Evaluating the use of octyl-2-cyanoacrylate in unilateral cleft lip repair

Abstract

Background:Facial cosmetic results are one of the most concerning issues for the parents who get their children operated for cleft lip. Moreover, the postoperative care of the surgical site, the discomfort associated with the suture removal, and additional visit for suture removal are other reasons which encourages one to use any new technologies that may replace the need for suture placement. In this study, we used octyl-2-cyanoacrylate, a tissue adhesive which offers a viable alternative to traditional techniques without compromising optimal wound closure.Objective:To perform a comprehensive comparison of the outcomes from the use of Dermabond in patients undergoing primary repair of congenital cleft lip ± palate anomalies.Materials and Methods:Twenty patients, in the age group of 3–18 months were treated surgically for unilateral cleft lip deformity using Millard rotation-advancement flap. Pre- and post-operative photographs of the patients were taken at 1 week, 2 week, 1 month, 6 months, and 1 year postoperatively and were evaluated using Vancouver scar scale which was given by Sullivan in 1990. Paired t-test was used for statistical analysis.Results:Increased vascularity (hyperemia) was seen in the 1st and 2nd week in 35% and 30% patients, respectively which gradually reduced to normal in subsequent follow-ups. The scar was flat in 85% of patients in 1st week, and the number decreased to 10% at the end of 1 year. No wound dehiscence was found in any patients. Statistical analysis showed that among all the follow-ups, only the difference between the first and second follow-ups. Comparison of the results of 1 week with all other follow-ups yielded no significant results.Conclusion:Octyl-2-cyanoacrylate can be used for cleft lip closure effectively. The procedure is relatively painless and quick. Added to this are benefits of protection from wound infection since the material is bacteriostatic.

Oral Applications of Cyanoacrylate Adhesives: A Literature Review

“…Contraindications for the use of cyanoacrylate adhesives are limited. Specifically, they cannot be used in areas of tension, such as joints, areas subjected to friction, and areas showing infection and/or contamination with exudate [34–37]. In addition, they cannot be used in conjunctival procedures and patients with allergy to cyanoacrylate [5, 8, 32, 38].…”

“…The pain-free application procedure for these adhesives allows their use in cases where the anesthetic effect has diminished [5, 10, 36, 37] and for anxious or fearful patients [42] such as children. Moreover, cyanoacrylates do not exhibit genotoxic activity or systemic toxicity, and they do not cause mucosal irritation or cutaneous sensitivity [4, 8, 10, 43].…”

“…One author applied ethyl cyanoacrylate adhesive to the skin of rats and saw no signs of toxicity [43], while other authors applied butyl cyanoacrylate over cuts in the oral mucosa of rats and did not observe any kidney or liver toxicity [6]. However, some authors [35, 37, 50] have also reported that the toxicity is related to the heat released during the polymerization reaction and the presence of unreacted monomers; moreover, there is a direct relationship between the degree of toxicity and the length of the alkyl chain. These reports require further studies for clarification.…”

“…Cyanoacrylate adhesives exhibit good bacteriostatic properties [34, 35] that are explained by the strong electronegative charge of the polymer and its ability to form a mechanical barrier that prevents the entry of any material or organisms [37]. In addition, butyl cyanoacrylate adhesives have been reported to exhibit antibacterial effects on Gram-positive organisms [1, 2].…”

Contact Dermatitis Caused by Dermabond Advanced Use

“…Regarding the cosmetic result, it is considered that DBA offers the same results as that of traditional suture closure. 5 – 7 Conversely, some case reports on contact dermatitis (CD) after DBA use, which is a bothersome complication and sometimes leads to a serious systematic allergic reaction, have been reported recently. 8 – 14 However, accurate and reliable information regarding the incidence has not been reported in previous studies and also in the attached document on DBA.…”