Successful Management of Moisture-, Friction-, and Trauma-Associated Skin Damage in the Pediatric and Neonatal Population Using Cyanoacrylate Skin Protectant

Vita Boyar, MD


Wounds. 2022;34(3):83-89. 

In This Article

Materials and Methods

This single-center, retrospective case series evaluated 15 pediatric and neonatal patients treated with CSP for wounds of diverse etiologies. The Table summarizes patient demographics and wound characteristics. Prior to CSP application, some patients underwent different treatments deemed necessary by the treating practitioner according to hospital protocols.

Cyanoacrylate liquid skin protectant is purple in color and has the active ingredients 2-octyl cyanoacrylate and n-butyl cyanoacrylate. It is available in a small-sized and large-sized ampoule with a foam tip applicator; when the vial is squeezed, the liquid immediately adheres to the skin, especially on a moisture-containing surface. A thin coat is applied across the affected area in an even, sweeping motion. Care should be taken to ensure that opposing skin folds do not adhere to each other while the liquid dries. The product takes approximately 1 minute to dry upon application. One coat is usually sufficient for an application, but the treating clinician should ensure that the desired area is completely coated. In this series, multiple applications at different time intervals were done as needed, depending on the skin condition and in accordance with the manufacturer's recommendations. In neonates, it may be necessary to apply CSP daily, because frequent bowel movements and cleaning may facilitate product removal. Physiologically, the outer epidermal layer desquamates in neonates every 2 to 3 days; this rate is more frequent than in older children or adults, resulting in shorter intervals between treatments. The parents or guardians of each patient provided written informed consent to publish the case details and images. Written consent for the treatment was not necessary, because it is standard of care in the treating unit.

A neonatal behavioral pain scale (Neonatal Infant Pain Scale; NIPS) was used to assess potential pain or discomfort upon CSP application. It ranges from 0 to 7 and consists of the following 6 indicators: facial expression, cry, breathing pattern, arms, legs, and state of arousal. A score of 0 to 2 is considered mild to no pain, 3 to 4 is mild to moderate pain, and 4 or higher is severe pain.