Octylcyanoacrylate for the treatment of contaminated partial-thickness burns in swine: A randomized controlled experiment

Objective: To compare infection and reepithelialization rates of contaminat ed second-degree burns treated with octylcyanoacrylate (OCA), silver sulfad iazine (SSD), polyurethane (PU) film, and dry gauze (control; C) in swine. Methods: Eighty standardized burns were created by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of young pigs for 20 sec onds. All burns were immediately contaminated with 0.1 mt of Staphylococcus aureus 10(5)/mL and randomly treated with OCA spray, SSD, PU, or dry gauze (C). Full-thickness biopsies were taken at 3, 7, and 14 days for blinded h istopathologic evaluation using hematoxylin and eosin (H&E)-stained slides. Burns were considered infected in the presence of interstitial reticular d ermal neutrophils containing bacteria (intraobserver agreement, K = 1.00). Quantitative wound cultures were performed on a second day-3 specimen. Resu lts: At day 3, wound infection rates were 30% (OCA), 50% (SSD), 55% (PU), a nd 50% (C); p = 0.40 (Kruskal-Wallis test). At day 7, infection rates were 35% (OCA), 85% (SSD), 70% (PU), and 65% (C); p = 0.01. Median bacterial cou nts at day 3 were 6,500 (OCA), 20,000 (SSD), 1,00,000 (PU), and 650,000 (C) ; p = 0.29. The proportion of completely reepithelialized wounds at day 14 were 75% (OCA), 90% (SSD), 85% (PU), and 90% (C); p = 0.50. Conclusions: Tr eatment of contaminated partial-thickness burns with OCA spray resulted in fewer infections at one week than with the other three treatments. Key word s: burns; skin; partial thickness; bacterial contamination; infection; reep ithelialization; healing; tissue adhesives; silver sulfadiazine; octylcyano acrylate.