Analysis of Octyl-2-Cyanoacrylate as a Dressing Material after Pediatric Urological Procedures

PURPOSE: We aimed to evaluate the efficacy of Octyl-2-cyanoacrylate (Dermabond(TM)) as a topical skin adhesive for pediatric urologic open surgery. METHODS: From August 2010 to August 2011, we retrospectively evaluated pediatric patients who underwent urologic open surgery at our institution. A total of 128 pediatric patients with 210 incisions used Dermabond(TM) for skin closure. RESULTS: We divided the 128 patients into 3 groups according to type of surgery. Group 1 underwent hydrocelectomy (55 cases, 41.3%), Group 2 underwent orchiopexy (43 cases, 32.3%), Group 3 underwent penoplasty (35 cases, 26.4%). One hundred and twenty eight patients who underwent 133 surgeries in total, with a total of 210 incisions visited our outpatient department postoperatively, and a total of 5 wound complications (2.3%) occurred, but were simple inflammations and no dehiscence was observed. When analyzed according to groups, no wound problems occurred in Group 1 (0/55, 0%), one occurred in Group 2 (1/43, 2.3%) and four cases occurred in Group 3 (4/35, 11.4%) respectively. When re-analyzed according to wound locations, one occurred in an inguinal wound (1/120, 0.83%), none occurred in scrotal wounds (0/55, 0%), and four occurred in penile wounds (4/35, 11.4%). In Group 3, the incidence of penile wounds was significantly increased compared to other groups (P=0.008). All 5 wound problems were inflammatory and healed at an average of 13.8 days (13-15 days) with antibiotic ointment application only. CONCLUSION: Dermabond(TM) is feasible and safe topical skin adhesive alternative to standard skin suture in pediatric urologic surgery. However, further research about its efficacy and safety could be valuable in the future.

Treatment of Facial Bone Fracture Using Octyl-2-Cyanoacrylate: Case Report

Precise fixation of fracture fragments is important for the successful management of facial bone fractures. However, the conventional metal plates and screws used in such procedures are sometimes difficult to place when the facial bone fracture occurs in a narrow area or has significant comminution. We report herein our experience with 6 patients with facial fractures, which were difficult to fix using titanium plates and screws. All injuries were satisfactorily repaired using octyl-2-cyanoacrylate (OCA). In addition, there were no significant complications related to OCA during the follow-up period.

Nailbed Repair using 2-octyl Cyanoacrylate (Dermabond(R))

PURPOSE: Nailbed repair using fine 6-0 or 7-0 absorbable sutures can be technically demanding and time-consuming. We describe a simpler method of nailbed repair using 2-octyl cyanoacrylate (Dermabond(R)) topical adhesive. MATERIALS AND METHODS: Fifteen consecutive patients with nailbed injuries not involving the germinal matrix were repaired with Dermabond(R). There were 7 simple lacerations, 4 stellate lacerations and 4 severe crush injury according to Zook's classification. The appearance of the nail at twelve months was graded according to ridging, splitting, deformity, and sheen of the nail. RESULTS: Nailbed repairs using Dermabond(R) took on average 3.2 minutes to complete. Six patients had excellent aesthetic results, Eight had good results, and one patient with a crush injury had a fair result. There were no complications. CONCLUSION: Dermabond(R) is a useful tool for rapidly repairing acute nailbed injuries. The outcome of repairing injuries not involving the germinal matrix is similar to that expected for suture repairs of similar injuries.

Use of 2-Octylcyanoacrylate (Dermabond(R)) on Breast Surgery

This study is to compare a tissue adhesive, 2-octylcyanoacrylate (Dermabond(R)), with conventional wound closure techniques for vertical reduction mammaplasty. Twenty patients presenting large breast from November to December 2005 were enrolled into this prospective clinical trial study. These patients' breasts were randomly assigned to treatment with either 2-octylcyanoacrylate or 5-0 monofilament sutures. Photography taken at six months after treatment were rated by two plastic surgeons and six layperson blinded to the method of closure. There was no significant difference between the two groups for appearance scores based on a visual analog scale(81.9mm for 2-octylcyanoacrylate versus 75.7mm for 5-0 monofilament sutures). The length of time for periareoalr repair was decreased in the 2-octylcyanoacrylate group(2.7 minutes for 2-octylcyanoacrylate versus 8.3 minutes for 5-0 monofilament sutures, p<0.001). The patients' satisfaction rate in the 2-octylcyanoacrylate group was high. Moreover, the use of 2-octylcyanoacrylate obviates the need for suture removal. In conclusion, the use of 2-octylcyanoacrylate for vertical reduction mammaplasty is an acceptable alternative which includes several advantages to conventional suturing with a comparable cosmetic outcome.

