MARATHON®Liquid Skin Protectant

Supreme Protection from Friction and Moisture that lasts and lasts

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MARATHON Liquid Skin Protectant is a non-stinging, cyanoacrylate-based monomer that forms a remarkably strong protective layer overskin. As the cyanoacrylate polymerizes, it bonds to the skin surface andintegrates with the epidermis, supporting the natural integrity of theskin.1 It resists external moisture, yet it allows the skin to breathe.

What is MARATHON?

When should MARATHON be used?MARATHON Liquid Skin Protectant is designed to protect skin thatis intact or damaged from the effects caused by friction or moisture,resulting from the following situations and areas.

Under Medical Devices

• Ostomy care, including G-Tubes and tracheostomy

• Negative pressure wound treatment• Tapes and adhesive dressings• O2 tubing

Fragile and Compromised

• Skin tears• Perineal and perianal area• Periwound area• Intertrigo • Fistulas• Heels

Skin tear, wrist

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Buttocks region

Ostomy site

Closed skin

MARATHON forms a remarkably STRONG film that:

• Minimizes friction and reduces the risk of developing skin tears

• Protects skin from prolonged exposure to moisture, which weakens anddamages the skin surface and makes it more susceptible to breakdown2

• Resists the onslaught of corrosive body fluids such as urine, faeces, digestive juices and wound drainage

• Maintains skin surface cell integrity

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MARATHON Liquid Skin Protectant consists of individual molecules(cyanoacrylate-based monomers) that polymerize when they come incontact with moisture on the skin surface. This reaction continues until100% of the monomer molecules have joined either to each other(cohesion) or to molecules of substances present in skin (adhesion).

This type of bonding with skin at a molecular level ensures that theproduct remains in place until the epidermal cells naturally sloughaway3, enhancing skin integrity.

Because no solvents are used, there is no evaporation and 100% ofthe product remains on the skin.

How does MARATHON work?

MARATHON Polymer Chain

( )The bond between the

two monomersThe bond

between the skin and MARATHON

The double bond between the two carbonatoms breaks when the monomer polymerizes,allowing it to join another monomer molecule.3

MARATHON Monomer Molecule

SIDE CHAINS

R = C4H9 (butyl), C8H17 (octyl)

This process is repeated a million-fold, resulting in theformation of a polymer film that protects the skin.3

A >20 μm layer of cyanoacrylate-based barrier can be clearly seen at x500 magnification. There are NO visible gaps between the skin and Marathon, since it bonded directly to the skin.3

The approximate <5 μm layer of a solvent-based barrier at x1500magnification is seen in this image. The gap between the skin and the solvent-based barrier is visible.3

Cyanoacrylate-based barrier

Skin

Solvent-based barrier

Skin

Gap

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How does MARATHON work? (continued)

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Immediately after skin barrier application Immediately post abrasion

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WL

gm

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me

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No Treatment BarrierMARATHON Liquid Skin Protectant

3M Cavilon No Sting Barrier

Comparison P value

Cavilon vs MARATHONCavilon vs No treatmentMARATHON vs No treatment

<0.05>0.05<0.001

Abrasion Damage to Skin Test

An independent test involving 12 people over age 60 compared how bare skin, skin with an application of MARATHON Liquid Skin Protectant, and skin with an application of 3M Cavilon resisted theeffects of abrasion (friction).4, 5

Transepidermal Water Loss (TEWL) was measured at the applicationsites as a gauge of skin injury. High TEWL post abrasion is a knownmeasure of the extent of skin damage.6

Results:Areas where MARATHON was applied showed better protection of skinfrom frictional forces and from TEWL compared to Cavilon or no treatmentat all.

Independent lab testing data on file.4

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An independent test involving 12 people over age 60 compared howbare skin, skin with an application of MARATHON, and skin with anapplication of Cavilon resisted exposure to a corrosive fluid (synthetic urine).

Results:Areas where MARATHON was applied showed better resistance after eachof the five urine and washoff cycles compared to the areas where Cavilon orno product at all were applied. Therefore, MARATHON shows greater pro-tective capabilities than Cavilon against corrosive fluids (synthetic urine) andwashoff.

