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Surgical pearl: A simplified method of using cyanoacrylate glue for getting soft and supple epidermal grafts
*Corresponding author: Muhammed Mukhtar, Department of Dermatology, Mukhtar Skin Centre, Katihar, Bihar, India. drmmukhtar20@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Mukhtar M. Surgical pearl: A simplified method of using cyanoacrylate glue for getting soft and supple epidermal grafts. CosmoDerma 2023;3:4.
PROBLEM
In the treatment of localized, stable vitiligo, a suction blister graft, is widely employed. Various techniques of blister graft harvesting are used, including the application of cyanoacrylate glue.[1] After painting the blister with glue, harvesting the graft becomes simple. If more glue is applied, the graft surface becomes more dry, wrinkled, and stiff, and the graft, including melanocytes, can be burned as a result of its strong exothermic and curing effects in the presence of moisture and fluid, potentially jeopardizing graft uptake and procedure success [Figure 1a and b]. To address this issue, an innovative and simple approach for harvesting the glued blister is employed.
- (a and b) The changes in the blister roof after glue application.
SOLUTION
To obtain a soft, anti-curled, and anti-wrinkled epidermal graft, the blister roof is first treated with antibiotic ointment and then with cyanoacrylate glue. Following that, the blister’s margin is pierced in one location to drain its fluid. Following that, the graft is gently detached from its margin with a tissue or artery forceps. After harvesting, the epidermis remained anti-curled and anti-wrinkled [Figure 2a-d]. This graft may be easily identified after patching a small piece of adhesive tape on the roof of the blister. This graft can be resized to any size and shape and transported without the help of a transport device. The loss of graft on the margin is almost nil, as it occurs when the graft is harvested using scissors. The glue anti-wrinkles, anti-curls the graft, and strengthens the fragile graft which prevent it from being damaged during the forceps detachment [Figure 3a-f]. The ointment moderates the effect of the glue and helps in getting a soft and supple epidermal graft. There is no need to expand the blister before harvesting to increase the size of the graft.
- (a-d) The various stages of blister roof harvesting to get soft, antiwrinkled, and anticurled epidermal grafts following ointment painting before glue.
- (a-f) The different steps of the epidermal graft harvestation of ointment and glue-painted blister.
Declaration of patient consent
Patient’s consent not required as patient’s identity is not disclosed or compromised.
Conflicts of interest
There are no conflicts of interest.
Financial support and sponsorship
Nil.
References
- Surgical pearl: 2-Octyl-cyanoacrylate for transferring suction induced epidermal grafts. Cosmet Dermatol Cedar Knolls. 2006;19:279-82.
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