Detailed Instructions for Use

Detailed Instructions for Use

Step One – Cleanse and Prepare the Wound

A. The application of derma+flex® Tissue Adhesive requires thorough wound cleansing. Follow standard surgical practice for wound preparation before application of high viscosity derma+flex® Tissue Adhesive (i.e., anesthetize, irrigate, debride, obtain hemostasis and close deep layers).

B. Pat the wound dry with sterile gauze (dry) to assure direct tissue contact for adherence of the derma+flex® Tissue Adhesive to the skin. Moisture and blood accelerates derma+flex® Tissue Adhesive’s polymerization and may affect wound closure results.

C. To prevent inadvertent flow of liquid to unintended areas of the body, the wound should be positioned to prevent adhesive from flowing onto the unwanted area. (Figure 1)

Step Two – Opening the Device

derma+flex® Tissue Adhesive should be used shortly after connecting the applicator tip to the tube holding the adhesive to prevent premature polymerization. Remove the applicator tip from the pouch. Both applicator tips are connected to the tube the same way. To connect the applicator to the tube, hold the applicator tube with the thumb and a finger by the crimped base. While holding the applicator tip, twist the tube in a counter-clockwise motion until the aluminum seal has been pierced. (Figure 2)

Step Three – Device Preparation

Apply the tip away from the patient to prevent any unintentional placement of the liquid derma+flex® Tissue Adhesive into the wound or on the patient. While holding the applicator tube, and with applicator tip pointed upward, invert and gently squeeze the applicator tube just sufficiently to express the liquid derma+flex® Tissue Adhesive to moisten the applicator tip. When using the nozzle applicator tip, gently squeeze the applicator tube until the adhesive can be seen at the tip, which will allow a more controlled application. Excess adhesive on the tip can be removed with sterile gauze.(Figure 3)

Step Four – Application

Approximate wound edges with gloved fingers or sterile forceps. When using the dauber applicator tip, slowly apply the liquid derma+flex® Tissue Adhesive in one single thin layer that is equal and sufficient to cover the approximated wound edges using a gentle brushing motion. (Figure 4)

The nozzle applicator should be used for focal areas only, avoiding the application of large droplets. Maintain manual approximation of the wound edges for approximately 40 seconds; it may take several minutes for the entire adhesive layer to dry completely.

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