Percentage of retained dye after all five urine and wash-off cycles: (mean percentage)7

MARATHON 94%Cavilon 66%Skin with no treatment 18%

No Treatment BarrierMARATHON Liquid Skin Protectant3M Cavilon No Sting Barrier

Independent lab testing data on file .7

After cycle 1 After cycle 2 After cycle 3 After cycle 4 After cycle 5Immediately afterskin barrier application

Corrosive Fluids and Wash-off Resistance Test

Comparison P value

Cavilon vs MARATHONCavilon vs No treatmentMARATHON vs No treatment

>0.05<0.001<0.001

(mea

n pe

rcen

tage

)

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Managing Skin TearsThe management of skin tears in the elderly is an area of concern forHealthcare personnel. Skin tear incidence rate in the elderly rangesfrom 0.9 to 2.5% per person/year1. One study reports an acute careincidence range of 14-24%(2). Skin tears usually result from shear,friction or blunt trauma related insult to the skin1,2. Marathon is a viable option for protection against the effects from friction.

References:1. Ratliff C, Fletcher K. Skin tears: A review of the evidence to support prevention and treatment. Ostomy/Wound Management2007; 53(3):32-42.

2. McTigue T, D’Andrea S, Doyle-Munoz J, Forrester DA. Efficacy of a Skin Tear Education Program: Improving the Knowledge of Nurses Practicing in Acute Care Settings. Journal of Wound, Ostomy and Continence Nursing.2009; 36(5):486-492.

Managing Peristomal Skin Irritation Under Ostomy Skin Barrier WafersPeristomal irritation in ostomy patients is a common occurrence1,2,3

and it has been reported that 10 to 70% of ostomy patients experi-ence some type of peristomal skin problems.4,5 Leakage of urine,undigested food matter, and feces are the major cause of peristomalirritant dermatitis.2 Prompt management of affected peristomal skinleads to improvement in ostomy barrier wafer efficiency and patientcomfort, both of which significantly upgrade the quality of life.

References:1. Rolstad B, Erwin-Toth P. Peristomal skin complications: Prevention and Management. Ostomy Wound Management. 2004;50(9):68-77.

2. Ratliff CR, Scarano KA, Donovan AM,Colwell JC. Descriptive study of peristomal complications. J Wound Ostomy Continence Nursing. 2005;32(1):33-7.

3. Herlufsen P, Olsen AG, Carlsen B, et al. Ostomy skin study: a study of peristomal skin disorders in patients with permanent stomas. Br J Nurs. 2006;15(16);854-862.

4. Colwell J, Goldberg M, Carmel J. The state of the standard diversion. J Wound Ostomy Continence Nurse. 2001;28:6–17.

5. Ratliff CR, Donavan AM. Frequency of peristomal complications. Ostomy Wound Manage. 2001;47:26–29. (PubMed)

Managing Skin Protection against bodily fluids in the perineal areaThe corrosive nature of bodily fluids requires a greater amount of pro-tection than what conventional skin preps can provide.1 Marathon actsan exceptional barrier against corrosive bodily fluids when used as askin protectant (independent lab test results on file) for patients withstage II pressure ulcers and incontinence-associated skin irritation.

References:

1. Mary Webb, BSN, MA, RN, CIC San Mateo Medical Center Long Term

Care Services, San Mateo, CA

Protection from the effects of moisture and friction

Day 1

Day 8

Day 1

Day 10

Day 1

Day 16

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Preventing Superficial Tissue Injury Mechanical forces such as friction and moisture applied to the buttocks, coccyx, heels and elbows are especially prone to superficialtissue injury that present as dermal erosions.1

Marathon has proven to provide extra-protection against abrasiveforces and can be used on the areas above to prevent skin injury related to friction.

References:1. Berlowitz D, Brienza D. Are all pressure ulcers the result of deep tissue injury? A review of the literature. Ostomy/WoundManagement 2007; 53(10):34-38.

