Adhesive, liquid or equal, any type, per oz
HCPCS code
Name of the Procedure:
Adhesive, Liquid or Equal (HCPCS Code: A4364)
Common Names: Tissue Adhesive, Medical Adhesive, Skin Glue
Technical Terms: Cyanoacrylate Adhesive, Liquid Adhesive
Summary
Liquid adhesive is a topical tissue adhesive used to close wounds and surgical incisions. It acts as a non-invasive alternative to stitches, staples, or bandages, providing a protective layer that promotes healing.
Purpose
Medical Conditions or Problems
- Superficial cuts and lacerations
- Post-surgical incisions
- Minor wounds that require closure and protection
Goals or Expected Outcomes
- To close and protect the wound
- To promote a clean and optimal healing environment
- To reduce the risk of infection
Indications
Specific Symptoms or Conditions
- Minor cuts or wounds less than 5cm
- Surgical incisions
- Wounds that are not heavily bleeding or at high risk of infection
Patient Criteria
- No known allergy to cyanoacrylates
- The wound must not require deep stitches
Preparation
Pre-Procedure Instructions
- Clean the affected area with mild soap and water
- No need for fasting or significant medication adjustments
- Inform the healthcare provider of any known allergies
Diagnostic Tests or Assessments
- Physical examination of the wound
- Medical history review to check for allergies or contraindications
Procedure Description
- Cleansing: The wound area is cleaned and disinfected.
- Drying: Ensure the wound is dry.
- Application: The liquid adhesive is applied directly to the wound edges while approximating the edges until the adhesive sets.
- Drying Time: Allow the adhesive to dry completely, forming a protective film.
Tools and Equipment
- Cyanoacrylate-based adhesive
- Sterile gloves
- Cleansing solution
Anesthesia or Sedation
- Typically, no anesthesia or sedation is required as the procedure is non-invasive.
Duration
The procedure usually takes about 5-10 minutes.
Setting
- Emergency room
- Outpatient clinic
- Physician's office
Personnel
- Physician or surgeon
- Nurse or medical assistant
Risks and Complications
Common Risks
- Mild skin irritation
- Temporary sensitivity at the application site
Rare Risks
- Allergic reaction
- Infection if the wound was not properly cleaned
Possible Complications and Management
- If the adhesive bond fails, alternative wound closure techniques may be needed.
- Infection management may require antibiotics.
Benefits
- Minimally invasive
- Quick application
- Reduced scarring compared to stitches
- Provides a protective barrier
Recovery
Post-Procedure Care
- Keep the adhesive film dry and avoid submerging in water.
- Monitor for signs of infection.
- Allow the adhesive to slough off naturally within 5-10 days.
Expected Recovery Time
- Healing usually occurs within 1-2 weeks, depending on wound size and location.
Restrictions and Follow-Up
- Avoid strenuous activities that may stress the wound.
- Follow-up may be needed if signs of infection or adhesive failure are noticed.
Alternatives
Other Treatment Options
- Sutures (stitches)
- Staples
- Traditional bandages or wound dressings
Pros and Cons of Alternatives
- Sutures/Staples: More secure but invasive and may leave noticeable scars.
- Bandages/Dressings: Less secure and may require frequent changes but are non-invasive.
Patient Experience
During the Procedure
- Minimal discomfort expected.
- Tingling as the adhesive dries.
After the Procedure
- Possible mild itching or sensitivity.
- Pain management typically not necessary, but over-the-counter pain relievers can be used if needed.
By following these guidelines, patients can understand what to expect and how to prepare for the use of liquid adhesive as a wound closure method.