2-Octyl-cyanoacrylate for wound closure in cervical and lumbar spinal surgery

Abstract

It is claimed that wound closure with 2-octyl-cyanoacrylate has the advantages that band-aids are not needed in the postoperative period, that the wound can get in contact with water and that removal of stitches is not required. This would substantially enhance patient comfort, especially in times of reduced in-hospital stays. Postoperative wound infection is a well-known complication in spinal surgery. The reported infection rates range between 0% and 12.7%. The question arises if the advantages of wound closure with 2-octyl-cyanoacrylate in spinal surgery are not surpassed by an increase in infection rate. This study has been conducted to identify the infection rate of spinal surgery if wound closure was done with 2-octyl-cyanoacrylate. A total of 235 patients with one- or two-level surgery at the cervical or lumbar spine were included in this prospective study. Their pre- and postoperative course was evaluated. Analysis included age, sex, body mass index, duration and level of operation, blood examinations, 6-week follow-up and analysis of preoperative risk factors. The data were compared to infection rates of similar surgeries found in a literature research and to a historical group of 503 patients who underwent wound closure with standard skin sutures after spine surgery. With the use of 2-octyl-cyanoacrylate, only one patient suffered from postoperative wound infection which accounts for a total infection rate of 0.43%. In the literature addressing infection rate after spine surgery, an average rate of 3.2% is reported. Infection rate was 2.2% in the historical control group. No risk factor could be identified which limited the usage of 2-octyl-cyanoacrylate. 2-Octyl-cyanoacrylate provides sufficient wound closure in spinal surgery and is associated with a low risk of postoperative wound infection.

Body mass index and risk of surgical site infection following spine surgery: a meta-analysis

“…Of the 34 articles that underwent full-text review, 12 [22][23][24][25][26][27][28][29][30][31][32][33] met eligibility criteria for inclusion in the meta-analysis and 22 were excluded. The most common reasons for exclusion of the 22 studies were: criteria for the diagnosis of SSI not reported and/or CDC/NNIS criteria not applied [34][35][36][37][38][39][40][41][42][43][44][45][46][47], non-scalar definitions of obesity used [47][48][49], risk estimates of the association between obesity/BMI and SSI not reported or raw data not provided to calculate risks [44,47,[50][51][52][53], and analyses restricted to deep wound infections [54,55].…”

Sealants (Adhesives) to Prevent Bleeding

“…To identify the rate of infection associated with spinal surgery after wound closure with octyl-2-cyanoacrylate, a study was performed in a total of 235 patients with one-or two-level surgery of the cervical or lumbar spine [ 59 ] . Skin closure was performed with octyl-2-cyanoacrylate after anterior cervical ( n = 100) and dorsal lumbar ( n = 135) spinal surgery.…”

Use of 2‐Octyl cyanoacrylate in Cartilage Interposition Adherence During Ossiculoplasty

“…2‐octyl cyanoacrylate (Dermabond, Ethicon Inc., Somerville, NJ) is an FDA‐approved topical medical adhesive that has been shown to have excellent adhesive properties and low reactivity in vivo . It has been studied in a variety of ophthalmologic, neurosurgical, and cardiothoracic procedures, among others. Early reports of use of cyanoacrylate derivatives in the middle ear to augment ossiculoplasty using hydroxyapatite prostheses exist; however, there are no detailed reports of extrusion rates using this technique in the long term with use of titanium prostheses.…”