Managing Skin Damage in Neonates and InfantsPeristomal skin damage in neonates and infants is a common occurrence that can lead to further complications. Given the fragility of the infant or neonatal skin, which is still not fully developed at birth, the clinician’s options in terms of choosing a skin protectant are very limited. Denuded skin prevents containment devices from adhering appropriately to the skin.

Marathon forms a flexible yet strong barrier that can protect the skinagainst the effects caused by moisture / corrosive bodily fluids.

Due to the fragility of the nascent skin structure, the use of adhesivedressing type barriers which are frequently used present potentialtrauma injury risk to skin during adhesive removal. Spreadable ointment type barriers for protection and management of at risk ordamaged skin tend to have transient presence on skin, and areprone to removal with movement of the skin relative to its surround-ing because by their very nature, ointments are not totally adherentto skin.

Marathon provides a dependable, non-removable barrier that lasts longer.1

References:1. Prevention and Management of Pain in the Neonate: An Update.(5 November 2006) American Academy of Pediatrics, 118, 2231- 2241.

No visible difference between two heels.

. . .that lasts and lasts and lasts

11-25-2009

11-25-2009

Buttock skin, denuded, from a 7 month-old infant born at 24 weeks gestation.

Buttock skin post cyanoacrylate use, Day 7.

Case 2 – 22 month old, 31 week gestation

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How to apply MARATHON

References1 Bond P. Scanning Electron Microscope Examination and Assessment of SUPERSKIN (Liquishield® S). 2001. University of Plymouth, UK. Data held on file at MedLogic Global Limited.

2 The Merck Manuals Online Medical Library. Pressure Sores. Available at: http://www.merck.com/mmhe/sec18/ch205/ch205a.html?qt=moisture%20skin%20damage&alt=sh#sec18-ch205-ch205a-262.

3 Coover HW and McIntire JM. Cyanoacrylate Adhesives. In:Skeist, I, ed. Handbook of Adhesives. 2nd ed. New York: Van Nostrand Reinhold Co.;1977:569-580.

4 Abrasion Test. Data on file.5 Pinnagoda J, Tupker RA, Anger T, Serup J. Guidelines for transepidermal water loss (TEWL) measurement. Contact Dermatitis. 1990;22:164-178.6 Nangia A, Patil S, Berner B, Boman A et al. In vitro measurement of transepidermal water loss: a rapid alternative to tritiated water permeation for assessing skin barrier functions. International Journal of Pharmaceutics. 1998;170(1):33-40.

7 Study to Compare the Wash-off Resistance of Two Barrier Films Exposed to Synthetic Urine. Data on file.

ORDERING INFORMATION

Item Number Description Packaging

MSC093005 MARATHON Liquid Skin Protectant 10 ea/bx

MSC093001 MARATHON Liquid Skin Protectant 5 ea/bx

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How to OrderContact your Medline Representative or call 1-800-MEDLINE.For direct sales to patients, visit shop4remedy.com.

1. Clean and dry the skin, making sure that no moisturizer or ointment is left on the skin.2. Hold the applicator upright with the sponge tip at the top. Crush the sealed inner tube by firmly squeezing the middle of the tube.Note: If additional pressure is needed, include your other hand. Do not try to break the tube by holding with both hands on the ends.3. Turn the applicator upside down and gently squeeze it to allow theliquid to soak through the sponge tip.4. Once the sponge is wet, slowly and gently spread a thin, even coatof Marathon that extends about 2.5 cm beyond the affected area.

Informative Video Visit www.medline.com/wound-skin-care/marathon to watch a videoshowing the proper use of Marathon’s applicator along with other valuable information.

MKT211466 / LIT183R / CLC15 / 10M

Medline United States1-800-MEDLINE (633-5463)www.medline.com

Medline Canada1-800-396-6996www.medline.ca |canada@medline.com

Medline México01-800-831-0898www.medlinemexico.com |mexico@medline.com

Medline Industries, Inc.One Medline PlaceMundelein, IL 60060

Some products may not be available for sale in Mexico or Canada. We reserve the right to correct any errors that may occur within this brochure. 3M and Cavilon are registered trademarks of 3M Company Corporation. Medline and MARATHON are registered trademarks of Medline Industries, Inc.

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