Comparison of 2-Octylcyanoacrylate and Suture with 8-0 Polyglactin for Conjunctival Wound Closure in Rabbits

PURPOSE: To evaluate the clinical efficacy and the histopathologic tolerance of 2-octylcyanoacrylate versus 8-0 polyglactin sutures for conjunctival wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Conjunctival peritomy of 8 mm was done in the superior limbus followed by extensive subconjunctival dissection in both eyes. The eyes of the rabbits were divided into two groups. The conjunctiva was then attached to the limbus again by the proposed 2-octylcyanoacrylate adhesive (left eye, Group A) or 8-0 polyglactin suture (right eye, Group B). The clinical efficacy of the closure of the conjunctival wound, either with sutures or adhesives, and the clinical and histopathologic tolerances such as hyperemia, discharge, residual adhesive or suture, inflammatory change and fibrosis were observed at 1 day and at 1, 2, 4 and 6 weeks after surgery. Two rabbits were sacrificed at each of 1, 2, 4 and 6 weeks, and specimens of their conjunctiva were examined histologically. RESULTS: Both conjunctival surgical closure methods were found to be equally efficacious in fixing the conjunctiva to the limbus. There were no significant clinical or histopathologic tolerance differences between the two groups. The conjunctiva at 6 weeks of Group A showed nearly normalized morphology with disappeared inflammatory cells and fibroblasts, whereas those of Group B showed foreign body inflammatory reaction around the absorbing suture materials. CONCLUSIONS: 2-Octylcyanoacrylate adhesive was an efficient conjunctival closure method and was very well tolerated by the ocular surface. 2-Octylcyanoacrylate may be a possible tissue adhesive for conjunctival wound closure.

Application of 2-Octylcyanoacrylate (Dermabond(R) for Laceration Repair in Emergency Department

A retrospective, randomized controlled clinical trial to assess the effectiveness of Dermabond(r) for repair of traumatic laceration in 86 patients, who signed the informed consent, was studied. Patient selection was limited to facial laceration, less than 2cm in length, non-contaminated, non-bitten, and non-crushed lacerations. All of 86 patients were available for the primary follow-up within 7 to 10 days after Dermabond(r) application and the survey was carried out for outcomes of cosmesis, pain, complications and cost. 76 patients (88%) were satisfied and 10 patients(12%) were dissatisfied with Dermabond(r) application. All of 10 unsatisfied patients had complication, such as wound dehiscence in 6 patients, depressed scar in 2 patients, skin necrosis in 1 patient and wound infection in 1 patient. Among 86 patients, 80 patients(93%) pointed the painlessness as the best advantage of Dermabond(r). The cost was compared between Dermabond(r) and standard suture technique on similar facial laceration, resulted in 69,720 won vs. 43,747 won, which difference was not significant to most of the patients. Second follow-up evaluation was done 5 months after Dermabond(r) application. At this time, the quality of scar was compared by patients and two plastic surgeons. Among 63 patients included in second evaluation, 58 cases (92%) satisfied the scar qualities. Dermabond(r) is highly effective and satisfactory material for facial wound repair if the wound is properly selected.

A Comparison of Wound Repair by Tissue Adhesive(2-Octylcyanoacrylate, Dermabond(R) and Standard Wound Closure Techniques in Rats

The ideal method of wound closure should be simple, rapid, inexpensive, painless, and bactericidal, and should achieve optimal cosmetic results. Tissue adhesives offer many of these characteristics. Until recently, the only commercially available tissue adhesive was 2-butylcyanoacrylate. A new tissue adhesive, 2-octylcyanoacrylate (Dermabond(R)), offers several advantages over 2-butylcyanoacrylate. It is more pliable and less brittle. To compare a new tissue adhesive, 2-octylcyanoacrylate, with standard wound closure techniques for the repair of open wound, two groups of each 20 rats were studied. Two groups were similar for demographic and clinical characteristics. Photographs taken at three months were rated by seven plastic surgeons blinded to the method of closure. There was no difference between two groups for appearance or complication. In conclusion, wound treated with Dermabond(R) and standard wound closure techniques have similar cosmetic results 3 months later, and Dermabond(R) is a faster method of wound repair that has cosmetic results similar to the use of sutures.

