The use of cyanoacrylates in the management of dry heel fissures: a preliminary study

Abstract

Topical tissue adhesives have been used widely in healthcare for the closure of wounds and lacerations (Beam 2008). A recent Cochrane review (Coulthard et al 2009) has indicated the benefit of this modality over other more traditional types of closure. However, little investigation has been undertaken into the potential applications of tissue adhesives in podiatry, such as closure of dry heel fissures which often cause pain and offer a challenge for podiatrists to manage effectively (Singh 1996).

A case series is presented reporting the use of a glue in the management of dry heel fissures. A review of 18 patients treated with Octyl-Blend10™ tissue adhesive (MedLogic Global Ltd®, Plymouth, UK) was undertaken across four private practices in Hampshire. Each patient underwent administration of tissue adhesive by the podiatrist and was followed up for a minimum of three weeks. Outcomes were measured using a patient/practitioner evaluation and feedback form and digital photographs of the lesions before, during, immediately after and three weeks post treatment. Overall the response was positive from patients and practitioners alike with regard to ease of application, aesthetics and patient comfort. During the study period, 94% (17 patients) of lesions healed with no adverse events. Instant and lasting pain relief following application was reported by the majority of patients. Dehiscence of the fissure occurred in only 1 subject. This exploratory work suggests that cyanoacrylates, and the Octyl-Blend10™ tissue adhesive in particular, may have a place in the management of painful heel fissures.

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