate adhesive per square
centimeter of skin surface area.
The amount of cyanoacrylate adhesive applied onto the
skin surface area can be controlled by the amount of
adhesive packaged in a single dose product or by use of a
multiple use dispenser which governs the amount of material
applied onto a unit area of surface skin. In this regard, the
dispenser described by Otake, U.S. Pat. No. 4,958,748,
which is incorporated by reference in its entirety, is particu-
larly advantageous because it dispenses the adhesive in a
controlled dropwise manner. Other methods for the con-
trolled dispersement of the cyanoacrylate adhesive are as
described above including, by way of example, a conven-
tional spray applicator, a brush or solid paddle applicator,
and the like.
Upon application of the cyanoacrylate adhesive, the sur-
face skin moisture, tissue protein. and temperature are
suflicient to initiate polymerization of the adhesive upon
application. Thereafter, the skin surface is maintained under
suitable conditions to allow polymerization to proceed to
formation of an adhesive coating.
In general, the particular length of time required for
polymerization will vary depending on factors such as the
amount of adhesive applied, the temperature of the skin, the
moisture content of the skin, the surface area of skin to
which the adhesive was applied, and the like. However, in a
preferred embodiment, polymerization is generally com-
plete within about 10 to about 60 seconds while the sldn is
maintained at ambient conditions. During this period, the
person to whom application of the cyanoacrylate adhesive
has been made merely allows the adhesive to form a coating
while minimizing any action to prevent the adhesive fiom
being dislodged from that portion of the skin where it was
applied or to adhere to unintended objects. l-"access adhesive
polymer can be removed with acetone (nail polish remover)
which can be readily conducted except in the case where the
adhesive polymer binds to a sensitive skin part (e.g., the eye
lids) where it should be removed by a health care profes-
sional.
After the adhesive coating has formed, the coating
strongly adheres to the skin, is flexible and waterproof,
thereby forming a protective coating which enhances the
integrity of the underlying skin and protects the skin from
further irritation thereby retarding or inhibiting surface skin
irritation.
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In general, the coating will adhere to the skin for a period
of about 2-3 days after which time it sloughs off. Additional
applications can be made if desired.
Because the cyanoacrylate polymer coating is waterproof,
the patient is not prevented from bathing and other activities
involving exposme to water during the period the adhesive
layer protects this skin area.
The following examples illustrate certain embodiments of
the invention but is not meant to limit the scope of the claims
in any way.
EXAMPLES
Example 1
A cyanoacrylate adhesive formulation is prepared in
monomeric form using n-butyl or-cyanoacrylate and which
contains a colorant to readily ascertain where the formula-
tion is applied, 20 weight percent of dioctyl phthalate which
‘ acts as a plasticizer to enhance the flexibility of the resulting
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polymer composition, and 200 parts per million (ppm) of
sulfur dioxide which acts as a stabilizer.
The above described formulation is applied onto an
approximately 80 square centimeter area of skin surface
which will abut a prosthetic device, which in this case, is an
artificial foot. The formulation is applied so as to provide 0.1
milliliter of adhesive per square centimeter of treated skin
and, after application. the sldn is maintained at ambient
condition until a polymer coating forms in about 30 seconds.
After the polymer coating has formed, the prosthetic device
is attached.
The polymer coating strongly adheres to the skin surface
and serves as a physical barrier integrated with the skin to
protect the skin from friction and to improve adaption of the
device to the body with decreased irritation.
Example 2
A cyanoacrylate adhesive formulation is prepared in
monomeric form using n-butyl ot—cyanoacrylate and which
contains a colorant to readily ascertain where the formula-
tion has been applied and 20 weight percent of dioctyl
phthalate which acts as a plasticizer. The formulation is
applied onto approximately 4 square centimeter areas cor-
responding to the adhesive areas of a bandage. The formu-
lation is applied so as to provide about 0.1 milliliter of
adhesive per square centimeter of treated skin and, after
application, the skin is maintained at ambient condition until
a polymer coating forms in about 30 seconds. After the
polymer coating has formed, the bandage is applied in such
a manner that the adhesive areas of the bandage overlay the
polymer coatings. Insofar as the polymer coating forms a
barrier layer between the adhesive areas of the bandage and
the human skin surface, the bandage can be removed and
optionally replaced without irritation to the underlying skin.
Alternatively, the bandage can be maintained as applied until
the polymer coating sloughs off after 2-3 days. At this point,
the bandage also will fall off.
The method of this example inhibits skin irritation and/or
allergic reaction due to bandage adhesive and inhibits skin
tears when the bandage is removed. The polymer coating
will naturally slough olf from the skin over a period of about
2 to 3 days. This method increases comfort and improves
skin integrity.
Example 3
A cyanoacrylate adhesive formulation is prepared in
monomeric form using octyl or-cyanoacrylate which con-
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tains a colorant to readily ascertain where the formulation
has been applied and about 200 ppm of sulfur dioxide which
acts as a stabilizer.
The above described formulation is applied onto skin
surface areas on the hand and upper arm which are to be in
contact with the edges of a cast to be placed from the upper
arm to the hand of a male patient in response to a broken
wrist. The formulation is applied so as to provide about 0.1
milliliter of adhesive per square centimeter of treated skin
and, after application, the skin is maintained at ambient
condition until a polymer coating forms in about 30 seconds.
After the polymer coating has formed. the cast is placed onto
the arm.
In this example. the polymer coating prevents chafling
and skin irritation at the edges of the cast and is replaced as
needed during the adaption period of the cast.
Also. the cyanoacrylate adhesive can be applied in the
manner similar to Examples 1 and 3 after skin irritation due
to attachment of a prosthesis or a cast respectively. Such
irritated skin is characterized by redness and patient sensi-
tivity.
From the foregoing description, various modifications and
changes in the composition and method will occur to those
skilled in the art All such modifications coming within the
scope of the appended claims are intended to be included
therein.
What is claimed is:
1. A method for inhibiting irritation from prosthetic
devices which contact the human skin surface which method
comprises:
applying to unbroken skin surface area(s) without disor-
ders which will be in contact with the prosthetic device
and which will be prone to surface skin irritation, a
suflicient amount of a cyanoacrylate adhesive so as to
cover said area(s) and, which upon polymerization,
forms a polymer layer on the skin surface having a
thickness of less than about 0.5 mm;
polymerizing the cyanoacrylate adhesive so as to form a
flexible. waterproof, adhesive polymer coating which
adheres to the area(s) where the adhesive was applied;
and
subsequently directly placing the prosthetic device onto
the skin smface such that at least a portion of said skin
surface area(s) abutting said device has said polymer
coating which adheres to the underlying skin and which
forms a physical barrier interposed between the skin
surface and the prosthetic device,
wherein the cyanoacrylate, in monomeric form, is repre-
sented by formula I:
o I
II
CH2=(E—COR
CN
where R is selected from the group consisting of:
alkyl of 2 to 10 carbon atoms.
alkenyl of 2 to 10 carbon atoms,
cycloalkyl groups of from 5 to 8 carbon atoms,
phenyl,
2-ethoxyethyl,
3-methoxybutyl,
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10
and a substituent of the formula:
R'O
I ll
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