Use of 2-Octylcyanoacrylate (Dermabond(r)) for Repair of Hand Trauma

Dermabond(r) (2-Octylcyanoacrylate) has an eight-carbon alkyl derivative that is less inflammative and stronger than its short chain derivatives (i.e. 2-Butylcyanoacrylate, Histoacryl(r)). This study is to compare a tissue adhesive, 2-octylcyanoacrylate (Dermabond(r)), with conventional wound closure techniques for hand trauma. Thirty-eight patients presenting to Asan Medical Center Emergency Department with hand trauma from March 2003 to June 2003 were enrolled into this prospective clinical trial study. These patients were randomly assigned to treatment with either 2-octylcyanoacrylate or 5-0 monofilament sutures. The two groups were similar in both clinical and demographic characteristics. Photography taken at three months after treatment was rated by two plastic surgeons blinded to the method of closure. There was no difference between the two groups for appearance scores based on a visual analog scale (73.3mm for 2-octylcyanoacrylate versus 69.9mm for 5-0 monofilament sutures). The length of time for skin repair was similar between these two groups. (9.2 minutes for 2-octylcyanoacrylate versus 8.9 minutes for 5-0 monofilament sutures) Moreover, the use of 2-octylcyanoacrylate obviates the need for suture removal. In conclusion, the use of 2-octylcyanoacrylate for hand skin repair is an acceptable alternative, which includes many advantages to conventional suturing with a comparable cosmetic outcome.

Use of 2-Octylcyanoacrylate(Dermabond(R)) for Repair of Pediatric Facial Lacerations

This study is to compare a tissue adhesive, 2-octylcyanoacrylate(Dermabond(R)), with conventional wound closure techniques for pediatric facial lacerations. Twenty children presenting to Asan Medical Center Emergency Department with facial lacerations in July 2001 were enrolled into this prospective clinical trial study. These patients were randomly assigned to treatment with either 2-octylcyanoacrylate or 6-0 monofilament sutures. The two groups were similar in both clinical and demographic characteristics. Photography taken at three months after treatment were rated by two plastic surgeons blinded to the method of closure. There was no difference between the two groups for appearance scores based on a visual analog scale(60.4mm for 2-octylcyanoacrylate versus 62.9mm for 6-0 monofilament sutures). The length of time for laceration repair was decreased in the 2-octylcyanoacrylate group(3.1 minutes for 2-octylcyanoacrylate versus 9.3 minutes for 6-0 monofilament sutures, p<0.001). The parents' assessment of the pain felt by their children in the 2-octylcyanoacrylate group was less. Moreover, the use of 2-octylcyanoacrylate obviates the need for suture removal. In conclusion, the use of 2-octylcyanoacrylate for pediatric facial laceration repair in Korean is an acceptable alternative which includes many advantages to conventional suturing with a comparable cosmetic outcome.

Application of 2-Octylcyanoacrylate (Dermabond(R)) on the Incisional Wound of Thyroidectomy

2-Octylcyanoacrylate(Dermabond(R)) has an eight-carbon alkyl derivatives that is less inflammative with stronger adhesive property than its short chain derivatives (ie. 2-ethylcyanoacrylate, 2-butylcyanoacrylate).1 To assess the effectiveness of the tissue adhesiveness of 2-octylcyanoacrylate with dermal suture for the closure of head and neck incision wound, 20 patients who underwent thyroidectomy at Asan Medical Center were studied. Ten patients underwent skin closure with paper adhesive and the other 10 with the new tissue adhesive, 2-octylcyanoacrylate. At the time of 2 weeks and 3 months respectively, the incisions were evaluated by authors. Photographs of the incisions were rated using a visual analogue scale by 2 plastic surgeons who had no idea of the method of skin closure. The length of time required for skin repair was increased(161 seconds 2-octylcyanoacrylate vs 65 seconds paper adhesive), and the incision closed with tissue adhesive had similar cosmetic scores(84mm 2-ocylcyanacrylate vs 82.5mm paper adhesive). But the satisfaction of patient was higher in 2-octylcyanoacrylate group. The practical advantages of tissue adhesives are easy application, convenience of taking early showers and no need of suture removal. In conclusion, 2-octylcyanoacrylate is found to be an effective method of skin closure in clean head and neck incisions.