Everyone is familiar with “Crazy Glue”. Strong enough to hold a man suspended in mid-air, right? Well, since the 1970’s, people have been tinkering with the formula for medical purposes. These days, we’ve got some decent second generation tissue adhesives, but they’re not perfect. Typically, the glued closure isn’t nearly as strong as a sutured skin closure, so it’s more prone to pop open. And that’s not a good thing.
Enter “Prineo”, from Ethicon. Introduced in Europe a few years ago, it combines a high-tech tape dispenser and a cousin of Crazy-Glue. I saw it demonstrated at the ASPS meeting, and compared to current tissue glues, the new combination system is three times stronger than glue alone. With Prineo, the wound strength is about the same as a standard suture closure.
Here’s how it works: the surgeon sutures the deep layers of the incision, as usual. Next, the tape-like mesh strip is applied over the incision. The mesh contains activating agents for the glue. Once everything is nicely lined up, the glue is painted over the mesh tape, and it sets (polymerizes) within about 30 seconds. This is a bit like a high-tech version of wall patching, with mesh covered by plaster!
Prineo makes a water-tight and reasonably strong closure. Patients can shower immediately postoperatively. The glue peels off easily in about 3 weeks. Reportedly, the cosmetic result is just as good as a subcuticular sutured closure – the plastic surgeon’s usual closure – but we’ll have to see about that! More patient information can be found here.
FDA approval is expected shortly.
Impression: I think this new product could be quite useful for our body-lift patients, especially those with thin skin following massive weight loss. Having additional wound closure strength together with a waterproof closure could be quite helpful for brachioplasties, thighlifts, lower body lifts and such.
One drawback: maybe not so good for hairy areas when it comes time for tape removal. Ouch!